Direccionalidad de la violencia en ambientes familiares de drogodependientes / Directionality of violence in family settings of drug addicts

La investigación tuvo el objetivo de determinar la direccionalidad de la violencia intrafamiliar en relación con el tipo de agresión, droga de inicio de consumo, nivel educativo, sexo, experiencias perturbadoras, grupo de edad y estado civil, en pacientes drogodependientes atendidos en la Unidad de Conductas Adictivas (UCA) del Instituto de Neurociencias de Guayaquil (INC), durante el periodo comprendido entre 2010 y 2016. Se realizó un estudio no experimental-correlacional mediante el análisis de las historias clínicas de 1015 (845 hombres y 170 mujeres) pacientes con perfil de violencia intrafamiliar consumidores de drogas y sustancias psicoactivas. Entre la población estudiada predominó el consumo de alcohol como droga de inicio (95%), el nivel escolar secundario (94%), el estado civil soltero(a) o divorciado(a), el grupo de edades comprendido entre 21 y 30 años (35%) y la experiencia perturbadora del divorcio. Los resulta-dos de la técnica del árbol CHAID reflejaron una conexión estadísticamente significativa con el tipo de droga de inicio y el nivel educativo en los participantes.

The objective of the research was to determine the directionality of intrafamily violence in relation to the type of aggression, drug of initiation of consumption, educational level, sex, disturbing experiences, age group and marital status. The research was conducted in a group of drug-dependent patients treated in the Addictive Behaviors Unit of the Guayaquil Institute of Neurosciences, during the period between 2010 and 2016. A non-experimental-correlational study was carried out by analyzing the medical records of 1015 (845 men and 170 women) patients with a profile of intrafamily violence who used drugs and psychoactive substances. Among the population studied, the consumption of alcohol as a starting drug prevailed (95%), the secondary school level (94%), the marital status of single or divorced, the age group between 21 and 30 years (35%) and the disturbing experience of divorce. The results of the CHAID tree technique reflected a statistically significant connection with the type of starting drug and educational level in the participants.

Direct healthcare costs and their relationships with age at start of drug use and current pattern of use: a cross-sectional study

ABSTRACT BACKGROUND: It is well known that early start of drug use can lead users to psychosocial problems in adulthood, but its relationship with users' direct healthcare costs has not been well established OBJECTIVES: To estimate the direct healthcare costs of drug dependency treated at a community mental health service, and to ascertain whether early start of drug use and current drug use pattern may exert influences on these costs. DESIGN AND SETTING: Retrospective cross-sectional study conducted at a community mental health service in a municipality in the state of São Paulo, Brazil. METHODS: The relationships between direct healthcare costs from the perspective of the public healthcare system, age at start of drug use and drug use pattern were investigated in a sample of 105 individuals. A gamma-distribution generalized linear model was used to identify the cost drivers of direct costs. RESULTS: The mean monthly direct healthcare costs per capita for early-start drug users in 2020 were 1,181.31 Brazilian reais (BRL) (274.72 United State dollars (USD) according to purchasing power parity (PPP)) and 1,355.78 BRL (315.29 USD PPP) for late-start users. Early start of drug use predicted greater severity of cannabis use and use of multiple drugs. The highest direct costs were due to drug dependence combined with alcohol abuse, and due to late start of drug use. CONCLUSIONS: Preventive measures should be prioritized in public policies, in terms of strengthening protective factors before an early start of drug use.

Research Progress on the Effect of Synthetic Cathinones on Animal Behavior / 法医学杂志

Synthetic cathinones are a class of new psychoactive substances with a structure similar to amphetamine drugs, which can produce excitatory effects similar to drugs such as amphetamine and cocaine after being taken. In recent years, the abuse of synthetic cathinones worldwide has become increasingly serious, posing a serious threat to social security and public health. This article focuses on several common synthetic cathinones, collects their research results in animal autonomous activity experiments and drug dependence model experiments and summarizes their relevant experimental conclusions in animal body temperature regulation, learning and memory, and anxiety, in order to provide data reference and method guidance for the domestic development of related drug research.

Necesidades de aprendizaje de los adolescentes en relación a las adicciones / Learning needs of adolescents in relation to addictions / Necessidades de aprendizagem dos adolescentes em relação aos vícios

RESUMEN La drogodependencia representa un problema mundial. Los adolescentes constituyen un grupo vulnerable. El desconocimiento en relación a las adicciones y la baja percepción del riesgo que tal conducta supone constituyen factores significativos entre los mecanismos psicosociales que determinan esta problemática. Con el objetivo de determinar el nivel de conocimiento de los adolescentes sobre las adicciones se realizó un estudio descriptivo en la población comprendida en este grupo etario del consultorio médico 22, del Policlínico Jimmy Hirzel, Bayamo, provincia Granma. El universo lo conformaron 217 adolescentes dispensarizados, la muestra la constituyeron los 93 adolescentes que cumplieron los criterios de selección. Se estudiaron las variables: sexo, edad, ocupación y nivel de conocimiento. Se aplicaron métodos teóricos, empíricos y estadísticos. Como resultados, predominó el grupo de estudiantes, con edades comprendidas entre 10 y 14 años, del sexo masculino. Al realizar la encuesta 83.8% de los adolescentes tenía conocimientos insuficientes; 83.9% desconocía el efecto depresor de las drogas, 73.2% consideró que el uso frecuente de cantidades moderadas de algún tipo de droga no es una manifestación de tal conducta, 63.4% omitió que la ingestión de alcohol facilita el consumo de otras sustancias y 73.2% no valoró el consumo de sustancias como enfermedad.

