Drug use among medical students in São Paulo, Brazil: a cross-sectional study during the coronavirus disease 2019 pandemic

ABSTRACT BACKGROUND: Medical students demonstrate higher rates of substance use than other university students and the general population. The challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic raised significant concerns about mental health and substance use. OBJECTIVES: Assess the current prevalence of substance use among medical students at the University of São Paulo and evaluate the impact of the COVID-19 pandemic on drug consumption. DESIGN AND SETTING: A cross-sectional study was conducted on 275 medical students from the University of São Paulo Medical School (São Paulo, Brazil) in August 2020. METHODS: Substance use (lifetime, previous 12 months, and frequency of use before and during the COVID-19 pandemic) and socioeconomic data were assessed using an online self-administered questionnaire. Symptoms of depression were assessed using the Patient Health Questionnaire-9. RESULTS: Alcohol was the most consumed substance in their lifetime (95.6%), followed by illicit drugs (61.1%), marijuana (60%), and tobacco (57.5%). The most commonly consumed substances in the previous year were alcohol (82.9%), illicit drugs (44.7%), marijuana (42.5%), and tobacco (36%). Students in the first two academic years consumed fewer substances than those from higher years. There was a decreasing trend in the prevalence of most substances used after the COVID-19 pandemic among sporadic users. However, frequent users maintained their drug use patterns. CONCLUSION: The prevalence of substance use was high in this population and increased from the basic to the clinical cycle. The COVID-19 pandemic may have affected the frequency of drug use and prevalence estimates.

Prevention of drug diversion and substance use disorders among anesthesiologists: a narrative review

Abstract Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions. Healthcare systems are placed in jeopardy by the legal impact associated with illegal routes of drug release including sanction and financial liability and loss of public trust. Healthcare institutions have implemented many measures to reduce diversion from the perioperative area. These efforts include education, medical record surveillance, automated medication dispensing systems, urine drug testing, substance waste management systems, and drug diversion prevention teams. This narrative review evaluates strengths, weaknesses, and effectiveness of these systems and provides recommendations for leaders and care providers.

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia

Objective: This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia. Methods: This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09 ± 1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted. Results: Physical aggression (t = 7.74; p < 0.01), cognitive depression (t = 5.03; p < 0.01), affective depression (t = 8.24; p <0.01), affective instability (t = 3.46; p <0.01), few social relationships (t = 3.36; p < 0.01), self-harm (t = 3.45; p< .01), cannabis and tranquilizer use (t = 2.83; p < 0.05; and t = 2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t = 2.59; p <0.05), components of depression (t = 9.03; p <0.01) and borderline personality traits (t = 4.12; p <0.01) also predicted suicidal behaviour. Conclusions: More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Objetivo: El objetivo de este estudio es examinar la asociación del comportamiento suicida con el consumo de sustancias, síntomas depresivos, agresividad y rasgos de personalidad límite en adolescentes de Sincelejo (Sucre), una ciudad rural del norte de Colombia. Métodos: Este estudio transversal incluyó a 352 participantes seleccionados por muestreo intencional de una escuela pública y privada ubicada en Sincelejo, distrito de Sucre, en el norte de Colombia. Las edades de los estudiantes oscilaron entre los 12 y los 18 anos (media, 15,09 ± 1,82). Los participantes completaron 3 instrumentos de cribado: uno de datos sociodemográficos, uno sobre consumo de algunas sustancias, tales como tabaco y cannabis, y su frecuencia y un instrumento de autoinforme para evaluar varios dominios de la personalidad y algunas psicopatologías. Se realizaron una serie de pruebas de la t, ANOVA y análisis de regresión lineal. Resultados: La agresión física (t = 7,74; p <0,01), el componente cognitivo de la depresión (t = 5,03; p <0,01), el componente afectivo de la depresión (t = 8,24; p <0,01), la inestabilidad afectiva (t = 3,46, p < 0,01), las pocas relaciones sociales (t = 3,36, p < 0,01), las autolesiones (p <0,01; t = 3,45, p <0,01), el cannabis (t = 2,83; p <0,05) y la toma de tranquilizantes (t = 2,37; p <0,05), se asociaron con el comportamiento suicida. La agresión (t = 2,59; p <0,05), los componentes de la depresión (t = 9,03; p <0,01) y los rasgos de personalidad límite (t = 4,12, p <0,01) predijeron el comportamiento suicida. Conclusiones: Se requieren más estudios longitudinales en esta área con el fin de identificar las relaciones causales entre los factores estudiados y el comportamiento suicida de los jóvenes en Sincelejo.

Grupo de apoio diante das necessidades da família do dependente químico / Support group for the needs of the chemical dependent's family

Objetivou-se identificar as necessidades dos participantes de um Grupo de Apoio à Família no tocante à convivência com o familiar dependente químico. Tratou-se de um estudo qualitativo, desenvolvido com seis familiares que frequentam o Grupo de Apoio à Família em um Centro de Atenção Psicossocial para usuários de Álcool e outras Drogas, em uma cidade do Sul do Brasil. Os dados foram coletados em junho de 2020, mediante entrevista semiestruturada; e, posteriormente, foram analisados por meio de análise temática de conteúdo. Após a observação, emergiram três categorias: Necessidades dos familiares em relação às perspectivas do Grupo de Apoio à Família; Vivência dos familiares em relação ao suporte do Grupo de Apoio à Família e Aspectos a serem reconsiderados no Grupo de Apoio à Família. Nesse contexto, o estudo possibilitou reflexões sobre a elaboração de estratégias mais efetivas a fim de proporcionar um processo terapêutico mais eficaz e resultados mais positivos.

The objective was to identify the needs of participants of a Family Support Group regarding coexistence with the family member who is chemically dependent. This was a qualitative study, developed with six family members who attend the Family Support Group in a Psychosocial Care Center for users of Alcohol and other Drugs in a city in southern Brazil. The data were collected in June 2020 in a semi-structured interview and subsequently analyzed through thematic content analysis. After observation, three categories emerged: Needs of family members in relation to the perspectives of the Family Support Group; Experience of family members in relation to the support of the Family Support Group; and Aspects to be reconsidered in the Family Support Group. In this context, the study enabled reflections on the development of more effective strategies in order to provide a more effective therapeutic process and more positive results.

