Comparison of traffic data and blood alcohol concentration among fatally injured drivers in Norway and Sao Paulo, Brazil, 2005-2015.

Objective: Road traffic crashes (RTCs) are responsible for a large number of deaths worldwide, but low- and middle-income countries frequently present higher rates of deaths; for example, Norway, a high-income country, has a rate of 2.0 drivers killed per 100,000 inhabitants, whereas Brazil, a middle-income country, has a rate of 18.4. A significant fraction of RTCs are related to use of psychoactive substances, especially alcohol, due to its availability, legality, and relatively low price. The aim of the present study was to evaluate differences in alcohol-related fatal RTCs in Sao Paulo, the largest city in Brazil, and Norway during an 11-year period (2005-2015). Methods: The authors compared databases of drivers killed in RTCs in Sao Paulo and in Norway, a country renowned for its success in reducing traffic fatalities and keeping them at a low level. Results: In total, 772 victims from Norway (11 years, 2005 to 2015) and 584 victims from Sao Paulo (2 years, 2005 and 2015) were analyzed. Sao Paulo presented higher proportions of motorcycle drivers, men involved in RTCs, and blood alcohol concentration (BAC)-positive cases. The mean BAC for alcohol-positive cases was similar in both sites. For both regions, the percentage of alcohol-positive cases decreased during the study period (from 45.6% to 35.3% in Sao Paulo and from 24.4% to 15.8% in Norway) but remained higher for Sao Paulo. Conclusions: The study shows a different profile of RTC victims and higher alcohol consumption among drivers in Sao Paulo. The differences between the sites can possibly be attributed to public policies regarding traffic safety and alcohol control, which could be further improved by following the Norwegian model in Sao Paulo.

Alcohol use by suicide victims in the city of Sao Paulo, Brazil, 2011-2015.

Excessive alcohol consumption is a serious public health issue, because drunkenness affects critical judgment and self-control which could trigger violent and self-harm behavior, with thus a potential association between alcohol consumption and suicide deaths. The objective of the present study was to assess the association between alcohol consumption and suicide deaths in the city of Sao Paulo, Brazil, from 2011 to 2015, and its relationship with socio-demographic characteristics of the victims and the circumstances of the suicide. A cross-sectional retrospective study was conducted by collection of data from 1,700 suicide victims subjected to examination of blood alcohol concentration (BAC) from toxicology reports from the Institute of Legal Medicine of the State of Sao Paulo, Brazil. Alcohol was detected in blood samples of 30.2% of the victims and mean BAC levels were 1.73 ± 0.08 g/L. The mean age of the victims was 39.90 ± 0.75 years. The majority of the victims were male (74.6%) and the prevalence of positive BAC was higher amongst men (34.7%) than women (17.1%), p<0.05. The majority of the victims were white skinned (64.7%), but there was a higher proportion of victims with positive BAC among mulatto and black individuals, p<0.05. Hanging was the most prevalent suicide method in the sample (48.7%) and amongst men (55.4%), but amongst women it was jumping from a height (35%), p < 0.05.

Blood alcohol levels in suicide by hanging cases in the state of Sao Paulo, Brazil.

Suicide is one of the main causes of violent death worldwide, and has become a public health issue. Since alcohol consumption is associated with the increase in the number of suicides and hanging is one of the main methods used worldwide, the present study consists of an epidemiological analysis of BACs in victims of suicide by hanging autopsied in the State of Sao Paulo, Brazil. The objective of the present work was to establish an epidemiological profile and evaluate blood alcohol concentrations in victims of suicide by hanging in the State of São Paulo, Brazil, in the year of 2007. A cross-sectional retrospective study was conducted by collection of secondary data from autopsy reports of victims of hanging. According to the present study, positive results for alcohol were higher in male victims, but the mean BAC was higher in women.

Crack cocaine use in Barcelona: a reason of worry.

In Spain, crack cocaine use is silently increasing. In Barcelona, an intentional sample was selected to describe the general characteristics of this consumption. Participants were submitted to an interview and data were analyzed through qualitative research procedures. Users are young males and of low socioeconomic status and formal education. The major pattern of use is compulsive. Illegal income activities are the choice for crack cocaine or money acquisition, increasing individual and social health costs. Polydrug use is a matter of concern. Although these findings can not be generalized, they should be considered for the development of public policies to adequately address crack cocaine users' needs.

Drug consumption among medical students in São Paulo, Brazil: influences of gender and academic year.