ABSTRACT Drug dependence represents a worldwide problem. Adolescents are a vulnerable group. The ignorance in relation to addictions and the low perception of the risk that such behavior supposes constitute significant factors among the psychosocial mechanisms that determine this problem. In order to determine the level of adolescents' knowledge about addictions, a descriptive study was carried out in the population included in this age group of the medical office 22, from the Jimmy Hirzel Polyclinic, Bayamo, Granma province. The universe was made up of 217 dispensed adolescents, the sample was made up of 93 adolescents who met the selection criteria. Variables were studied: sex, age, occupation and level of knowledge. Theoretical, empirical and statistical methods were applied. As a result, the group of students, aged between 10 and 14 years, of the male sex predominated. When carrying out the survey 83.8% of the adolescents had insufficient knowledge; 83.9% were unaware of the depressant effect of drugs, 73.2% considered that the frequent use of moderate amounts of some type of drug is not a manifestation of such behavior, 63.4% omitted that the ingestion of alcohol facilitates the consumption of other substances and 73.2% did not value substance use as disease.

RESUMO A dependência de drogas representa um problema mundial. Os adolescentes são um grupo vulnerável. O desconhecimento em relação aos vícios e a baixa percepção do risco que esse comportamento supõe constituem fatores significativos entre os mecanismos psicossociais que determinam esse problema. Para determinar o nível de conhecimento dos adolescentes sobre dependências, foi realizado um estudo descritivo na população incluída nessa faixa etária do consultório médico 22, da Policlínica Jimmy Hirzel, Bayamo, província de Granma. O universo foi composto por 217 adolescentes dispensados, a amostra foi composta por 93 adolescentes que atenderam aos critérios de seleção. As variáveis ​​estudadas foram: sexo, idade, ocupação e nível de conhecimento. Foram aplicados métodos teóricos, empíricos e estatísticos. Como resultado, predominou o grupo de estudantes, comidades entre 10 e 14 anos, do sexo masculino. Ao realizar a pesquisa, 83,8% dos adolescentes possuíam conhecimento insuficiente; 83,9% desconheciam o efeito depressivo das drogas, 73,2% consideravam que o uso frequente de quantidades moderadas de algum tipo de droga não é manifestação desse comportamento, 63,4% omitiam que a ingestão de álcool facilita o consumo de outras substâncias e 73,2% não valorizou o uso de substâncias como doença.

Correlation of Life Events in Alcohol and Drug Dependence: A Case Control Study

Background: A life course viewpoint for alcohol and otherdrug studies recognizes altering forms of alcohol and drugusage over a due course of time and the status of socialcontext and life proceedings in terms of their effect on shifts inalcohol or drug use and problem trajectories. In a 3-year studyof adults who drank on monthly basis prior to baseline, theperceived adequacy of drinking and social obligations to drinkor abstain were consistency correlates of their drinkingtermination. The present study was conducted with the aim todetermine correlation of life events in alcohol and drugdependence.Materials and Methods: The present prospective, hospitalbased survey was performed for a period of one year witheffect from September 2018 to August 2019. It was carried outin the Department of Psychiatry, New STNM MultispecialtyHospital Gangtok. The type of drug abused was also notedamongst all the subjects. Any history of suicidal attempts wasnoted in a tabulated form. Details regarding the stressfulevents was noted amongst the subjects. All the data thusobtained was arranged in a tabulated form and analyzed usingSPSS software.Results: Separation was observed amongst 3 subjects and 3controls. There were 6 cases of divorce amongst subjects and3 cases amongst controls. Illness of family member was seenamongst 3 subjects and 2 controls. There were 21 subjectsand 45 controls who started at 10-20 years, 25 subjects and 4controls started at 21-30 years and 4 subjects and 1 controlstarted at 31-40 years of age. There were 4 control with opioidaddiction, 26 with cannabis addiction and 20 with polysubstance addiction.Conclusion: Amongst majority of the subjects drug andalcohol initiation began at 10-21 years of age and pleasure wasthe reason for initiation amongst majority of subjects.

