Jogo de tabuleiro sobre drogas psicoativas para pessoas com deficiência visual / Juego de tablero sobre drogas psicoactivas para personas con discapacidad visual / Board game about psychoactive drugs for visually disabled people

Resumo Objetivo Avaliar o aprendizado de pessoas com deficiência visual após participação em jogo educativo sobre drogas psicoativas. Métodos Pesquisa quase-experimental, realizada em uma associação de cegos e em laboratório experimental de ensino de saúde de uma universidade, com 60 cegos maiores de 18 anos, com cegueira ou baixa visão, alfabetizados em Braille ou capazes de ler textos com letras ampliadas. Foi aplicado o jogo educativo de tabuleiro "Drogas: jogando limpo", que contempla conteúdo sobre o conceito, tipos de drogas, prejuízos, fatores de risco, situações envolvendo o uso das drogas e fatores de proteção/prevenção. Aprendizagem foi avaliada em entrevista individual, antes e após aplicação do jogo com questões organizadas por níveis de complexidades. Comparação do número de acertos avaliados pelo teste McNemar. Resultados Questões de baixa complexidade apresentaram diferença significativa (p=0,0001) nos acertos após uso do jogo e elevado índice de acertos antes e após (81,7% e 98,3%). Não houve diferença estatística nas questões de média e alta complexidade. Conclusão O jogo Drogas: jogando limpo, contribuiu, de forma significativa, para a aprendizagem das pessoas com deficiência visual, representando estratégia de inclusão de individuos com deficiência no acesso à informação.

Resumen Objetivo Evaluar el aprendizaje de personas con discapacidad visual después de la participación en juego educativo sobre drogas psicoactivas. Métodos Investigación cuasi experimental, realizada en una asociación de ciegos y en un laboratorio experimental de enseñanza de salud de una universidad, con 60 ciegos de más de 18 años, con ceguera o con baja visión, alfabetizados en Braille con capacidad para leer textos con letras ampliadas. Se aplicó un juego educativo de tablero "Drogas: jugando limpio", que contempla contenidos sobre el concepto, tipos de drogas, perjuicios, factores de riesgo, situaciones que involucran el uso de drogas y factores de protección/prevención. El aprendizaje fue evaluado en entrevista individual, antes y después de la aplicación del juego con preguntas organizadas por niveles de complejidad. Comparación del número de aciertos evaluados por la prueba McNemar. Resultados Preguntas de baja complejidad presentaron diferencias significativas (p=0,0001) en los aciertos después del uso del juego y elevado índice de aciertos antes y después (81,7 % y 98,3 %). No hubo diferencia estadística en las preguntas de mediana y alta complejidad. Conclusión El juego Drogas: jugando limpio, contribuyó, de forma significativa, para el aprendizaje de las personas con discapacidad visual, lo que representa una estrategia de inclusión de personas con discapacidad para el acceso a la información.

Abstract Objective Evaluate the learning of visually disabled people after participating in an educational game about psychoactive drugs. Methods Quasi-experimental research, conducted in an association of the blind and in an experimental laboratory of health teaching at a university, involving 60 blind people over the age of 18, blind or with low vision, literate in Braille or able to read texts with enlarged letters. The educational board game "Drugs: playing fair" was applied, which covers content on the concept, types of drugs, harms, risk factors, situations involving the use of drugs and protection/prevention factors. Learning was evaluated in an individual interview, before and after the application of the game, with questions organized by levels of complexity. Comparison of the number of hits evaluated using the McNemar test. Results Questions of low complexity presented a significant difference (p=0.0001) in the hits after using the game and a high index of hits before and after (81.7% and 98.3%). There was no statistical difference in the medium and high complexity questions. Conclusion The game Drugs: playing fair, significantly contributed to the learning of people with visual disabilities, representing a strategy to include individuals with disabilities in the access to information.