Intervenciones facilitadoras para las mujeres en el tratamiento por consumos problemáticos desde un enfoque de género / Facilitating interventions for women in treatment for problematic drug use from a gender perspective

RESUMEN INTRODUCCIÓN: Existen barreras para la atención y permanencia de las mujeres en los tratamientos por consumos problemáticos. Se relacionan con los espacios y el diseño de programas donde no se tienen en cuenta las necesidades específicas para un trabajo con enfoque de género. El objetivo fue explorar las intervenciones que funcionan como facilitadoras para alojar y escuchar a las mujeres a partir de la experiencia de un grupo de ellas en el marco de un tratamiento por consumo problemático de sustancias. MÉTODOS: Se utilizó un diseño mixto, tomando como referencia empírica la implementación de un grupo de mujeres. Se trabajó con una muestra de 33 mujeres de la población de 79 pacientes atendidas en un dispositivo ambulatorio para el tratamiento de consumos problemáticos en la ciudad de Buenos Aires entre julio de 2020 y julio de 2022. RESULTADOS: Los datos relevados describen un aumento en la población de mujeres desde la creación del grupo, mientras que el análisis de las experiencias permite distinguir cuatro categorías de intervenciones: las que vinculan los consumos con el rol social de las mujeres; las destinadas a mejorar el apoyo mutuo entre las compañeras; las que permiten construir un espacio de apertura para el trabajo de situaciones de violencia; y las que nacen de la creación del grupo de mujeres para trabajar la accesibilidad. DISCUSIÓN: El presente trabajo refleja la importancia de abordar la perspectiva de género al interior de los tratamientos de un modo transversal.

ABSTRACT INTRODUCTION: There are barriers for women's care and staying in treatment for problematic drug use. They are related to spaces and design of programs that do not consider the specific needs for gender perspective work. The objective was to explore the interventions that work as facilitators to support and listen to women, based on the experience of a group of women in the context of a treatment for problematic substance use. METHODS: A mixed design was used, taking as empirical reference the implementation of a women's group. The study worked with a sample of 33 women from a population of 79 patients in an outpatient facility for the treatment of problematic substance use in the city of Buenos Aires from July 2020 to July 2022. RESULTS: The collected data show an increase in the population of women since the creation of the group, while the analysis of the experiences allows to distinguish four categories of interventions: the ones that link drug use with women's social role; the ones aimed at improving mutual support among partners; the ones that allow building a space of openness to tackle situations of violence; and the ones arising from the creation of a women's group to work on accessibility. DISCUSSION: This work reflects the importance of addressing gender perspective in the treatment in a cross-sectional way.

Riesgo de consumo de sustancias psicoactivas y su relación con el uso problemático de videojuegos y redes sociales en estudiantes universitarios

Introducción: El nivel de riesgo de consumo se establece a partir de la exposición que tiene una persona a ciertos factores de riesgo o características individuales, familiares o sociales, que posibilitan o aumentan el consumo de sustancias psicoactivas (SPA). Objetivo: Este estudio tuvo como propósito relacionar el nivel de riesgo de consumo de SPA con el uso problemático de videojuegos y redes sociales, a fin de establecer su posible papel como factores de riesgo de tipo social. Método: Se realizó un estudio de tipo cuantitativo con un diseño no experimental transversal de alcance descriptivo correlacional con la participación de 736 estudiantes. Se emplearon como instrumentos de recolección de datos el cuestionario sociodemográfico, prueba de tamizaje ASSIST 3,1, cuestionario de adicción a redes sociales - ARS y el cuestionario de Experiencias Relacionadas con los Videojuegos - CERV. Resultados: Algunos resultados sugieren mayor exposición al consumo de sustancias alcohólicas, derivados del tabaco, del cannabis y mayores niveles en el uso problemático de redes sociales y videojuegos. Conclusiones: A partir de lo hallado, las evidencias apuntan a que el aumento de riesgo no depende de la tipología familiar, al contrario de lo que pasa con el sexo, a su vez el consumo de tabaco, alcohol, cocaína, inhalantes, sedantes y opiáceos dependen de variaciones.

Introduction: The level of risk of consumption is established from the exposure that a person has to certain risk factors or individual, family, or social characteristics, which enable or increase the consumption of psychoactive substances (PAS). Objective: The purpose of this study was to relate the level of risk of PAS consumption with the problematic use of video games and social networks, in order to establish their possible role as social risk factors. Method: A quantitative study was carried out with a non-experimental cross-sectional design of descriptive correlational scope with the participation of 736 students. The sociodemographic questionnaire, ASSIST 3,1 screening test, social network addiction questionnaire ARS and the Video Game Related Experiences Questionnaire CERV were used as data collection instruments. Results: It was found Some results suggest greater exposure to the consumption of alcoholic substances, tobacco derivatives, cannabis derivatives and higher levels in the problematic use of social networks and video games. Conclusions: From what was found, the evidence points to the fact that increased risk does not depend on family typology, contrary to what happens with sex, in turn the consumption of tobacco, alcohol, cocaine, inhalants, sedatives and opiates depend on variations.

Factores asociados al consumo de sustancias psicoactivas de un grupo de pacientes con diagnóstico de esquizofrenia de una institución de salud mental de Medellín, Antioquia / Factors associated with the consumption of psychoactive substances in a group of patients diagnosed with schizophrenia from a mental health institution in Medellín, Antioquia / Fatores associados ao consumo de substâncias psicoativas em um grupo de pacientes com diagnóstico de esquizofrenia de uma instituição de saúde mental de Medellín, Colômbia

Objetivo: establecer la relación entre factores sociodemográficos y clínicos con el con­sumo de sustancias psicoactivas (SPA) en un grupo de pacientes con diagnóstico de esquizofrenia, atendidos en una institución de salud mental de la ciudad de Medellín, Colombia. Metodología: estudio observacional, retrospectivo de intención analítica, de un grupo de 268 pacientes atendidos en una institución de salud mental de Medellín, en los últi­mos seis meses del año 2021. Se identificaron factores sociodemográficos, de consumo de SPA y clínicos como tipo de medicamentos, reingresos hospitalarios y adherencia al tratamiento farmacológico. Se consideraron valores de Odds Ratio con intervalo de confianza (IC95%) y se identificaron factores asociados al consumo por medio de un modelo de regresión logística. Resultados: se identificó que el 34.7% de la muestra reporta consumo de SPA; variables clínicas asociadas, tipo de medicamentos, número de ingresos hospitalarios y adherencia al tratamiento. Se encontraron diferencias significativas en la edad entre el grupo de consumidores y no consumidores, con una mediana de edad menor para el grupo de consumidores. Se determinó que ser hombre, tener una mediana de edad de 27 años y estar desempleado representa un riesgo mayor para el consumo de SPA. Finalmente se establece que la edad, el sexo, la ocupación y la adherencia al tratamiento, podrían predecir el consumo en un 34%. Conclusiones: los pacientes jóvenes, en su mayoría hombres, con diagnóstico de es­quizofrenia, tienen mayor riesgo de consumo de SPA, lo que implica mayor riesgo de recaídas y menor adherencia al tratamiento farmacológico.