OBJECTIVE: To analyze alcohol, tobacco and other drug use among medical students. METHOD: Over a five-year period (1996-2001), we evaluated 457 students at the Universidade de São Paulo School of Medicine, located in São Paulo, Brazil. The students participated by filling out an anonymous questionnaire on drug use (lifetime, previous 12 months and previous 30 days). The influence that gender and academic year have on drug use was also analyzed. RESULTS: During the study period, there was an increase in the use of illicit drugs, especially inhalants and amphetamines, among the medical students evaluated. Drug use (except that of marijuana and inhalants) was comparable between the genders, and academic year was an important influencing factor. DISCUSSION: Increased inhalant use was observed among the medical students, especially among males and students in the early undergraduate years. This is suggestive of a specific behavioral pattern among medical students. Our findings corroborate those of previous studies. CONCLUSION: Inhalant use is on the rise among medical students at the Universidade de São Paulo School of Medicine. Because of the negative health effects of illicit drug use, further studies are needed in order to deepen the understanding of this phenomenon and to facilitate the development of preventive measures.

Drug consumption among medical students in São Paulo, Brazil: influences of gender and academic year / Consumo de drogas entre estudantes de medicina em São Paulo: influências de gênero e ano letivo

OBJECTIVE: To analyze alcohol, tobacco and other drug use among medical students. METHOD: Over a five-year period (1996-2001), we evaluated 457 students at the Universidade de São Paulo School of Medicine, located in São Paulo, Brazil. The students participated by filling out an anonymous questionnaire on drug use (lifetime, previous 12 months and previous 30 days). The influence that gender and academic year have on drug use was also analyzed. RESULTS: During the study period, there was an increase in the use of illicit drugs, especially inhalants and amphetamines, among the medical students evaluated. Drug use (except that of marijuana and inhalants) was comparable between the genders, and academic year was an important influencing factor. DISCUSSION: Increased inhalant use was observed among the medical students, especially among males and students in the early undergraduate years. This is suggestive of a specific behavioral pattern among medical students. Our findings corroborate those of previous studies. CONCLUSION: Inhalant use is on the rise among medical students at the Universidade de São Paulo School of Medicine. Because of the negative health effects of illicit drug use, further studies are needed in order to deepen the understanding of this phenomenon and to facilitate the development of preventive measures.

OBJETIVO: Analisar o consumo de álcool, tabaco e outras drogas entre os estudantes de Medicina da Faculdade de Medicina da Universidade de São Paulo dentro de um período de cinco anos (1996-2001). MÉTODO: Participaram 457 universitários que responderam a um questionário anônimo sobre o uso de drogas (medidas: uso na vida, nos últimos 12 meses e nos últimos 30 dias). A influência do gênero e do ano letivo do universitário sobre o uso de drogas também foi analisada. RESULTADOS: Em cinco anos, houve um aumento do uso de drogas ilegais entre os estudantes de Medicina da Faculdade de Medicina da Universidade de São Paulo, especialmente de inalantes e anfetaminas. Há uma convergência desse consumo entre os gêneros (exceto para maconha e inalantes) e o ano letivo é fator interferente de relevância. DISCUSSÃO: Entre os estudantes de Medicina da Faculdade de Medicina da Universidade de São Paulo, observou-se um aumento do uso de inalantes, especialmente entre os alunos do sexo masculino e dos primeiros anos de graduação. Sugere-se que seja um comportamento específico dos estudantes de Medicina, tendo corroborado com os resultados de estudos prévios. CONCLUSÃO: O uso de inalantes é crescente entre os universitários de Medicina da Faculdade de Medicina da Universidade de São Paulo. Devido aos seus efeitos nocivos sobre a saúde, outros estudos são necessários para aprofundar a compreensão desse fenômeno, assim como para que sejam desenvolvidas medidas de prevenção que interrompam sua evolução.

Álcool em vítimas de suicídio em São Paulo / Alcohol in suicide victims in Sao Paulo