Research progress on effect and mechanism of cannabidiol in drug dependence / 中国药理学通报

Drug abuse is a serious public health and social problem in the world today. Due to its strong mental dependence, high relapse rate and high neurotoxicity, it has a serious negative impact on the family and society. However, the effective treatment of drug dependence is siili an obstacle in the medical and health care. Cannabidiol is a non-toxic component extracted from plant marijuana, which has potential value in treatment of a variety of nervous system diseases (such as Parkinson'sdisease, epilepsy, Alzheimer's disease, etc.)and has attracted wide attention. Recent studies have shown that Cannabidiol has a good intervention effect on psycho-dependence induced by methamphetamine, morphine, cocaine, alcohol and other drugs, but the specific mechanism is still unclear. This paper reviews the role of marijuana in the intervention of drug dependence and its related mechanisms, in order to further study the potential value and related mechanisms of marijuana in treatment of drug dependence, aiming to further study the potential value and related mechanisms of cannabidiol in treatment of drug dependence, and to provide important references for discovering new mechanism targets for the prevention and treatment of drug dependence.

Percepción del estado de salud bucal de adolescentes y adultos jóvenes en tratamiento por drogodependencia / Perception of the oral health status of drug-dependent individuals

Resumen Objetivo general: conocer la percepción de adolescentes y adultos jóvenes vinculados al consumo abusivo de drogas a partir de la situación de dependencia. Material y método: se planteó un modelo de investigación cualitativo. La muestra teórica por saturación fue población adolescente y adulta joven que se asistió en régimen de internación en el Portal Amarillo. Criterios de inclusión: a) tener entre 15 y 24 años, b) estar en tratamiento por consumo de drogas. Criterios de exclusión: a) pacientes no lúcidos, b) pacientes no colaboradores. Resultados: los participantes refieren como salud bucal tener los dientes limpios, blancos y alineados; como enfermedad caries, sangrado de encías y enfermedades transmisibles; y como funciones alteradas la masticación, la estética y el gusto. Antes de la situación de dependencia la higiene bucal era regular, después de las comidas y con instrucción recibida, a partir de la dependencia la higiene fue muy irregular, si se acordaban y sin refuerzo de la instrucción. Previo al consumo eran individuos integrados al estudio o al trabajo, con vida familiar ordenada, con pareja o en procura de tenerla; posteriormente al consumo relatan automarginación con pérdida de contacto con la pareja e hijos, aislamiento de la familia y discriminación social. El consumo dificulta el acceso a la atención odontológica, excepto en situaciones de urgencia. Conclusiones: Las personas jóvenes en tratamiento por dependencia a las drogas perciben el deterioro de su salud bucal a partir de la situación de consumo, alterando la estética, las funciones orales, la autoestima y la calidad de vida.

Abstract General objective: To determine the perception of adolescents and young adults regarding drug abuse as a result of drug dependence. Materials and methods: a qualitative research model was proposed. The theoretical sample by saturation included adolescents and young adults treated at Portal Amarillo. Inclusion criteria: a) aged between 15 and 24, b) in treatment for drug use. Exclusion criteria: a) non-lucid patients, b) non-collaborating patients. Results: Participants viewed oral health as having clean, white and aligned teeth; and caries, bleeding gums and communicable diseases as disease; chewing, aesthetics and taste were seen as altered functions. Before drug dependence, their oral hygiene was regular, after meals, and following the instructions received. With addiction, hygiene became irregular, only if they remembered to do it and without instruction reinforcement. Before drug consumption, participants were students or held a job; they had a good family life, with a partner, or in search of one. After consumption, they report self-marginalization, loss of contact with partners and children, isolation from the family, and social discrimination. Consumption makes it difficult for them to seek dental care, except in emergency situations. Conclusions: Young people in treatment for drug dependence are aware that addiction damages oral health, deteriorating aesthetics, affecting oral functions, self-esteem, and quality of life.

Lucha Contra el Narcotráfico vs. Protección de Derechos Humanos: análisis desde el Consumo de Drogas en Colombia / Fight Against Drug Trafficking vs. Protection of Human Rights: Analysis from Drug Consumption in Colombia / Luta Contra o narcotráfico vs. Proteção dos Direitos Humanos: Análise desde o Consumo de Drogas na Colômbia

Resumen Introducción. Para los Estados y los organismos internacionales, una de las principales preocupaciones en materia de drogas es hallar un balance entre la lucha contra el narcotráfico y el respeto al Derecho Internacional de los Derechos Humanos. Objetivo. Este artículo pretende analizar si existe un tratamiento internacional para la protección de los derechos de los consumidores de drogas en el Sistema Universal e Interamericano de Derechos Humanos y si los elementos abordados por estos se han implementado en la legislación y jurisprudencia colombiana, en desarrollo de los compromisos internacionales sobre derechos humanos adquiridos por Colombia. Materiales y métodos. La investigación se desarrolló en tres fases, siguiendo una metodología cualitativa, dogmática y prescriptiva, cuyo insumo principal fue la recolección de normas nacionales e instrumentos del marco internacional de los Derechos Humanos, relacionados con el consumo de drogas y su tratamiento, durante el periodo 2010-2019. Resultados. Los principales hallazgos evidenciaron que no existen estándares internacionales con enfoque especial para la protección y reconocimiento de los derechos de los consumidores de drogas. Así mismo, no se han observado avances representativos en las leyes nacionales e internacionales, y aunque la jurisprudencia colombiana propone algunas referencias a normas internacionales, no hay un desarrollo profundo del tema. Conclusiones. Se plantea como reto principal que el Estado colombiano aborde el tema desde una perspectiva distinta a la punitiva.