Objective: to establish the relationship between sociodemographic and clinical factors with the consumption of psychoactive substances (PAS) in a group of patients diagnosed with schizophrenia, treated at a mental health institution in the city of Medellín, Colombia. Methodology: observational, retrospective study with analytical intent, of a group of 268 patients treated at a mental health institution in Medellín, in the last six months of 2021. Sociodemographic, SPA consumption, and clinical factors such as the type of medication, hospital readmissions and adherence to drug treatment were identified. Odds Ratio values with confidence interval (95% CI) were considered and factors associated with consumption were identified by means of a logistic regression model. Results: it was shown that 34.7% of the sample reports PAS consumption, associated clinical variables, type of medication, number of hospital admissions, and adherence to treatment. Significant differences in age were found between the group of users and non-users, with a lower median age for the group of users. It was determined that being a man, having a median age of 27 years and being unemployed represent a greater risk for the consumption of PAS. Finally, it is established that age, sex, occupation, and adherence to treatment could predict consumption by 34%. Conclusions: young patients, mostly men, with a diagnosis of schizophrenia, have a higher risk of PAS consumption, which implies a higher risk of relapse and lower adherence to drug treatment.

Objetivo: estabelecer a relação entre fatores sociodemográficos e clínicos com o consumo de substâncias psicoativas (SPA) em um grupo de pacientes diagnosticados com esquizofrenia, atendidos em uma instituição de saúde mental na cidade de Medellín, Colômbia. Metodologia:estudo observacional, retrospectivo com intenção analítica, de um grupo de 268 pacientes atendidos em uma instituição de saúde mental em Medellín, nos últimos seis meses de 2021. Foram identificados fatores sociodemográficos, consumo de SPA e clínicos quanto ao tipo de medicamento, readmissões hospitalares e adesão ao tratamento medicamentoso. Valores de Odds Ratio com intervalo de confiança (IC95%) foram considerados e fatores associados ao consumo foram identificados por meio de um modelo de regressão logística. Resultados: identificou-se que 34,7% da amostra relata consumo de SPA; variáveis clínicas associadas, tipo de medicamento, número de internações e adesão ao tratamento. Foram encontradas diferenças significativas de idade entre o grupo de usuários e não usuários, com menor mediana de idade para o grupo de usuários. Foi determinado que ser homem, ter idade mediana de 27 anos e estar desempregado representa maior risco para o consumo de SPA. Por fim, estabelece-se que idade, sexo, ocupação e adesão ao tratamento poderiam predizer o consumo em 34%. Conclusões: pacientes jovens, em sua maioria homens, com diagnóstico de esquizofrenia, apresentam maior risco de consumo de SPA, o que implica maior risco de recaída e menor adesão ao tratamento medicamentoso

Guidelines for integrating spirituality into the prevention and treatment of alcohol and other substance use disorders

Alcohol and other substance use disorders are complex problems with multiple variables and determinants, requiring a multidimensional approach to prevention and treatment. A robust body of research shows that religiosity and spirituality (R/S) play a prominent role in these disorders; however, how to apply this knowledge remains unclear. We present practical guidelines on how to integrate R/S into substance use prevention and treatment in an ethical, evidence-based manner. These guidelines have been endorsed by prominent academic leaders in these topics and by health associations affiliated with the three major Brazilian religions. The integration of R/S is part of a respectful, person-centered, interdisciplinary approach, which imposes neither religious beliefs nor secular worldviews. The most critical interventions include collecting a history of spiritual and religious beliefs, practices, and experiences and evaluating how these may be used positively in treatment. It is also essential that health professionals are encouraged to value and respect the R/S of patients, and that religious groups recognize that professional and technical interventions can make a valuable contribution to preventing and treating these disorders.

Substance use disorders and social functioning from an occupational perspective: a pre and post-study / Transtornos pelo uso de substâncias e funcionamento social sob uma perspectiva ocupacional: um pré e pós estudo

Abstract Introduction Improvements in the social functioning (SF) of people experiencing substance use disorders (SUD) can occur even without use discontinuation. Occupational Therapy (OT) performs multifaceted work on it. Objective This study analyzes the SF of people experiencing SUD before and after treatment and the contributions of OT. Method A pre and post-study before and after starting treatment for SUD in a Psychosocial Care Centre - Alcohol and other Drugs (CAPS-AD) in Brasilia, Brazil - was conducted with 35 clients based on an SF questionnaire. A measure of the participant's SF improvement was defined as the difference between the SF before treatment (SFpre) with the SF after treatment (SFafter). The association between SF and sociodemographic variables/drug/previous treatment was verified by linear regression; all analyses considered a significance level <5%. Results Most of the 35 participants were male (83%), 30-49 years old (77%), attended elementary school (57%), unemployed (57%), single (46%), Black (40%), had been treated previously (60%) and had present alcohol use disorder (46%). Overall, people undergoing treatment significantly improved their SF. Multivariate analysis showed that Whites improved their SF more (mean of 18.8± 10.4) than Pardos/Blacks (10.8± 8.7; 14.1± 6.4), and the improvement in SF was lower for participants who were taking treatment for the first time (10.3± 5.7) compared with those who had previous treatment (17.2± 9.4). Conclusion Treatment in CAPS-AD improved the SF of people experiencing SUD, and the OT professional is a key agent in improving SF due to its performance and approach to clients in vulnerable contexts.