CONTEXTO: A tendência a comportamentos violentos e impulsivos é aumentada após o consumo de álcool, sendo importante para a etiologia de mortes por causas externas. Nesse contexto, os suicídios aparecem como uma atitude impulsionada pelo consumo de álcool, ou como uma expressão da mesma patologia que leva ao abuso de substância. OBJETIVOS: Como carecemos de dados nacionais sobre suicídios sob a influência de álcool, o objetivo do presente estudo foi analisar a prevalência do consumo de álcool previamente ao suicídio. MÉTODOS: Leitura direta de 632 laudos necroscópicos de vítimas de suicídios necropsiadas no Instituto Médico-Legal do Estado de São Paulo no ano de 2005. RESULTADOS: Dos 632 casos analisados, 33,1 por cento apresentaram alcoolemia positiva, sendo essa prevalência maior para os homens (37,1 por cento) do que para as mulheres (20,1 por cento). Os enforcamentos apresentaram a maior prevalência de alcoolizados, com 38,9 por cento dos casos; as intoxicações apresentaram a maior média, com 1,78 g/L. CONCLUSÕES: Os resultados mostram que cerca de um terço dos suicídios na amostra foram cometidos subseqüentemente ao consumo de álcool, com diferenças entre os diversos métodos.

BACKGROUND: A tendency toward violent and impulsive behavior is enhanced following the consumption of alcohol and is important in determining the etiology of deaths by external causes. In this context suicide appears to result from an attitude brought about by alcohol consumption or an expression of that same pathology which leads to substance abuse. OBJECTIVES: Considering the inexistence nationwide of data on suicides occurring under the influence of alcohol, the aim of the present study was to analyze the prevalence of alcohol consumption prior to suicide. METHODS: Direct analysis of 632 medical examinerÆs reports on suicide victims autopsied at the ExaminerÆs Office (Instituto Médico-Legal) of the State of Sao Paulo, in the year 2005. RESULTS: Of the 632 cases reviewed, 33,1 percent presented a positive Blood Alcohol Concentration (BAC), with a higher occurrence in the case of men (37,1 percent) than that of women (20,1 percent). Hangings presented the highest prevalence of intoxicated victims, at a rate of 38,9 percent of the cases; intoxications presented the highest BAC mean, at 1,78 g/L. CONCLUSIONS: The results demonstrate that roughly speaking, about one third of the suicides in our sample carried out by differing methods were subsequent to alcohol consumption.

Drogas ilícitas e trânsito: problema pouco discutido no Brasil: [revisão] / Illegal drugs and the traffic: a problem rarely discussed in Brazil: [review]

CONTEXTO: Dirigir é uma tarefa complexa na qual o condutor recebe informação continuamente, analisa-a e reage a respeito desta. Substâncias que influem nas funções cerebrais ou em processos mentais envolvidos na condução certamente irão afetar o desempenho do condutor. Alterações motoras provocadas por drogas ilícitas têm recebido crescente atenção em anos recentes como uma possível ameaça à segurança no trânsito. Pesquisas têm indicado a presença de drogas psicoativas em motoristas mortos ou feridos em acidentes de trânsito, e estudos experimentais mostram prejuízo na performance de indivíduos sob efeito de drogas. OBJETIVOS: Em razão de esse problema ser pouco discutido em nosso país, embora seja preocupante, este trabalho visa fornecer dados sobre o problema do uso de drogas por motoristas, a legislação brasileira vigente sobre drogas e direção veicular e quais são as medidas que podem ser adotadas para que os acidentes de trânsito relacionados ao uso de drogas sejam reduzidos. MÉTODOS: Revisão bibliográfica de trabalhos publicados nos últimos quinze anos. RESULTADOS: Os trabalhos mais relevantes apontaram claros indícios de prejuízo na capacidade de dirigir sob efeito de drogas psicotrópicas. CONCLUSÕES: Todas as drogas psicotrópicas causam prejuízos nas funções psicomotoras e riscos aumentados de envolvimento em acidentes de trânsito, sendo necessária uma legislação específica que aborde esse tema.

BACKGROUND: Driving is a complex task in which the driver receives, analyzes and reacts to information continuously. Substances that influence brain functions and/or mental processes involved in driving will certainly affect the driverÆs performance. Psychomotor alterations caused by illegal drugs have received growing attention in recent years as a possible threat to roadway safety. Research has shown the presence of psychoactive drugs in drivers who were killed or injured in driving accidents, and experimental studies have shown impairment in the performance of individuals under the influence of drugs. OBJECTIVES: This study aims to present data on the problem of drug abuse by drivers, the current Brazilian legislation on driving and drug abuse, and what possible measures might be adopted in order to reduce drug-related driving accidents. METHODS: The method applied was a literature review of the last fifteen years of publications. RESULTS: The most relevant publications indicate clear evidence of impairment in driving skills under the influence of psychotropic drugs. CONCLUSIONS: All psychotropic drugs cause impairment in psychomotor functions and as such, a higher risk of involvement in driving accidents, which makes specific legislation dealing with this issue necessary.