Narcotraficantes en Chile. Análisis estadístico-descriptivo de sujetos detenidos por tráfico de drogas durante el periodo 2017-2021 / Drug traffickers in Chile. Statistical-descriptive analysis of subjects arrested for drug trafficking during the period 2017-2021 / Os traficantes de drogas no Chile. Análise estatística-descritiva dos sujeitos presos por tráfico de drogas durante o período 2017-2021

Desde tiempos remotos, la conducta delictiva ha sido una de las principales preocupaciones de la sociedad. En particular, el narcotráfico ha movilizado a las instituciones del Estado y también a investigadores provenientes de distintas áreas del saber; pese a ello ­en Chile­ esta manifestación del crimen organizado ha sido un fenómeno poco abordado y con escasa evidencia científica. Mediante el lenguaje de programación R se realizó un estudio estadístico descriptivo dirigido a caracterizar el perfil actual del narcotraficante en Chile, a partir de los factores sociocriminógenos presentes en una muestra de 28 397 sujetos, quienes fueron detenidos por tráfico de drogas durante el periodo 2017­2021. Los resultados obtenidos dan cuenta de la inexistencia de un perfil único, sin embargo, se estableció que se trata ­mayoritariamente­ de un hombre adulto, de estado civil soltero, que promedia los 32.5 años, sin un trabajo u oficio formal, con antecedentes policiales y una carrera delictiva caracterizada por la versatilidad criminal. También se discutió el rol de los extranjeros, las mujeres y los adolescentes dentro del narcotráfico, pues, aun cuando su frecuencia estadística es mayor que en otros delitos, su participación dentro de la estructura criminal sigue limitándose a los eslabones más bajos de la organización.

Since ancient times, criminal behavior has been one of society's main concerns. In particular, drug trafficking has mobilized state institutions and researchers from different areas of knowledge; however, in Chile, this manifestation of organized crime has been a phenomenon that has been little addressed and with little scientific evidence. Using the R programming language, a descriptive statistical study was conducted aimed at characterizing the current profile of the drug trafficker in Chile, based on the sociocriminogenic factors present in a sample of 28 397 subjects, who were arrested for drug trafficking during the period 2017-2021. The results obtained show the inexistence of a unique profile, however, it was established that it is -mostly- an adult male, of single marital status, averaging 32.5 years of age, without a formal job or trade, with a police record and a criminal career characterized by criminal versatility. The role of foreigners, women and adolescents in drug trafficking was also discussed, since, although their statistical frequency is higher than in other crimes, their participation in the criminal structure continues to be limited to the lowest links in the organization.

Desde os tempos antigos, o comportamento criminoso tem sido uma das principais preocupações da sociedade. Em particular, o tráfico de drogas mobilizou instituições estatais e pesquisadores de diferentes áreas do conhecimento; entretanto, no Chile, esta manifestação do crime organizado tem sido um fenômeno pouco abordado e com poucas evidências científicas. Usando a linguagem de programação R, foi realizado um estudo estatístico descritivo para caracterizar o perfil atual do traficante de drogas no Chile, baseado nos fatores sócio-criminógenos presentes em uma amostra de 28.397 indivíduos que foram presos por tráfico de drogas durante o período 2017-2021. Os resultados obtidos mostram que não existe um perfil único, no entanto, foi estabelecido que se trata principalmente de um homem adulto, solteiro, com idade média de 32,5 anos, sem um emprego ou ocupação formal, com antecedentes criminais e uma carreira criminosa caracterizada pela versatilidade criminal. O papel dos estrangeiros, mulheres e adolescentes no tráfico de drogas também foi discutido, pois, embora sua freqüência estatística seja maior do que em outros crimes, sua participação na estrutura criminal ainda está limitada aos elos mais baixos da organização.