Resumo Introdução Melhorias no funcionamento social (FS) de pessoas com transtornos pelo uso de substâncias (TUS) podem ocorrer mesmo sem descontinuar o uso. A terapia ocupacional realiza um trabalho multifacetado sobre isso. Objetivo Este estudo analisa o funcionamento social das pessoas com transtornos pelo uso de substâncias antes e depois do tratamento e contribuições da terapia ocupacional. Método Um pré e pós-estudo - antes e depois do tratamento para TUS em um Centro de Atenção Psicossocial álcool/drogas (CAPS-AD) em Brasília, Brasil - foi realizado com 35 clientes com um questionário sobre FS. A melhora do FS foi definida como a diferença entre o valor do FS antes (FSpre) e depois do tratamento (FSafter). A associação entre o FS e as variáveis sociodemográficas/drogas/tratamento anterior foi verificada por regressão linear; foi considerado um nível de significância <5%. Resultados A maioria era homens (83%), 30-49 anos de idade (77%), com ensino fundamental (57%), desempregados (57%), solteiros (46%), negros (40%), com tratamento anterior (60%), e apresentavam TU de álcool (46%). Em geral, as pessoas submetidas a tratamento melhoraram significativamente seu FS. A análise multivariada mostrou que os brancos melhoraram mais seu FS (média de 18.8± 10.4) que os Pardos/Negros (10.8± 8.7; 14.1± 6.4), e foi menor entre os que estavam fazendo tratamento pela primeira vez (10.3± 5.7) em comparação com os que o fizeram anteriormente (17.2± 9.4). Conclusão O tratamento no CAPS-AD melhorou o FS das pessoas com TUS, o profissional terapeuta ocupacional é um agente chave para melhorar o FS devido a sua atuação e abordagem em contextos vulneráveis.

Vivências e sentidos do uso prejudicial de álcool e outras drogas / Experiences and meanings of the harmful use of alcohol and other drugs / Experiencias y significados del consumo nocivo de alcohol y otras drogas

Objetivo: compreender os sentidos e as vivências de uso prejudicial de álcool e outras drogas, sob a ótica de usuários da Rede de Atenção Psicossocial. Método: estudo qualitativo, descritivo, exploratório, que entrevistou 13 participantes adultos nos meses de setembro a dezembro de 2019. A análise firmou-se nos aportes da análise de conteúdo temática de Bardin, resultando as categorias, perdas e fracasso na vida, culpa, dualismo vida e morte - das cinzas à fênix, recaída. Resultados: o uso de substâncias remete a perdas familiares, de moradia, trabalho, dignidade; a destruição, fracasso. A recaída denota falha, pecado; acarreta culpa, auto-estigma. O sofrimento trespassa as tentativas de buscar do cuidado; reverbera na perda do sentido da vida, no comportamento suicida ou na resiliência e esperança-equilibrista. Conclusão: a clínica ampliada deve valorizar a geografia afetiva dos usos e a redução de danos.

Objectives: to understand the meanings and experiences of harmful use of alcohol and other drugs, from the perspective of users of the Psychosocial Care Network. Method: qualitative, descriptive, exploratory study that interviewed 13 adult participants in the months from September to December 2019. The analysis was based on Bardin's thematic content analysis, resulting in the categories, loss and failure in life, guilt, life and death dualism - from ashes to phoenix, relapse. Results: substance use refers to loss of family, housing, work, dignity; destruction, failure. Relapse denotes failure, sin; it brings guilt, self-stigma. Suffering goes through the attempts to seek care; it reverberates in the loss of the meaning of life, suicidal behavior or resilience and hope-equilibrist. Conclusion: the expanded clinic must value the affective geography of uses and harm reduction.

Objetivos:comprender los significados y experiencias del uso nocivo de alcohol y otras drogas, desde la perspectiva de los usuarios de la Red de Atención Psicosocial. Método: estudio cualitativo, descriptivo, exploratorio, que entrevistó a 13 participantes adultos en los meses de septiembre a diciembre de 2019. El análisis se basó en el análisis de contenido temático de Bardin, resultando en las categorías, pérdida y fracaso en la vida, culpa, dualismo vida y muerte - de las cenizas al ave fénix, recaída. Resultados:el uso de sustancias se refiere a pérdidas familiares, vivienda, trabajo, dignidad; destrucción, fracaso. La recaída denota fracaso, pecado; conlleva culpa, autoestigma. El sufrimiento pasa por los intentos de buscar atención; reverbera en la pérdida del sentido de la vida, conducta suicida o resiliencia y esperanza-equilibrista. Conclusión: la clínica ampliada debe valorar la geografía afectiva de los usos y la reducción de daños.

Early discharge predictors among inpatient crack cocaine users

Abstract Introduction High rates of early hospital discharge are often observed in crack cocaine users and are related to adverse outcomes and increased public spending. This study evaluated clinical and sociodemographic factors associated with early treatment discharge among crack users. Methods The sample comprised 308 men diagnosed with crack cocaine use disorder (crack only), aged 18 to 65 years, admitted between 2013 and 2017 to a male-only hospital unit to treat substance use disorders. Sociodemographic and clinical data were obtained using the Addiction Severity Index, 6th version, and a Sociodemographic Questionnaire. Results Early discharge (within 7 days) was significantly associated with lack of own income, insufficient family support, being single, and recent homelessness. Regarding drug use, lower treatment retention was related to younger age of crack use onset, recent alcohol use, and nicotine use. Factors such as age, skin color, and educational level showed no relation to the outcome. Conclusion Our findings suggest that presence of characteristics verifiable at the time of admission may be related to crack users' treatment retention. Identification of these factors can contribute to target interventions in order to improve treatment adherence in crack cocaine users.