Abstract Introduction: For states and international organizations, one of the main concerns regarding drugs is finding a balance between the fight against drug trafficking and respect for International Human Rights law. Objective: This article aims to analyze whether there is an international treatment for the protection of consumer rights in the Universal and Inter-American Human Rights System and if the elements addressed by these have been implemented in Colombian legislation and jurisprudence, in the development of international obligations on human rights adopted by Colombia. Materials and method: The research was carried out in three phases, following a qualitative, dogmatic and prescriptive methodology, the main input of which was the collection of national laws and instruments of the international framework of Human Rights, related to drug consumption and treatment, during the period 2010-2019. Results: The main findings showed that there are no international standards with a special focus for the protection and recognition of the rights of drug users. Likewise, no representative progress has been observed in national and international regulations, and although Colombian jurisprudence proposes some references to international laws, there is no in-depth development of the subject. Conclusions: The main challenge is for the Colombian State to approach the subject from a different perspective other than just puni shment.

Resumo Introdução. Para os Estados e os organismos internacionais, uma das principais preocupações no tema de drogas é encontrar um equilíbrio entre a luta contra o narcotráfico e o respeito ao Direito Internacional dos Direitos Humanos. Objetivo. Este artigo pretende analisar se existe um tratamento internacional para a proteção dos direitos dos consumidores de drogas no Sistema Universal e Interamericano de Direitos Humanos e se os elementos abordados por estes se têm implementado na legislação e jurisprudência colombiana, no desenvolvimento dos compromissos internacionais sob direitos humanos adquiridos pela Colômbia. Materiais e métodos. Apesquisa foi desenvolvida em três fases, seguindo uma metodologia qualitativa, dogmática e prescritiva, cujo insumo principal foi a coleta de normas nacionais e instrumentos do marco internacional dos Direitos Humanos, relacionados com o consumo de drogas e seu tratamento, durante o período 2010-2019. Resultados. As principais descobertas evidenciaram que não existem padrões internacionais com a abordagem especial para a proteção e reconhecimento dos direitos dos consumidores de drogas. Mesmo assim, não se têm observado avances representativos nas leis nacionais e internacionais, e embora a jurisprudência colombiana propõe algumas referências às normas internacionais, não têm um desenvolvimento profundo do tema. Conclusões. Se coloca como reto principal que o Estado colombiano aborde o tema desde uma perspectiva distinta da punitiva.

Genome-wide DNA methylation profile in the peripheral blood of cocaine and crack dependents

Objective: Cocaine use disorders (CUDs) represent a major public health problem in many countries. To better understand the interaction between the environmental modulations and phenotype, the aim of the present study was to investigate the DNA methylation pattern of CUD patients, who had concomitant cocaine and crack dependence, and healthy controls. Methods: We studied DNA methylation profiles in the peripheral blood of 23 CUD patients and 24 healthy control subjects using the Illumina Infinium HumanMethylation450 BeadChip arrays. Results: Comparison between CUD patients and controls revealed 186 differentially methylated positions (DMPs; adjusted p-value [adjP] < 10-5) related to 152 genes, with a subset of CpGs confirmed by pyrosequencing. DNA methylation patterns discriminated CUD patients and control groups. A gene network approach showed that the EHMT1, EHMT2, MAPK1, MAPK3, MAP2K1, and HDAC5 genes, which are involved in transcription and chromatin regulation cellular signaling pathways, were also associated with cocaine dependence. Conclusion: The investigation of DNA methylation patterns may contribute to a better understanding of the biological mechanisms involved in CUD.

Operacionalización psicodinámica del eje estructura en un paciente drogodependiente / Psycho-dynamic Operationalization of the Structure Axis in Drug Addicted Patients / Operacionalização psicodinâmica do eixo estrutura num paciente drogo-dependente

Resumen Objetivo. Comprender la relación entre el perfil psicodinámico y la adicción a las drogas en pacientes internos en una comunidad terapéutica, considerando la operacionalización del eje estructura según el Diagnóstico Psicodinámico Operacionalizado (OPD-2). Método. Se implementó el estudio cualitativo de cuatro procesos individuales de psicoterapia psicodinámica. Cada caso fue analizado por separado y se operacionalizaron los ejes diagnósticos del OPD-2; instrumento validado internacionalmente para la investigación, evaluación, focalización e indicación del tratamiento. Resultados. El análisis de caso permitió concluir que las limitaciones en las capacidades cognitivas, emocionales y vinculares corresponden a un nivel estructural medio-bajo. Discusión. Para la intervención psicoterapéutica es importante comprender la dinámica psíquica que sostiene la conducta adictiva con base en un acertado diagnóstico dimensional.