Psychosocial consequences and reasons for illicit drug use among police officers in a northern Nigerian city: A mixed-method study

Harmful use of drugs is one of the principal risk factors affecting population health worldwide. Chronic use has been linked to medical, psychological and socioeconomic consequences. This study assessed the psychosocial consequences and reasons for illicit drug use among police officers in Kano, Nigeria. Using a mixed method of data collection, quantitative data was obtained from a cross-section of 275 officers using the Shortened Inventory of Problems-Drug Use (SIP­DU) and a pretested adapted questionnaire. In-depth interviews with 10 officers who used illicit drugs provided additional information. Almost half of the respondents (46.5%, n=128) were in their fourth decade of life with a mean age (±SD) of 35.1 ± 7.7 years. Over a quarter of the respondents (n=75) reported ever using illicit drugs, out of which 14.9% (n=41) were current users. Among the current drug users, 80.5% (n=33) attested to having money problems, 61.0% (n=25) agreed that they had spent too much money, and 56.1% (n=23) failed to do what was expected of them as a result of drug use and have hurt their family. Helping to stay awake and improving confidence were the major reasons (100%, n=41) for drug use mentioned by the respondents. The Nigerian Police Force should look into easing shifts and introducing stress-relieving activities. There is also the need to strengthen substance education and counselling and support officers with confidence issues, sleep disorders, and treat those with mood disorders.

Red cell distribution width may help to discriminate synthetic cannabinoid users in the emergency department

Background: Differentiating bonsai users from the suspected users is problematic. The aim was to determine whether bonsai using men and the others can be distinguished via the hemogram parameters such as mean corpuscular volume (MCV), mean platelet volume (MPV), red cell distribution width (RDW) and Plateletcrit (PCT).Methods: In this retrospective case-control study, a total of 138 men admitted to ED were investigated in Kanuni Sultan Suleyman Hospital, Istanbul, Turkey in 2014. The patients were divided into 2 groups which were the first group had included bonsai users whereas the second group was consist of men not using bonsai. Complete blood count tests were performed on all patients.Results: Among the suspected bonsai users, 68 were diagnosed to use bonsai. It was found that MCV, RDW and PCT levels were significantly higher in bonsai users compared to controls while MPV levels were lower in the users. Author put all these parameters to logistic regression analysis model using enter method. RDW (OR: 3.98, 95%CI:2.180-7.266, p<0.0001), MPV (OR:0.526, 95%CI:0.373-0.742, p<0.0001) and PCT (OR:<0.0001, 95%CI:0.000-0.058, p=0.007) were independent variables to discriminate bonsai users from that of suspected users. The most promising parameter to differentiate bonsai users from suspected users was RDW (AUC: 0.748, 95%CI: 0.668-0.828, p:<0.0001). The optimal cut-off value was found as 10.8 for RDW with a sensitivity, specificity, +LR and -LR as 66.2%, 64.3%, 1.85, 0.53, respectively.Conclusions: RDW marker can be a reliable parameter to discriminate bonsai users from that of suspected users with moderate sensitivity and specificity.

Contribución del servicio de policía a la conformación del Estado-nación durante el conflicto armado en Colombia, de 1970 al año 2006. Aproximaciones desde los conceptos de globalización y glocalización / Police service contribution to the conformation of the Nation-State during the armed conflict in Colombia, from 1970 to 2006. Approaches from the concepts of globalization and glocalization / A contribuição do serviço das polícias à conformação do Estado-Nação ddurante o conflito armado na Colômbia, de 1970 ao ano 2006. Aproximações dos conceitos da globalização e do glocalização