Estudo retrospectivo de caracterização epidemiológica de queixa, diagnóstico e população pouco explorados num serviço de urgência de psiquiatria da infância e adolescência / Retrospective study of the epidemiological characterization of little explored complaints, diagnoses and population in a child and adolescent psychiatry emergency service

Introdução: A prevalência de transtornos mentais na população pediátrica é presumida em 13,4%. Porém, apenas um em cada seis recebe tratamento apropriado, evidenciando a lacuna entre necessidade e acesso à assistência. Isso resulta em maior risco para situações de crise psicossocial, especialmente entre aqueles em situações de vulnerabilidade com acesso limitado a recursos de tratamento. Diante da diversidade de temas no cenário de urgência em psiquiatria da infância e adolescência (PIA), nosso estudo escolhe tópicos menos explorados, visando compreender fatores sociodemográficos que levam essa população ao serviço de urgência de PIA. Objetivos: Caracterização epidemiológica de queixa (irritabilidade e uso de substâncias), diagnóstico (Autismo) e população (adolescentes em medidas socioeducativas) pouco explorados num serviço de urgência de PIA. Métodos: Estudo transversal retrospectivo realizado pela análise de prontuários dos pacientes, de até 18 anos, atendidos no período de 01 de junho de 2017 a 31 de maio de 2018 na urgência de PIA de um serviço de Belo Horizonte. Resultados: Agressividade, agitação e irritabilidade foram as queixas mais comuns no atendimento de urgência. A irritabilidade esteve associada ao diagnóstico de transtorno de humor sem especificação no atendimento de urgência. Transtorno do Espectro Autista foi o único diagnóstico associado à busca de atendimento por irritabilidade, com taxa de primodiagnóstico de 23% e em idade tardia. O uso de maconha, cocaína e álcool foi comum entre os pacientes atendidos na urgência, e a depressão foi o diagnóstico mais relacionado ao uso de substâncias (SPA). 24,8% dos atendimentos com relato de uso de SPA envolviam adolescentes em medidas socioeducativas (SE). Estes, frequentemente relataram vivências traumáticas e maior chance de quadros de transtornos relacionados ao estresse, de conduta e por uso de SPA. Conclusões: Os achados reforçam a hipótese de que as unidades de urgência podem servir como ponto inicial de diagnóstico e acesso de crianças e adolescentes com transtornos mentais, destacando possíveis lacunas na atenção básica. As unidades de SE parecem precisar aprimorar a abordagem de questões ligadas ao uso de SPA. Compreender as características da população que frequenta a urgência de PIA permite debater estratégias para prevenção e tratamento de transtornos com impacto na rede de cuidados da infância e adolescência.

Introduction: The prevalence of mental disorders in the pediatric population is estimated at 13.4%. However, only one in every six individuals receives adequate treatment, highlighting the gap between necessity and access to care. This disparity results in an elevated risk for psychosocial crisis situations, particularly among those in vulnerable circumstances with limited access to treatment resources. Given the diversity of issues in the context of child and adolescent psychiatry (CAP) emergencies, our study focuses on less explored topics, aiming to comprehend the sociodemographic factors that lead this population to seek urgent care in CAP settings. Objectives: Epidemiological characterization of underexplored complaints (Irritability and Substance Use), diagnosis (Autism) and population (Adolescents imprisoned) in a CAP emergency service. Methods: Retrospective cross-sectional study conducted through the analysis of medical records of patients, up to 18 years, attended at the CAP emergency department of a facility in Belo Horizonte, during the period from June 1, 2017, to May 31, 2018. Results: Aggressiveness, agitation and irritability were the most frequent complaints in emergency care. Irritability was associated with the diagnosis of unspecified mood disorder in the clinical setting. Autism Spectrum Disorder was the only pre-existing diagnosis associated with seeking care due to irritability, with a first-diagnosis rate of 23%, occurring later in age. The use of marijuana, cocaine, and alcohol was prevalent among patients attending the emergency department, with depression being the diagnosis most closely linked to the substance use (SU). Among cases involving reported of SU, 24.8% involved adolescents within socio-educational measures (SE), who often reported traumatic experiences. This group also exhibited higher likelihood of stress-related disorders, conduct disorders, and SU-related conditions. Conclusions: The findings reinforce the hypothesis that emergency units can serve as an initial point of contact for children and adolescents with mental disorders, highlighting potential gaps in primary care. SE units demonstrated a need for improvement in addressing issues related to SU. By comprehending the population frequenting the CAP emergency department, it becomes possible to discuss strategies for the prevention and treatment of disorders with impacts on the childhood and adolescence care network.

Adolescentes usuários de substâncias psicoativas: experiências e desafios durante a internação psiquiátrica / Adolescent users of psychoactive substances: experiences and challenges during psychiatric hospitalization

Resumo Introdução O alcance do cuidado e a adesão ao tratamento de adolescentes usuários de substâncias psicoativas (SPA) é um desafio para profissionais e pesquisadores. Compreender os contextos situacionais e os itinerários percorridos por adolescentes pode auxiliar a busca de soluções para essa problemática. Objetivo Identificar as experiências e desafios durante a internação psiquiátrica a partir da percepção de adolescentes usuários de SPA. Método Estudo exploratório, qualitativo com a participação de quatro adolescentes com histórico de internação psiquiátrica, vinculados a dois Centros de Atenção Psicossocial - álcool e outras drogas (CAPSad) em diferentes cidades do interior do Estado de São Paulo, Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas abordando uso de SPA, percursos e contexto de vida, itinerário terapêutico e vivências durante a internação. As respostas foram transcritas na íntegra e analisadas pelo método de Análise de Conteúdo de Bardin. Resultados Os resultados evidenciaram início precoce do uso de SPA, experiências de uso abusivo de SPA, vulnerabilidade no contexto sociofamiliar e histórico de internações involuntárias. Os principais desafios vivenciados e retratados por esses adolescentes durante a internação foram: confinamento associado ao longo período de reclusão, distanciamento familiar, falta de segurança e carência de abordagens terapêuticas. Conclusão Evidenciou-se dificuldade de inserção dos adolescentes usuários de SPA nos dispositivos da Rede de Atenção Psicossocial dos municípios, assim como nos processos de articulação e responsabilização do cuidado. Há uma discrepância entre o que está preconizado e indicado nas políticas públicas e nas premissas da atenção psicossocial em comparação com a realidade de adolescentes internados em hospitais psiquiátricos.