Abstract Objective. To understand the relation between the psychodynamic profile and drug addiction in patients hospitalized in a therapeutic community, taking into account the operationalization of the structure axis based on the OperationalizationPsychodynamic Diagnostic (OPD-2). Method. A multi-case method was implemented consisting of the qualitative study of four individual processes of psychodynamic psychotherapy. Each case was analyzed individually and the diagnostic axes proposed by the OPD-2 were operationalized, this being an instrument of psychodynamic orientation, validated internationally through research, evaluation, focalization and treatment indication. The case of a drug-addicted patient in the process of rehabilitation was chosen for the purpose of multi-axial evaluation. Results. The case analysis concluded that limitations in cognitive, emotional and bonding abilities correspond to a middle-low structural level. Discussion. In psychotherapeutic interventions, it is important to understand the psychological dynamic present in addictive behavior starting with an appropriate dimensional diagnosis.

Resumo Escopo . Compreender a relação entre o perfil psicodinâmico e a adição às drogas em pacientes internos numa comunidade terapêutica, considerando a operacionalização do eixo estrutura com base no Diagnóstico Psicodinâmico Operacionalizado (OPD-2). Metodologia . Foi implementado um método multicaso, que consiste no estudo qualitativo de quatro processos individuais de psicoterapia psicodinâmica. Cada um dos casos foi analisado por separado e foram operacionalizados os eixos propostos pelo OPD-2, que é um instrumento de orientação psicodinâmica validado internacionalmente para a pesquisa, avalição, focalização e indicação do tratamento. Para o propósito da avaliação multiaxial, foi elegido o caso de um paciente drogo-dependente em processo de reabilitação. Resultados . A análise de caso permitiu concluir que as limitações nas capacidades cognitivas, emocionais e vinculares correspondem a um nível estrutural médio-baixo. Discussão . Para a intervenção psicoterapêutica é importante compreender a dinâmica psíquica que sustenta o comportamento aditivo com base num acertado diagnóstico dimensional.

Study of suicides in Mangalore region of South Karnataka, India

Background: To evaluate the various causes of suicides and mental illness of different age groups which enables the patients to commit suicide in both sexes.Methods: The data of suicides was collected from medical records of the different Hospital in Mangalore region of South Karnataka.Results: Total 32 cases of suicides in adults were studied at Mangalore city and district as a whole. The history of suicide was 6(18.7%) was alcoholic, 4(12.5%) were drug addicted (dependent), 5(15.6%) were HIV infected, 3(9.37%) had infertility 4(12.5%) had loss of job, 2(6.25%) had sudden loss of property, 8(25%) had failure in love affair. The clinical manifestations of suicides were (8.25%) had major depression 5(15.6%) had multiple personality disorder. 11(34.3%) were schizophrenic, 6(18.7%) had mood disorders, 2(6.25%) were epileptic.Conclusions: This study of suicides of young adults will be quite helpful to psychiatrist and medico-social workers to take preventive measures to prevents such suicides because suicide is not only social problem, but it is due to abnormal mental state too.

Abuse or dependence of narcotic drugs and psychotropic drugs inhospital patients / 预防医学

Objective @#To understand the current situation and characteristics of narcotic drugs and psychotropic drugs abuse or dependence among hospital patients and to provide reference for strengthening the management of narcotic drugs and psychotropic drugs.@*Methods @#We collected clinical data from hospitals in Shandong and Guizhou provinces in 2016 and selected patients with history of narcotic drugs and psychotropic drugs. We investigated them through telephone or face-to-face interview,then described the characteristics of demographic information and abuse or dependence of narcotic drugs and psychotropic drugs in diagnosed drug abusers.@*Results @#A total of 280 patients with drug abuse or dependence were recruited,of which 223 cases from nine hospitals in Shandong and 57 cases from five hospitals in Guizhou. There were 170 male patients,accounting for 60.71%; 193 patients aged 45 years and above,accounting for 68.93%; 223 married patients,accounting for 80.51%; 166 patients with a education level of junior high school and below,accounting for 61.25%; 125 patients engaged in agriculture,accounting for 48.64%. Benzodiazepine was the main drugs abused or dependenced by hospital patients,accounting for 73.57%（206 cases）. There were also 83 cases of polydrug abuse,accounting for 29.64%. Among the patients with drug abuse or dependence,45.71% had no special feelings,41.07% had symptoms or felt uncomfortable after withdrawal; 64.64% was for improving their sleep quality. @*Conclusion @#Most patients with abuse or dependence of narcotic drugs and psychotropic drugs are middle- or senior-aged and have polydrug abuse. Benzodiazepine are the main abused drugs. The common reason for narcotic and psychotropic drug abuse or dependence is to have a good sleep.

Psicosis, Discapacidad intelectual y trastornos conductuales: enfoque biopsicosocial / Psychosis, intellectual disability and behavioral disorders: biopsychosocial approach

Caso Clínico: Mujer, 23 años. Discapacidad intelectual. Asiste a colegio especial (no lee ni escribe). Institucionalizada. Motivo de ingreso: Paciente ingresa en octubre del 2017 traída por carabineros por ser encontrada en la calle bajo el efecto de múltiples sustancias, con ideación suicida. Días antes fue expulsada del hogar por agresión a cuidadoras. Diagnósticos de ingreso: Discapacidad intelectual moderado. Síndrome suicidal, Trastorno por dependencia a drogas. ¿Esquizofrenia hebefrénica? Evolución: Mantiene desajustes conductuales severos fluctuantes, con serias dificultades para manejar la rabia, lo que la lleva a tener conductas hetero y autoagresivas. Plan de tratamiento: Farmacológico (clozapina), Psicológico (TCC), Social (dispositivo adecuado post-alta). Clozapina para trastornos psicóticos en adultos con discapacidad intelectual. El principal riesgo de atribuir alguno de estos comportamientos a una supuesta "psicosis", es el de "medicalizar" y tratar de forma poco acertada. Es importante descartar factores ambientales y del aprendizaje (hábitos y conductas aprendidas, institucionalización, reacciones ante el estrés agudo.) La prevalencia de abuso y dependencia de sustancias en población con DI va desde el 0,5% al 2,6%. Lo cual es menor que la población general. Pacientes con DI y dependencia a drogas se asocia a otras enfermedades psiquiátricas (42-54%). Se ha informado que las personas con discapacidad intelectual en América Latina a menudo están institucionalizadas y escondidas de la sociedad en instalaciones deficientes y superpobladas.

Clinical Case: Female, 23 years old. Intellectual disability. He attends a special school (she does not read or write). Institutionalized. Reason for admission: Patient enters in October 2017 brought by police officers to be found in the street under the effect of multiple substances, with suicidal ideation. Days before she was expelled from the home because of assaulting caregivers. Admission diagnoses: Moderate intellectual disability. Suicidal syndrome, Disorder due to drug dependence. Hebephrenic schizophrenia? Evolution: Maintains fluctuating severe behavioral imbalances, with serious difficulties in managing rage, which leads to hetero and self-aggressive behaviors. Treatment plan: pharmacological (clozapine), Psychological (CBT), Social (adequate post-hospitalization discharge device). Clozapine for psychotic disorders in adults with intellectual disabilities. The main risk of attributing some of these behaviors to a supposed "psychosis" is that of "medicalizing" and dealing inappropriately. It is important to rule out environmental and learning factors (habits and behaviors learned, institutionalization, reactions to acute stress. The prevalence of substance abuse and dependence in the population with ID ranges from 0.5% to 2.6%. Which is less than the general population. Patients with ID and drug dependence are associated with other psychiatric illnesses (42-54%). It is reported that people with intellectual disabilty in Latin America are often institutionalized and hidden from society in poor and overcrowded facilities.

Política Criminal Reactiva frente al tráfico, fabricación y porte de estupefacientes y su impacto negativo en la reincidencia de la población carcelaria / Reactive criminal policy to tackle the traffic, manufacture and possession of narcotic drug and its negative impact in the prison population recidivism / Política criminal reativa relacionada ao tráfico, à fabricação e ao porte de entorpecentes, e seu impacto negativo na reincidência da população prisional

Resumen El presente artículo tiene como objetivo analizar el impacto negativo que guarda la política criminal y los sistemas penitenciarios de Colombia, en especial frente aquellas personas que han cometido delitos relacionados con el narcotráfico, cuya persecución altamente represiva contra la fabricación, posesión o tráfico de estupefacientes, no ha tenido ningún efecto significativo en reducir las estructuras delictivas que se han generado en torno al negocio de narcóticos. Lo que ha generado, es un aumento de la población carcelaria, personas que presentan una alta probabilidad de recaída cuando recobran su libertad, -reincidencia delictiva-, motivada por diferentes factores; pero especialmente por el tiempo y la influencia negativa que les ha generado la prisión, ello derivado de las fallas estructurales dentro de las prisiones, lo cual frena la prevención especial positiva, a falta de un tratamiento de resocialización.

Abstract The objective of this work is to analyze the negative impact that the criminal policy and the Colombian penitentiary systems hold, mainly against people who have committed drug trafficking offences, whose highly repressive persecution against the manufacture, possession or narcotic drugs traffic, have not got any significant effect in criminal structures reduction. These criminal structures have been produced on the narco-trafficking business. This has generated an increase in the prison population. These people have a high probability of relapse upon release from prison -criminal recidivism-; it is incited by different factors, particularly the time and the negative influence of prison on them, due to structural problems within the prisons which slow down the special positive prevention, in the absence of a resocialization treatment.

Resumo O objetivo deste trabalho é analisar o impacto negativo da política criminal e dos sistemas prisionais da Colômbia, em especial em relação àquelas pessoas que têm cometido crimes vinculados ao narcotráfico, cuja perseguição, altamente repressiva contra a fabricação, posse ou tráfico de entorpecentes, não tem tido nenhum efeito significativo na redução das estruturas delitivas do negócio dos narcóticos. No entanto, verifica-se um aumento da população prisional, composta por pessoas que apresentam uma probabilidade alta de reincidir quando recobram a liberdade - reincidência delitiva -, motivada por diferentes fatores, sobretudo pelo tempo e pela influência negativa causada pela prisão, devido às falhas estruturais dentro das cadeias, que impedem a prevenção especial positiva, a falta de um tratamentode ressocialização.

Lessons learned from government-academe-civil society partnership to improve the assessment and management of drug dependence in the Philippines

@#<p style="text-align: justify;"><strong>OBJECTIVE: </strong>This paper presents the experiences of, and lessons learnt from, a seven-year government-academe-civil society collaboration in the development, implementation, and evaluation of a training program for Filipino physicians and rehabilitation practitioners on the management of drug dependence.</p><p style="text-align: justify;"><strong>METHODS:</strong> Review of memoranda, records, and reports relevant to the initiation and implementation of the training activity. Where relevant, we also perused internal notes and minutes of meetings written by the authors, who are also members of the training team.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A tripartite collaboration between government, academe, and professional organizations developed a training program on the management of drug dependence for physicians and rehabilitation practitioners. Learner-centered approaches to education were adopted in the delivery of training content. Participation in the training is a prerequisite for government accreditation as rehabilitation professionals. A ladderized approach to the training was adapted, with participants first obtaining a broad introduction to the program, followed by in-depth focus on the assessment and management of drug dependency. This was done as a response to the perception that a single, two-week training program is insufficient to fully capacitate physicians and rehabilitation practitioners with the requisite knowledge and skills necessary to manage persons with drug dependence. Future plans include an executive course for established practitioners, and a course on community-based management of drug dependency.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The current perspective on drug use and dependence is transitioning from a politico-legal issue to a public health concern. Attaining the sustainable development goals in 2030 will necessitate the development of a cadre of professionals who are, among others, capable of assessing and treating persons who suffer from drug dependence. The Philippine experience may serve as a model for other countries struggling with the drug menace.</p>

Entre el hogar y el asfalto: relatos y experiencia de vida de habitantes en condición de calle / Between home and asphalt: stories and life experiences of homeless people / Entre o lar e o asfalto: relatos e experiência de vida de habitantes de rua

Resumen Introducción. El tema de la habitabilidad en la calle se constituye en una problemática social en crecimiento que se presenta en todas las ciudades del país, como un fenómeno que debe ser estudiado interdisciplinariamente para una comprensión más objetiva y así, desde las políticas públicas, poder plantear alternativas para su abordaje. Objetivo. Realizar un análisis descriptivo de habitantes en situación de calle, con el fin de evidenciar algunos rasgos característicos de su modo de vida desde una perspectiva emic. Materiales y métodos. El trabajo es de corte etnográfico, basado en entrevistas semiestructuradas relacionadas con experiencias de vida de las personas consultadas en el hogar de paso La Posada de la ciudad de Manizales. Resultados. Los principales hallazgos están relacionados con el modo de vida cotidiano determinado por aspectos socioeconómicos, familiares y uso de drogas. Conclusión. Se advierte que circunstancias de diferente naturaleza, asociadas a condiciones objetivas y subjetivas de existencia, podrían llegar a generar estos modos de vida. Asimismo, este trabajo abre una puerta a la discusión sobre el futuro de los jóvenes menores de 20 años que inician procesos de habitabilidad en la calle.

Abstract Introduction. Homelessness is an increasingly problematic social issue which is present in all cities of the country. For a more objective understanding of the problem, this phenomenon must be studied interdisciplinarily so that public policies can propose options to deal with it. Objective. Conduct a descriptive analysis of homeless people to evidence some characteristic traits of their lifestyle from an emic perspective. Materials and methods. This work is of an ethnographic nature, based on semi-structured interviews related with the life experiences of the people interviewed at the homeless shelter La Posada in the city of Manizales. Results. The main findings are related with their daily lifestyle determined by socioeconomic and family aspects and by drug use. Conclusion. It is evidenced that circumstances of different nature associated with objective and subjective existence conditions could lead to this lifestyle. Furthermore, this work opens the discussion on the future of young people under 20 years old who start their homelessness process.

Resumo Introdução. O assunto da habitabilidade na rua se constitui numa problemática social em crescimento que se apresenta em todas as cidades do país, como um fenómeno que deve ser estudado interdisciplinariamente para una compreensão mais objetiva e assim, desde as políticas públicas, poder plantear alternativas para sua abordagem. Objetivo. Realizar uma análise descritiva de habitantes de rua, com o fim de evidenciar alguns rasgos característicos do seu modo de vida desde uma perspectiva emic. Materiais e métodos. O trabalho é de corte etnográfico, baseado em entrevistas semiestruturadas relacionadas com experiências de vida das pessoas consultadas na casa de passo La Posada da cidade de Manizales. Resultados. As principais descobertas estão relacionados com o modo de vida cotidiano determinado por aspectos socioeconómicos, familiares e uso de drogas. Conclusão. Se adverte que circunstâncias de diferente natureza, associadas a condições objetivas e subjetivas de existência, poderiam chegar a gerar estes modos de vida. Assim mesmo, este trabalho abre uma porta à discussão sobre o futuro dos jovens menores de 20 anos que iniciam processos de habitabilidade nas ruas.

Conocimiento y consumo de drogas ilegales en estudiantes de un colegio público / Knowledge and consumption of illegal drugs in students ofa public school

Las drogas impactan y modifican múltiples órganos, especialmente el cerebro, con consecuencias más severas entre los jóvenes. Se determinó la asociación entre el conocimiento y consumo de drogas ilegales en estudiantes. El diseño de estudio fue observacional, descriptivo con un componente analítico. La población estuvo constituida por 222 alumnos de los Bachilleratos Científico y Técnico del primer al tercer curso de un colegio público que fueron seleccionados por un muestreo no probabilístico por conveniencia. Se aplicó un cuestionario impreso con 27 preguntas que abarcaban tres aspectos: datos sociodemográficos, conocimiento y consumo, y que fue autoadministrado en forma anónima. Se concluyó que más de la mitad de los estudiantes tenían conocimientos sobre drogas ilegales y la mayoría no consumió drogas ilegales. En la minoría que si consumió droga, la más frecuente fue la marihuana, con una edad de inicio de 15 años, una periodicidad de consumo de una vez por semana en compañía de amigos/as y en la casa de un amigo/a o familiar. Se determinó asociación significativa entre el conocimiento y el consumo de drogas ilegales. Se sugiere que los programas de educación preventiva se enfoquen en estudiantes de 14 a 15 años y que en ellos se haga énfasis en las drogas según nivel de dependencia y los efectos negativos de la marihuana.

Drugs affect and modify multiple organs, especially the brain, with more severeconsequences among young people. The association between knowledge and consumptionof illegal drugs in students was determined. The study design was observational, descriptivewith an analytical component. The population consisted of 222 students of the Scientific andTechnical High School from the first to the third year of a public school who were selectedby a non-probabilistic convenience sampling. A printed questionnaire with 27 questionscovering three aspects: sociodemographic data, knowledge and consumption was applied,and self-administered anonymously. It was concluded that more than half of the studentshad knowledge about illegal drugs and most did not consume illegal drugs. In the minoritythat consumed drugs the most frequent was marijuana, and the starting age was 15 years,with a frequency of consumption of once a week in the company of friends and at the houseof a friend or family member. A significant association was identified between knowledgeand use of illegal drugs. It is suggested that preventive education programs focus onstudents aged 14 to 15 years emphasizing on drugs according to dependency level andnegative effects of marijuana.

A avaliação mecanística teórica da utilização de oxihidróxido de cobalto (III) em sensores eletroquímicos de tramadol / The mechanistic theoretical evaluation of the use of cobalt (III) oxyhydroxide in electrochemical sensors of tramadol

RESUMO A possibilidade da detecção eletroquímica de tramadol in vivo e in vitro por meio do sensor, baseado em oxihidróxido de cobalto trivalente e no seu compósito com polímeros condutores, foi avaliada do ponto de vista mecanístico. O modelo matemático, correspondente ao mecanismo de oxidação sugerido, foi desenvolvido e analisado, mediante a teoria de estabilidade linear e da análise de bifurcações. Foi detectado que CoO(OH) pode aplicar-se na detecção eletroquímica de tramadol nos valores de pH neutros e levemente alcalinos, correspondentes à oxidação mais eficiente do composto. A possibilidade da aparição de instabilidades oscilatória e monotônica também foi verificada.

SUMMARY The possibility of tramadol in vivo and in vitro electrochemical determination by means of the sensor, based on cobalt (III) oxyhydroxide and its composite with conducting polymers was evaluated from the mechanistic point of view. The mathematical model, correspondent to the suggested mechanism, was developed and analyzed by means of linear stability theory and bifurcation analysis. It was shown that CoO(OH) may be applied to the tramadol electrochemical determination in neutral and lightly alkaline pH values, correspondent to the more efficient oxidation of the compound. The possibility of oscillatory and monotonic instabilities has also been modified.

Development of metabonomics of drug dependence / 中华行为医学与脑科学杂志

Drug dependence brings heavy burden to globe medicine and security,however,the mechanism is unclear.And because of the legal question,patients tend to hide their history of drug use,which make the diagnosis difficult.Metabonomics is an emerging system biological technology which can offer a new view about the diseases.This paper reviewed the metabonomics research progress of the main dependence drugs,and proved that metabonomics technology may discover biomarkers for diagnosis and treatment of drug dependence.The relationship between peripheral metabonomics and center nerve system may become an important research field.More information may come from the united apply of genomics,proteomics and metabonomics.Finally,there will be a breakthrough in identification of individuals with susceptibility to drug dependence,and supply a preventive or treatment plan.

Development of metabonomics of drug dependence / 中华行为医学与脑科学杂志

Drug dependence brings heavy burden to globe medicine and security,however,the mechanism is unclear.And because of the legal question,patients tend to hide their history of drug use,which make the diagnosis difficult.Metabonomics is an emerging system biological technology which can offer a new view about the diseases.This paper reviewed the metabonomics research progress of the main dependence drugs,and proved that metabonomics technology may discover biomarkers for diagnosis and treatment of drug dependence.The relationship between peripheral metabonomics and center nerve system may become an important research field.More information may come from the united apply of genomics,proteomics and metabonomics.Finally,there will be a breakthrough in identification of individuals with susceptibility to drug dependence,and supply a preventive or treatment plan.