Resumen El objetivo es abordar los factores que determinaron la contribución y evolución del servicio de la Policía Nacional de Colombia durante el conflicto armado, a la luz de la explicación del fenómeno del narcotráfico y de los hechos terroristas acaecidos el 11 de septiembre del 2001 -como dos circunstancias que cambiaron la historia mundial y que rompieron paradigmas en temas de convivencia y seguridad-, dada su incidencia en la redefinición de la lucha contra el delito transnacional. La metodología abordó la correlación de hitos históricos del periodo comprendido entre los años de 1970 y 2006. La hipótesis de esta investigación expresa que la conexión entre procesos, doctrina policial y políticas gubernamentales para afrontar los delitos de narcotráfico y terrorismo, desde la perspectiva de los conceptos de globalización y glocalización, contribuyó a la conformación del Estado-Nación en temas de gobernabilidad, durante el desafío que representó el conflicto armado, el cual internacionalizó el servicio de policía de Colombia y lo transformó en eje de referenciación doctrinal y operacional en el ámbito hemisférico y mundial. La investigación hace parte de las discusiones académicas y de los análisis de la Unidad para la Edificación de la Paz - UNIPEP, para la preparación de escenarios de atención policial, durante la transición de Colombia hacia una paz estable y duradera.

Abstract The objective in this article consists of addressing the factors having determined the contribution and evolution of the Colombian National Police service during the armed conflict, in the light of the drug trafficking phenomenon and the terrorist events occurring in September 11, 2001 - explained as two circumstances that changed world history and broke paradigms in issues dealing with coexistence and security, by reason of its impact in the redefinition of the war against transnational crime. The methodology approached the correlation of historical milestones ranging from events taking place in the period between 1970 and 2006. The hypothesis of this research expresses that the connection between processes, police doctrine, and government policies established to deal with drug trafficking and terrorism crimes from the perspective of the globalization and glocalization concepts contributed to the conformation of the Nation-State in governance issues, during the challenge posed by the armed conflict having internationalized the Colombian police service and transformed it into a doctrinal and operational reference axis in the hemispherical and global environment. Research makes part of the academic discussions and analyses carried out by the Police Unit for the Construction of Peace ("Unidad Policial para la Edificacion de la Paz" (UNIPEP) for the preparation of police attention scenarios during Colombia's transition from the armed conflict into stable and lasting peace.

Resumo O objetivo é abordar os fatores que determinaram a contribuição e a evolução do serviço da Policia Nacional da Colômbia durante o conflito armado, à luz da explicação do fenômeno de narcotráfico e dos fatos terroristas acontecidos o 11 de setembro de 2001, -como duas circunstâncias que mudaram a história do mundo e que quebraram paradigmas em assuntos de coexistência e segurança- dada sua incidência na redefinição da luta contra o crime transnacional. A metodologia abordou a correlação de marcos históricos do período entre os anos 1970 e 2006. A hipótese desta pesquisa expressa que a conexão entre processos, doutrina policial e políticas governamentais para confrontar os crimes de narcotráfico e de terrorismo, da perspectiva dos conceitos de globalização e glocalização, contribuiu à conformação do Estado-Nação em assuntos do governabilidade, durante o desafio que representou o conflito armado, que internacionalizou o serviço das polícias de Colômbia e o transformou na linha central de referenciação doutrinal e operacional no âmbito hemisférico e mundial. A pesquisa faz parte das discussões acadêmicas e das análises da Unidade para a Construção da Paz - UNIPEP, para a preparação dos cenários da atenção policial, durante a transição de Colômbia para uma paz estável e durável.

Substance use and sexual function in juvenile idiopathic arthritis / Uso de substâncias e função sexual na artrite idiopática juvenil