Abstract Introduction The scope of care and adherence to treatment of adolescent users of psychoactive substances (PAS) is a challenge for professionals and researchers. Understanding the situational contexts and itineraries taken by adolescents can assist in searching for solutions to this problem. Objective Identify the experiences and challenges during psychiatric hospitalization from the perception of adolescent users of PSA. Method This is an exploratory, qualitative study conducted with four adolescents with a history of psychiatric hospitalization, linked to two Psychosocial Care Centers - alcohol and other drugs (CAPSad) in different cities in the interior of the state of São Paulo, Brazil. Data were collected through semi-structured interviews on substance use, life paths and context, therapeutic itinerary, and experiences during hospitalization. The responses were fully transcribed and analyzed using Bardin's Content Analysis method. Results The results showed an early start of PAS use, experiences of PAS abuse, vulnerability in the socio-family context, and a history of involuntary hospitalizations. The main challenges experienced and reported by these adolescents during hospitalization were: confinement associated with the long seclusion period, distance from family, lack of safety, and lack of therapeutic approaches. Conclusion It has become evident that there is a significant challenge in integrating adolescent users of PAS into the Psychosocial Care Network devices within municipalities, as well as into the processes of coordination and accountability of proper care. There is a discrepancy between what is recommended and indicated in public policies and the premises of psychosocial care versus the actual reality of adolescents in psychiatric hospitals.

Problemas de comportamento, habilidades sociais, abuso de substâncias e práticas educativas em adolescentes / Behavior problems, social skills, substance abuse and educational practices in adolescents / Problemas de conducta, habilidades sociales, abuso de sustancias y prácticas educativas en adolescentes

A literatura aponta relações entre comportamentos de adolescentes e práticas educativas, mas poucos estudos discriminam o tipo de problema, bem como examinam múltiplas variáveis simultaneamente O objetivo da presente pesquisa foi comparar as habilidades sociais, as práticas educativas e o uso de substâncias de adolescentes com problemas exclusivamente internalizantes ou externalizantes e com comorbidades (internalizante e externalizante) com um grupo de adolescentes sem problemas, em amostras separadas pelo sexo. Os adolescentes foram alocados nos grupos clínico e não clínico a partir do YSR, as variáveis sociais foram investigadas pelo IHSA, o uso abusivo de drogas pelo DUSI, e as práticas educativas pelo IEP. Para comparar os grupos, utilizou-se o Teste Mann Whitney e o qui-quadrado. As variáveis estaticamente significativas foram: habilidades sociais e práticas educativas (para meninos e meninas dos grupos externalizante e comorbidade), uso de drogas (meninas e externalizante); somente práticas educativas (para meninos e meninas do grupo internalizante)

The literature points out relationships between adolescent behavior and educational practices, but few studies specify the type of problem or examine multiple variables simultaneously. The objective was to compare social skills, educational practices and substance use of adolescents with internalizing, externalizing and comorbidity problems with a group of adolescents without problems, in samples separated by sex. The inclusion criteria for the clinical and non-clinical groups was obtained from the YSR, social variables from the SSI-Del-Prette, drugs from the DUSI, and educational practices from the IEP. To compare groups, we used the Mann-Whitney and chisquared tests. The statistically significant variables were: social skills and educational practices (for boys and girls from the externalizing and comorbidity groups), use of drugs (girls and externalizing); only educational practices (for boys and girls from the internalizing group)

La literatura señala relaciones entre los comportamientos de los adolescentes y las prácticas educativas, pero pocos estudios ni discriminan el tipo de problema ni examinan múltiples variables simultáneamente. El objetivo fue comparar habilidades sociales, prácticas educativas, habilidades sociales y consumo de sustancias de adolescentes con problemas de conducta internalización, externalización, comorbilidad, con un grupo de adolescentes sin problemas, en muestras separadas por sexo. El criterio de inclusión para adolescentes en los grupos clínico y no clínico se obtuvo del YSR, las variables sociales del IHSA-Del-Prette, los medicamentos del DUSI y las prácticas educativas del IEP. Para comparar los grupos, se utilizaron las pruebas de Mann-Whitney y chi cuadrado. Las variables estadísticamente significativas fueron: habilidades sociales y prácticas educativas (para niños y niñas de los grupos de externalización y comorbilidad), consumo de drogas (niñas y externalización); solo prácticas educativas (para niños y niñas del grupo internalización)

Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown

Background: Temporary shelters were established for street-based people during the national level 5 coronavirus disease 2019 (COVID-19) lockdown. However, street-based substance users' need to access substances was not addressed, resulting in large numbers of people experiencing withdrawal. The Community Oriented Substance Use Programme (COSUP) in Tshwane provided methadone to manage opioid withdrawal. Methods: A cross-sectional, descriptive study was conducted using the daily methadone dosing records from shelters in Tshwane between March 2020 and September 2020. Results: The final analysis included 495 participants, of which 64 (12.9%) were initiated on 20 mg ­ 30 mg of methadone, 397 (80.2%) on 40 mg ­ 50 mg, and 34 (6.9%) on 60 mg ­ 70 mg. A total of 194 (39.2%) participants continued their initiation dose for 1­2 months, after which 126 (64.9%) had their doses increased, and 68 (35.1%) had their doses decreased. Approximately 12 (2.4%) participants were weaned off methadone after 1­3 months and 46 (9.3%) after 4­6 months. In all, 100 (20.2%) participants left the shelter prematurely and did not continue with methadone. A total of 126 (25.5%) participants continued to stay in the shelters and received methadone for 6 months, with 125 (25.3%) participants leaving the shelter with continued follow-up at a COSUP site. Conclusion: This study demonstrates variability in methadone dosing regimens among shelter residents. As the lockdown measures eased, many chose to leave the shelters, while others remained to receive methadone and other services. The COSUP appears to be effective during periods of increased vulnerability, since a large number of participants were successfully followed up. Contribution: Opioid dependence is a persistent, lifelong disease. It is multifaceted with complex environmental and individual determinants. This study highlighted the use of opioid substitution therapy during a period of increased vulnerability.