ABSTRACT Objective: To evaluate alcohol/tobacco/illicit drug use and sexual function in adolescent juvenile idiopathic arthritis (JIA) and healthy controls. Methods: 174 adolescents with pediatric rheumatic diseases were selected. A cross-sectional study with 54 JIA patients and 35 controls included demographic/anthropometric data and puberty markers assessments, physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk and a questionnaire that evaluated sexual function, bullying and alcohol/tobacco/illicit drug use. Clinical/laboratorial data and treatment were also assessed in JIA. Results: The median current age was similar between JIA patients and controls [15(10–19) vs. 15(12–18) years, p = 0.506]. Frequencies of alcohol/tobacco/illicit drug use were high and similar in both JIA and controls (43% vs. 46%, p = 0.829). However, age at alcohol onset was significantly higher in those with JIA [15(11–18) vs. 14(7–18) years, p = 0.032], particularly in polyarticular onset (p = 0.040). High risk for substance abuse/dependence (CRAFFT score ≥ 2) was found in both groups (13% vs. 15%, p = 1.000), likewise bullying (p = 0.088). Further analysis of JIA patients regarding alcohol/tobacco/illicit drug use showed that the median current age [17(14–19) vs. 13(10–19)years, p < 0.001] and education years [11(6–13) vs. 7(3–12)years, p < 0.001] were significant higher in those that used substances. Sexual activity was significantly higher in the former group (48% vs. 7%, p < 0.001). A positive correlation was evidenced between CRAFFT score and current age in JIA patients (p = 0.032, r = +0.296). Conclusion: A high risk for substance abuse/dependence was observed in both JIA and controls. JIA substance users were more likely to have sexual intercourse. Therefore, routine screening is suggested in all visits of JIA adolescents.

RESUMO Objetivo: Avaliar o uso de álcool/tabaco/drogas ilícitas e a função sexual em adolescentes com artrite idiopática juvenil (AIJ) e controles saudáveis. Métodos: Selecionaram-se 174 adolescentes com doenças reumatológicas pediátricas. Fez-se um estudo transversal com 54 pacientes com AIJ e 35 controles. Foram feitas avaliações de dados demográficos/antropométricos e marcadores da puberdade; a escala de triagem CRAFFT (carro/relaxar/sozinho/esquecer/amigos/problemas) foi aplicada por um médico para determinar o alto risco de uso abusivo/dependência de substâncias. Um questionário avaliou a função sexual, a ocorrência de bullying e o uso de álcool/tabaco/drogas ilícitas. Também foram avaliados dados clínicos/laboratoriais e de tratamento da AIJ. Resultados: A média da idade atual foi semelhante entre pacientes com AIJ e controles [15 (10 a 19) vs. 15 (12 a 18) anos, p = 0,506]. As frequências de uso de álcool/tabaco/drogas ilícitas foram elevadas e semelhantes entre pacientes com AIJ e controles (43% vs. 46%, p = 0,829). No entanto, a idade em que começou a usar álcool foi significantemente maior naqueles com AIJ [15 (11 a 18) vs. 14 (7 a 18 anos), p = 0,032], em particular na doença de início poliarticular (p = 0,040). Encontrou-se um alto risco de uso abusivo/dependência de substâncias (pontuação no CRAFFT ≥ 2) em ambos os grupos (13% vs. 15%, p = 1,000), do mesmo modo que o bullying (p = 0,088). Uma análise mais aprofundada dos pacientes com AIJ em relação ao uso de álcool/tabaco/drogas ilícitas mostrou que a média da idade atual [17 (14 a 19) vs. 13 (10 a 19) anos, p < 0,001] e os anos de escolaridade [11 (6 a 13) vs. 7 (3 a 12) anos, p < 0,001] foram significativamente maiores naqueles que usaram substâncias. A atividade sexual foi significantemente maior no primeiro grupo (48% vs. 7%, p < 0,001). Foi evidenciada correlação positiva entre a pontuação na escala CRAFFT e a idade atual dos pacientes com AIJ (p = 0,032, r = + 0,296). Conclusão: Observou-se um alto risco de uso abusivo/dependência de substâncias em pacientes com AIJ e controles. Os usuários de substâncias que têm AIJ são mais propensos a ter relações sexuais. Portanto, sugere-se a triagem de rotina em todas as consultas de adolescentes com AIJ.