Impulsividade, fissura e comportamentos sexuais de risco em usuários de cocaína / Impulsivity, craving and risky sexual behavior in cocaine users

O estudo teve por objetivo avaliar as possíveis relações entre impulsividade, fissura e comportamentos sexuais de risco entre usuários de cocaína. Trata-se de um estudo transversal, de abordagem quantitativa. A amostra foi composta por 80 indivíduos acolhidos em duas Comunidades Terapêuticas (CTs). Os instrumentos utilizados foram: Informações sociodemográficas, Escala de Impulsividade de Barrat (BIS-11); o Crack Craving Questionnaire - Brief (CCQB) e Questionário sobre uso de substâncias e comportamentos sexuais (SUSBS). Da amostra, todos eram do sexo masculino adultos, com baixas condições socioeconômicas, acolhidos há mais de um mês, usuários crônicos de múltiplas drogas, sendo as mais usadas: o álcool, a maconha, a cocaína e o crack. Os participantes foram classificados como altamente impulsivos (33,3%), com nível grave de fissura (67,9%), perda o controle sobre o uso de substância (70,5%), metade usava drogas para melhorar o desempenho sexual, 45% concordaram que o uso era para favorecer a atividade sexual e 43% consideram o sexo indissociável do uso de substâncias. A fissura (CQB-B) foi associada com a impulsividade, mas não com o tipo de substância usada. Os resultados mostram a importância compreender e avaliar os entrelaces entre impulsividade, fissura e comportamentos sexuais entre usuários de substâncias psicoativas, assim como ir além da investigação desses problemas, com intuito de melhorar as práticas preventivas para os comportamentos sexuais de risco nas CTs

The study aimed to evaluate the associations between impulsivity, craving, and risky sexual behaviors among cocaine users. This is a cross-sectional study, with a quantitative approach. The sample consisted of 80 individuals hosted in two Therapeutic Communities in the region of Ribeirão Preto, SP. Sociodemographic information, the Barrat Impulsivity Scale (BIS-11); the Crack Craving Questionnaire - Brief (CCQ-B) and, the Substance Use and Sexual Risk Behavior Questionnaire (SUSBS) were used. Of the sample, all were adult males, with low socioeconomic conditions, housed for more than a month, chronic users of multiple drugs, the most used being: alcohol, marijuana, cocaine and crack. Participants were classified as highly impulsive (33.3%), with a severe level of craving (67.9%), loss of control over substance use (70.5%), half used drugs to improve sexual performance, 45% agreed that use was to promote sexual activity and 43% considered sex to be inseparable from substance use. Craving (CCQBB) was associated with impulsivity, but not with the type of substance used. The results show the importance of understanding and evaluating the links between impulsivity, craving and sexual behaviors among users of psychoactive substances, as well as going beyond investigating these problems, with the aim of improving preventive practices for risky sexual behaviors in TCs

Health and functioning benefits of aerobic exercise rehabilitation for substance abuse-induced mental and behavioral disorders: a systematic review / 中国康复理论与实践

ObjectiveTo examine the interventions and health benefits of aerobic exercise for substance abusers using International Classification of Diseases, Eleventh Revision (ICD-11) and International Classification of Functioning, Disability and Health (ICF) framework. MethodsThe PICO framework was developed and randomized controlled trials were searched in PubMed, Web of Science, Embase, and CNKI dated from the inception of the databases to April, 2023. Then a systematic review was conducted. ResultsSeven randomized controlled trials involving 498 participants from three countries were included. The studies were mainly published in international journals such as International Journal of Mental Health and Addiction, Psychiatry Research, Mental Health and Physical Activity, BMC Sports Science, and Medicine and Rehabilitation, and covered the period from 2010 to 2022. The substance abusers in the included studies were classified into seven categories of mental and behavioral disorders, including methamphetamine dependence, cocaine dependence, cannabis dependence, opioid dependence, sedative dependence, heroin dependence, and ketamine dependence. Aerobic exercise activities included running, cycling, Tai Chi, Qigong, yoga, jumping rope, climbing, etc., with a frequency of 20 to 60 minutes per session, one to ten times per week. The activity intensity was mainly concentrated in moderate to high intensity, and the duration ranged from 12 to 48 weeks. The health outcomes were evaluated in six aspects: physical motor function, cognitive function, emotional functioning, medication cravings, physical fitness, and overall function and quality of life. ConclusionBased on ICD-11 and ICF, a theoretical framework was constructed to evaluate the health effects of aerobic exercise for substance abusers. Aerobic exercise could improve flexibility and balance, grip strength, vertical jump height, and sit and reach distance, as well as enhance physical fitness, strength, flexibility, speed and agility in substance abusers' physical function. In terms of cognitive function, aerobic exercise could help to improve working memory, attention and executive function, as well as cognitive and neurological functions. Aerobic exercise rehabilitation could also improve psychological health, such as anxiety, depression and fatigue, and increase the ability to resist substance dependence in substance abusers. In addition, aerobic exercise rehabilitation could improve physical fitness, such as body mass, blood pressure and blood lipid levels, and reduce the risk of cardiovascular disease, diabetes and other diseases. It could also improve overall social function, increase social adaptability and quality of life, and reduce the risk of substance abuse relapse in substance abusers.

Consumo de sustancias: caracterización de pacientes pertenecientes a la unidad de salud mental adultos- Hospital Hernán Henríquez Aravena / Substance use: characterization of patients belonging to the adult mental health unit - Hernán Henríquez Aravena Hospital

Introducción: las sustancias psicoactivas han formado parte de la existencia humana por miles de años, han sido empleadas con distintos fines, consolidando su uso y abuso durante los últimos años como una condición altamente prevalente en la sociedad. Actualmente, existen gran cantidad de sustancias y, así mismo, diversas formas de clasificación. En términos de prevalencia mundial hasta el momento no hay un estándar de oro que permita medir de manera exacta el consumo según cada región geográfica, lo que dificulta el estudio y constituye un desafío al momento de realizar comparaciones entre regiones. No obstante, en términos de prevalencia mundial, la sustancia más consumida es el alcohol, seguida por cannabis, opioides, anfetaminas y cocaína respectivamente. Objetivo: caracterizar pacientes adultos del policlínico de salud mental del Hospital Hernán Henríquez Aravena con diagnóstico relacionado al consumo de sustancias y establecer las principales sustancias consumidas. Materiales y Método: se realizó un estudio descriptivo transversal en la población objetivo mediante revisión de fichas clínicas de pacientes adultos atendidos en policlínico de salud mental del Hospital Hernán Henríquez Aravena, durante los años 2018, 2019, 2020. Los antecedentes recolectados del estudio se analizaron según la población general y se compararon según género. Resultados: en la muestra estudiada, 73.2% de los consumidores son de sexo masculino, siendo el alcohol la sustancia de mayor consumo, seguida por cocaína, marihuana y benzodiacepinas.

Introduction: psychoactive substances have been part of the existence of humanity for thousands of years and have been used for different purposes, consolidating its use and abuse in recent years as a highly prevalent condition in our society. They are a large number of substances, and also various forms of classification. In terms of world prevalence, to date, there is no gold standard method that allows the exact measurement of substance consumption to each geographical region, which makes the study difficult and constitutes a challenge when making comparisons between regions. However, in terms of world prevalence, the most consumed substance is alcohol, followed by cannabis, opioids, amphetamines, and cocaine respectively. Objective: characterize adult patients of the mental health polyclinic of the Hernán Henríquez Aravena Hospital with a diagnosis related to substance use and establish the main substances consumed. Material and Method: A cross-sectional descriptive study was carried out in the target population by reviewing the clinical records of adult patients treated at the mental health polyclinic of the Hernán Henríquez Aravena Hospital, during the years 2018, 2019, and 2020. The antecedents collected from the study were analyzed according to the general population and compared according to gender. Results: In the sample studied, 73.2% of the users are male, alcohol being the substance most consumed, followed by cocaine, marijuana, and benzodiazepines

Vasculitis inducida por cocaína-levamisol con manifestaciones cutáneas, articulares y abdominales: reporte de caso / Cocaine-levamisole induced vasculitis with cutaneous, joint and abdominal manifestations: case report

Resumen El levamisol es un antiparasitario de uso veterinario que actualmente es empleado para aumentar el volumen y la potencia de la cocaína. La mezcla de estas dos sustancias puede causar un cuadro caracterizado por lesiones propias de la cocaína, como la afección del cartílago septal con perforación del tabique nasal, y vasculitis cutánea de pequeños vasos con afectación de los pabellones auriculares y del cartílago nasal, afección conocida como vasculitis inducida por cocaína-levamisol (VICOL) que puede avanzar a necrosis e incluso ulceraciones cutáneas, asociadas a agranulocitosis, artralgias y glomerulonefritis . En el presente artículo se describe el caso de un paciente con historia de consumo de sustancias en quien se encontraron lesiones purpúricas palpables en miembros superiores, tronco, pabellones auriculares y miembros inferiores. Se consideró una clínica sugestiva de VICOL dado el antecedente de consumo de sustancias. En el proceso diagnóstico se descartaron entidades como la vasculitis por anticuerpos contra el citoplasma de los neutrófilos (ANCAs) y crioglobulinemia, entre otras posibles afecciones. Se llevó a cabo un tratamiento con esteroides y con ello presentó una respuesta adecuada, pero luego recurrieron los síntomas, particularmente abdominales, los cuales se consideraron asociados con vasculitis. Se le brindó manejo adicional con ciclofosfamida y nuevos pulsos de esteroides, con que se logró el control total de los síntomas. A través este caso se resaltan entonces los ejercicios diagnósticos y clínicos en la vasculitis cocaína- levamisol, y se sugiere la consideración de los síntomas abdominales como posible componente del cuadro vasculítico.

Abstract Levamisole is an antiparasitic agent for veterinary use. Currently it is used to increase the volume and potency of cocaine. Levamisole and cocaine combined result in the septum nasal perforation and small-vessel vasculitis in the ears and nasal cartilage. These findings are known as cocaine levamisole-induced vasculitis and can progress to necrosis and even skin ulceration, which is associated with agranulocytosis, arthralgia, and glomerulonephritis. This article describes the case of a patient with a history of substance abuse in whom palpable purpuric lesions were found in the upper and lower limbs, trunk, and ears. A clinical condition suggestive of vasculitis induced by cocaine-levamisole was considered, given the history of substance consumption. In the diagnostic process, entities such as Anti-neutrophil Cytoplasmic Antibodiy (ANCA) vasculitis and cryoglobulinemia, among other possible conditions, were ruled out. Steroid treatment was carried out, to which the patient had an adequate response, but then symptoms recurred, particularly abdominal, which were associated with vasculitis. Additional management with cyclophosphamide and new steroid pulses were provided, and with those symptom control was achieved. In this case report highlights the diagnostic and clinical exercises in cocaine levamisole vasculitis and is suggested the consideration of abdominal symptoms as a possible component of the vasculitis flare.

Calidad de Vida, Ansiedad, Depresión y Consumo de Alcohol en Adultos con Diabetes Tipo Dos durante la Pandemia por COVID-19 / Quality of Life, Anxiety, Depression, and Alcohol Consumption in Adults with Type 2 Diabetes during the COVID-19 Pandemic

Resumen El objetivo de este estudio fue relacionar la calidad de vida, el consumo de alcohol, la depresión y ansiedad en pacientes con diabetes tipo 2 (DT2) durante la pandemia de COVID-19. Se aplicó una encuesta a un total de 119 pacientes con DT2 seleccionados mediante un muestreo no probabilístico intencional de la zona centro del país, con al menos un año de diagnóstico. Para evaluar la calidad de vida se utilizó la escala diabetes-39, la escala de autoevaluación de la depresión de Zung, la escala de ansiedad de Hamilton y la prueba de identificación de trastornos por uso de alcohol. Los hallazgos son: correlaciones positivas entre la preocupación por la disminución en la calidad de vida en todas las áreas con la ansiedad. Así como consumo de riesgo en hombres y calidad de vida, señalando mayor consumo de alcohol en esta población. Estos resultados indican que tener diabetes tipo 2 es un predisponente para presentar problemas de salud mental como: ansiedad, depresión y consumo de alcohol, lo que señala la importancia de trabajar con esta población en el periodo de postpandemia.

Abstract The aim of this study was to relate quality of life, alcohol consumption, depression, and anxiety in patients with type 2 diabetes (T2D) during the COVID-19 pandemic. A survey was applied to a total of 119 patients with T2D selected by non-probability purposive sampling from the central part of the country, with at least one year of diagnosis. The diabetes-39 quality of life scale, the Zung Depression Self-Assessment Scale, the Hamilton Anxiety Scale and the Alcohol Use Disorders Identification Test were used. The findings are positive correlations between concern for diminished quality of life in all areas with anxiety. As well as risk consumption in men and quality of life, indicating higher alcohol consumption in this population. These results indicate that having type 2 diabetes is a predisposing factor for presenting mental health problems such as anxiety, depression and alcohol consumption, which points to the importance of working with this population in the post-pandemic period.