Club drug use and its association with syphilis infection among female sex workers / 中华流行病学杂志

Objective To understand the prevalence rates of club drug use and how it associated with syphilis infection among female sex workers (FSWs) in different areas of China so as to provide reference for developing intervention programs.Methods In each of the study site,different kinds of venues where FSWs solicited clients were mapped and grouped into three strata.The number of FSWs at each venue was enumerated.A stratified proportional sampling design was adopted to recruit FSWs.Questionnaire survey was conducted to gather data on demographic information,club drug use and sexual behaviors.Blood samples were taken and tested for syphilis.Factors associated with syphilis infection and club drug use were assessed using univariate and multivariate logistic regression models.Results Results of the 1 630 participants,120 (7.4％) used club drugs in the past 12 months,and 5.4％ (88/1 630) tested positive for syphilis.Syphilis positive rate was not significantly different between FSWs who used club drugs and those who did not.Data from multivariate logistic regression analysis indicated that club drug use was associated with following factors as sites of the study,hometown of the FSWs,marital status,education level,having had STD symptoms or history of injecting drugs in the past 12 months of the sex workers.Conclusion Club drug use was highly prevalent among FSWs.Further studies are warranted to fully explore the association between club drug use and the risk of HIV/STD transmission.

Hábitos tóxicos en estudiantes de segundo año de medicina / Toxic habits in second year medical students

Se realizó un estudio descriptivo y transversal durante marzo del 2012 para determinar los hábitos tóxicos de 42 estudiantes de segundo año de medicina, pertenecientes a la Facultad No. 2 de la Universidad de Ciencias Médicas de Santiago Cuba, para lo cual se aplicó una encuesta anónima que recogía datos sociodemográficos y variables de interés para la investigación. Entre los principales resultados predominaron el sexo femenino y los educandos entre 18 y 19 años. También sobresalieron el café, el alcohol y el tabaco como drogas lícitas más consumidas; los medicamentos no recetados como drogas ilícitas más empleadas, además de la cerveza, el ron y alcohol preparado como bebidas más frecuentes. La mayoría de los estudiantes desconocían el daño que ocasionan las drogas ilícitas a la salud de los individuos.

A descriptive and cross-sectional study was carried out during March, 2012 to determine the toxic habits of 42 second year medical students, belonging to Faculty No. 2 of the Medical Sciences University in Santiago de Cuba, for which an anonymous survey was applied which compiled social and demographic data and variables of interest for the investigation. Female sex and the students between 18 and 19 years prevailed among the main results. Coffee, alcohol and tobacco were the most consumed licit drugs; the over-the-counter drugs were the most used illicit drugs, besides beer, rum and prepared alcohol, were the most frequent drinks. Most of the students ignored the damages caused by the illicit drugs to the health of the individuals.

Cuáles y qué tan graves son los daños a la salud individual y a la sociedad causados por el consumo de drogas lícitas e ilícitas / What and how severe is the damage inflicted by the consumption of licit and illicit drugs upon the health of human individuals and upon society

Resumen En vista del amplio consumo de drogas lícitas e ilícitas en casi todo el mundo occidental, nosotros sospechamos que no eran tantos ni tan graves los daños que causan, como se afirma, y decidimos evaluar la solidez de tal sospecha. La sospecha resultó correcta en términos de la salud física individual de los usuarios, pues las drogas no aparecen entre las primeras quince causas de Morbilidad ni de Mortalidad en los habitantes de México, EUA, Canadá, España, el Reino Unido y Holanda. En cambio, las drogas sí causan daño psicológico y social al individuo por propiciar indolencia motivacional, cuadros psicóticos serios, potencialmente irreversibles, e inducir la comisión de conductas riesgosas (accidentes de tránsito) y hasta criminales (robos, asaltos, violaciones). El consumo de drogas también lesiona la integridad y economía de las familias de los usuarios y daña a la comunidad, pues se eleva la tasa de desempleo, disminuyen los ingresos fiscales, incrementan los costos de los programas de desarrollo, de seguridad y de beneficencia, así como propician la exclusión de los usuarios en el trabajo, escuelas, clubes y servicios públicos diversos. Nuestros resultados son de interés para el diseño de las acciones destinadas al control del consumo de drogas para que sean congruentes con el tipo, gravedad y extensión del daño individual y social que las drogas causen.

Abstract In view of the widespread use of licit and illicit in most of the Western world, we suspect that there were not so many and so serious the damages that they cause, as stated, and we decided to assess the strength of such suspicion. The suspicion was correct in terms of physical health of individual users, as drugs do not appear among the top fifteen causes of morbidity or mortality in the population of Mexico, USA, Canada, Spain, the United Kingdom and the Netherlands. However, drugs do cause psychological and social harm to the individual by promoting motivational indolence, serious psychotic symptoms potentially irreversible, and induce the commission of risky behaviors (traffic accidents) and even criminals (robbery, assault, rape). Drug use also damages the integrity and economy of the families of users and harms to the community, since it raises the rate of unemployment, lower tax revenues, increase costs of development programs, safety and welfare, and favor the exclusion of users in the workplace, schools, clubs and various utilities. Our results are of interest for the design of actions to control drug use to be consistent with the type, severity and extent of the individual and social harm that drugs cause.

Prevalence of hepatitis C virus infection and associated factors among male illicit drug users in Cuiabá, Mato Grosso, Brazil

Intravenous drug injection has been reported as the main risk factor for hepatitis C virus (HCV) infection. The aim of the present study was to describe the prevalence and the epidemiological profile of HCV infection among abusers of illegal injected and non-injected drugs in Cuiabá, state of Mato Grosso, Central Brazil. A cross-sectional study including 314 male drug users from eight detoxification centres was performed. Out of 314 subjects studied, 48 (15.2 percent) were intravenous drug users. Participants were interviewed and had blood samples taken and tested for the presence of anti-HCV antibodies. Positive samples were tested for the presence of HCV RNA. Genotyping was performed on HCV RNA-positive samples. The overall prevalence of anti-HCV antibodies was 6.4 percent (n = 20). Out of 20 anti-HCV antibody-positive subjects, 16 (80 percent) were also HCV RNA-positive. Genotype 1 predominated (75 percent), followed by 3a (25 percent). Subtype 1a was more common than 1b. HCV infection was more prevalent among intravenous drug users (33 percent) than non-injecting users (1.5 percent). Logistic regression analyses showed independent associations between HCV infection and intravenous drug use, imprisonment and increasing age. In the present study, injecting drug use was the factor most strongly associated to HCV infection and inhaling or sniffing did not represent an increased susceptibility to infection.

Maternal and Neonatal Effects of Substance Abuse during Pregnancy: Our Ten-year Experience

PURPOSE: The aim of the study was to assess perinatal outcome of pregnancy burdened with maternal addiction in comparison with an unselected population from a European transition country. MATERIALS AND METHODS: Data on pregnancies complicated by illicit drug abuse (n = 85) managed during a 10-year period (1997-2007) at Split University Hospital were analyzed. Data on the type of drug, course of gestation and labor, and on perinatal outcome were considered. Data on all non-dependence pregnancies recorded during the study period were used as a control group. RESULTS: During the study period, there were 85 dependence-complicated pregnancies (0.2%). Use of heroin alone during pregnancy was recorded in 51 women (50%), methadone alone in 6 (7%), and a combination of heroin and methadone in 9 (11%). Premature delivery was significantly more common in the group of pregnant addicts (21% vs. 6%); 49% of pregnant addicts were carriers of hepatitis C virus (HCV) and 14% of hepatitis B virus (HBV). Neonatal abstinence syndrome developed in 61 infants (7%) born to addicted mothers. There were 4 cases (4.6%) of early neonatal death; 7 neonates had 5-minute Apgar score < or = 7 (8%); 29 neonates had low birth weight for age (33%); and 7 neonates had congenital anomalies (8%). The risk of various congenital anomalies was 3-fold in the group of children born to addicted mothers. CONCLUSION: Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome.