Lifeworld: socio-environmental influence on crack cocaine use by teenagers.

OBJECTIVE: To understand the influence of the lifeworld on crack cocaine use by teenagers undergoing treatment at the Psychosocial Care Center for users of alcohol and other drugs. METHOD: Qualitative research carried out with thirteen teenagers attended at the Psychosocial Care Center for users of alcohol and other drugs, from a municipality in the South of Brazil. The data were collected through semi-structured interviews and the Comprehensive Analysis was carried out from the Phenomenology of the Social World of Alfred Schütz. RESULTS: In the lifeworld, there is influence of the community to which the teenager belongs; of the family, by the excess of permissibility and being in an environment of drug use and violence; and the school, where it is influenced by individuals to consume them. CONCLUSION: Elements from the lifeworld influence the teenager for the consumption of crack cocaine, being necessary actions contextualized with their world of life.

Evaluation of families of crack users in relation to support groups.

OBJECTIVE: to evaluate the perception of the relatives of crack users in relation to the support groups offered to this population in a Psychosocial Care Center for Alcohol and Drugs in the South of Brazil. METHOD: the fourth-generation theoretical framework was used for evaluation, having as methodological device the hermeneutical-dialectic circle. Data collection occurred through 500 hours of observations and interviews with 12 relatives of crack users, and the comparative constant method was used in the analysis, generating the "family group" unit of meaning. RESULTS: this group was regarded by the family members as a space for guidance on the management of users in their home environment. They reported the need for a basic structure to conduct the groups, greater duration of the meetings, confidentiality of information and diversity of timetables. FINAL CONSIDERATIONS: investment in education and training of nursing professionals focused on group care is suggested to the education institutions.

Portraits on the crack user built by the media.

OBJECTIVE: evaluate how the crack user is portrayed by the media. METHOD: qualitative study, using fourth generation evaluation. The data were collected in interviews and field observations in a mental health network service of the Porto Alegre-RS metropolitan area. The participants were 10 users, 11 family members, 08 health service professionals and 07 managers. RESULTS: the findings revealed that media relates the crack user profile to violence, crime and disease, which does not correspond to the reality experienced in the health service. This image disregards the different ways of using the drug and the different productions of life of these individuals, increasing social exclusion and stigma. FINAL CONSIDERATIONS: The challenge is to build shared, integrated, clear and honest information.

Portraits on the crack user built by the media / Retratos construidos por los medios de comunicación sobre el usuario de crack / Retratos construídos pela mídia sobre o usuário de crack

ABSTRACT Objective: evaluate how the crack user is portrayed by the media. Method: qualitative study, using fourth generation evaluation. The data were collected in interviews and field observations in a mental health network service of the Porto Alegre-RS metropolitan area. The participants were 10 users, 11 family members, 08 health service professionals and 07 managers. Results: the findings revealed that media relates the crack user profile to violence, crime and disease, which does not correspond to the reality experienced in the health service. This image disregards the different ways of using the drug and the different productions of life of these individuals, increasing social exclusion and stigma. Final considerations: The challenge is to build shared, integrated, clear and honest information.

RESUMEN Objetivo: evaluar cómo el usuario de crack es retratado por los medios de comunicación. Método: estudio cualitativo, utilizando la evaluación de cuarta generación. Los datos fueron recolectados en entrevistas y observaciones de campo en un servicio de la red de salud mental del área metropolitana de Porto Alegre-RS. Participaron 10 usuarios, 11 familiares, 08 profesionales del servicio de salud y 07 gestores. Resultados: Los resultados revelaron que los medios de comunicación divulgan un perfil del usuario de crack vinculado a la violencia, la criminalidad y la enfermedad, lo que no corresponde a la realidad vivida en el servicio de salud. Esta imagen desconsidera las diferentes maneras de uso de la droga y las diferentes producciones de vida de esos individuos, aumentando la exclusión social y el estigma. Consideraciones finales: el desafío es construir informaciones compartidas, integradas, claras y honestas.

RESUMO Objetivo: avaliar como o usuário de crack é retratado pela mídia. Método: estudo qualitativo, utilizando-se avaliação de quarta geração. Os dados foram coletados em entrevistas e observações de campo em um serviço da rede de saúde mental da região metropolitana de Porto Alegre-RS. Os participantes foram 10 usuários, 11 familiares, oito profissionais do serviço de saúde e sete gestores. Resultados: os achados revelaram que a mídia divulga um perfil do usuário de crack ligado à violência, criminalidade e doença, o que não corresponde à realidade vivenciada no serviço de saúde. Essa imagem desconsidera as diferentes maneiras de uso da droga e as diferentes produções de vida desses indivíduos, aumentando a exclusão social e o estigma. Considerações finais: o desafio é construir informações compartilhadas, integradas, claras e honestas.

Evaluation of families of crack users in relation to support groups / Evaluación de las familias de usuarios de crack en el grupo de apoyo / Avaliação das famílias de usuários de crack sobre grupo de apoio

ABSTRACT Objective: to evaluate the perception of the relatives of crack users in relation to the support groups offered to this population in a Psychosocial Care Center for Alcohol and Drugs in the South of Brazil. Method: the fourth-generation theoretical framework was used for evaluation, having as methodological device the hermeneutical-dialectic circle. Data collection occurred through 500 hours of observations and interviews with 12 relatives of crack users, and the comparative constant method was used in the analysis, generating the "family group" unit of meaning. Results: this group was regarded by the family members as a space for guidance on the management of users in their home environment. They reported the need for a basic structure to conduct the groups, greater duration of the meetings, confidentiality of information and diversity of timetables. Final considerations: investment in education and training of nursing professionals focused on group care is suggested to the education institutions.

RESUMEN Objetivo: evaluar la percepción de los familiares de usuarios de crack sobre grupos de apoyo ofertados a ese núcleo de cuidado en un CAPS (Centro de Atención Psicosocial) Alcohol y Drogas del sur de Brasil. Método: se utilizó el referencial teórico de la evaluación de cuarta generación, teniendo como dispositivo metodológico el círculo hermenéutico-dialéctico. La recolección de datos ocurrió a través de 500 horas de observaciones y entrevistas con 12 familiares de usuarios de crack, y en el análisis se utilizó el método comparativo constante, que generó la unidad de significado "grupo de familia". Resultados: ese grupo fue evaluado por los familiares como un espacio que instrumentaliza para el manejo del usuario en domicilio. Evaluaron la necesidad de estructura básica para la realización de los grupos, de mayor duración de los encuentros, de sigilo de las informaciones y de diversidad de horarios. Consideraciones finales: se sugiere a las instituciones de enseñanza inversiones en la formación y en la calificación de profesionales de enfermería dirigidos a la atención en grupo.

RESUMO Objetivo: avaliar a percepção dos familiares de usuários de crack sobre grupos de apoio ofertados a esse núcleo de cuidado em um Caps Álcool e Drogas do sul do Brasil. Método: utilizou-se o referencial teórico da avaliação de quarta geração, tendo como dispositivo metodológico o círculo hermenêutico-dialético. A coleta de dados ocorreu através de 500 horas de observações e entrevistas com 12 familiares de usuários de crack, e na análise foi utilizado o método comparativo constante, que gerou a unidade de significado "grupo de família". Resultados: esse grupo foi avaliado pelos familiares como um espaço que instrumentaliza para o manejo do o usuário em domicílio. Avaliaram a necessidade de estrutura básica para a realização dos grupos, de maior duração dos encontros, de sigilo das informações e de diversidade de horários. Considerações finais: sugere-se às instituições de ensino investimentos na formação e na qualificação de profissionais da enfermagem voltados para o atendimento em grupo.

Lifeworld: socio-environmental influence on crack cocaine use by teenagers / Mundo de la vida: la influencia socioambiental para el consumo de crack por adolescentes / Mundo da vida: influência socioambiental para o consumo de crack por adolescentes

ABSTRACT Objective: To understand the influence of the lifeworld on crack cocaine use by teenagers undergoing treatment at the Psychosocial Care Center for users of alcohol and other drugs. Method: Qualitative research carried out with thirteen teenagers attended at the Psychosocial Care Center for users of alcohol and other drugs, from a municipality in the South of Brazil. The data were collected through semi-structured interviews and the Comprehensive Analysis was carried out from the Phenomenology of the Social World of Alfred Schütz. Results: In the lifeworld, there is influence of the community to which the teenager belongs; of the family, by the excess of permissibility and being in an environment of drug use and violence; and the school, where it is influenced by individuals to consume them. Conclusion: Elements from the lifeworld influence the teenager for the consumption of crack cocaine, being necessary actions contextualized with their world of life.

RESUMEN Objetivo: Comprender la influencia del mundo de la vida en el consumo de crack por adolescentes en tratamiento en un Centro de Atención Psicosocial para usuarios de alcohol y otras drogas. Método: Investigación cualitativa realizada con trece adolescentes atendidos en el Centro de Atención Psicosocial para usuarios de alcohol y otras drogas de un municipio del Sur de Brasil. Los datos fueron recolectados por medio de entrevistas semiestructuradas y el Análisis Comprensivo se realizó a partir de la Fenomenología Social de Alfred Schütz. Resultado: En el mundo de la vida, hay influencia de la comunidad a la que pertenece el adolescente; de la familia, por el exceso de permisibilidad y ser ambiente de uso de drogas y violencia; y de la escuela, donde es influenciado por los individuos a consumirlos. Conclusión: Los elementos del mundo de la vida influencian los adolescentes al consumo de crack, y son necesarias acciones contextualizadas con su mundo de la vida.

RESUMO Objetivo: Compreender a influência do mundo da vida no consumo de crack por adolescentes em tratamento em Centro de Atenção Psicossocial para usuários de álcool e outras drogas. Método: Pesquisa qualitativa realizada com treze adolescentes atendidos no Centro de Atenção Psicossocial para usuários de álcool e outras drogas, de um município do Sul do Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas e a Análise Compreensiva realizou-se a partir da Fenomenologia Social de Alfred Schütz. Resultado: No mundo da vida, há influência da comunidade a qual o adolescente pertence; da família, pelo excesso de permissibilidade e estar em ambiente de uso de drogas e violência; e da escola, onde é influenciado por indivíduos a consumi-las. Conclusão: Elementos do mundo da vida influenciam o adolescente para o consumo de crack, sendo necessárias ações contextualizadas com seu mundo da vida.

Un Jalón, Un Volteón, y Otra Vez: High-Risk Crack Smoking Paraphernalia in México City.

During the past decade, crack smoking has increased in Mexico among poor urban populations. Despite this increasing prevalence, little is known about the types of paraphernalia used and related sharing practices and physical harms. Data come from in-depth semi-structured interviews and observations with 156 current crack smokers in Mexico City. Findings reveal a complex, crack-smoking process in Mexico City that represents an interconnected structure of paraphernalia items and pipes that could contribute to detrimental health consequences. Specifically, we identify essential paraphernalia items that make the smoking of crack possible; describe the homemade construction of two categories of pipes; and detail the sharing practices and physical harms associated with these paraphernalia. Results point towards a smoking process that is embedded in impoverished urban neighborhoods sustained by an accessible street-level crack market. Discussed are the policy and intervention implications associated with reducing crack-related health consequences in Mexico and other Latin American countries.

Characteristics of clients using a community-based drug treatment service ('CAPS-AD') in Brazil: An exploratory study.

BACKGROUND: Substance use is common in Brazil. In order to improve availability of substance misuse care services, over 400 Psycho-Social Care Centres for Alcohol and Drugs (CAPS-AD) - providing community-based care - have been established following mental health care reform (2001). Information on CAPS-AD clients and outcomes is limited. The present study examined select characteristics of local CAPS-AD clients. METHODS: N=143 adult CAPS-AD clients in Ceilândia (suburb of Brasília, Federal District) participated in a 1-week 'snapshot' assessment of service users (February 2015). Following consent, descriptive data were collected by a brief, anonymous interviewer-administered questionnaire that included socio-demographic, drug use, treatment history and needs/barriers information. RESULTS: Participants were predominantly male; middle-aged; unemployed; married; with middle-school education; primary problem drugs indicated were alcohol and cocaine/crack; half had prior treatment histories and indicated that treatment was externally motivated; 60% reported ways to improve treatment and possible reasons for treatment discontinuation; in multi-variate analyses, the latter was associated with employment and education status (both p<.05). CONCLUSION: CAPS-AD services appear to have increased low-barrier substance misuse treatment availability in Brazil, as well as attract individuals new to the treatment system. Various potential barriers to continuing in treatment should be addressed and more research on CAPS-AD clients and outcomes is needed.

Consumo autoreportado de sustancias psicoactivas ilegales en una población habitante de calle de Cali-Colombia / Self-Reported consumption of illegal psychoactive substances in a street inhabitant population from Cali, Colombia

Objetivo Determinar la prevalencia autoreportada de consumo de sustancias psicoactivas ilegales en una población habitante de calle de la ciudad de Cali. Métodos: Estudio descriptivo de prevalencia de periodo. La población objetivo fueron 763 habitantes de calle registrados durante el año 2010 en la base de datos proporcionada por un hogar de paso de la ciudad de Cali. El análisis estadístico se realizó en R versión 3.2.0. Investigación sin riesgo según la resolución 8430 de 1993. Resultados El 76,9 % de los habitantes de calle reconoce que consume algún tipo de sustancia psicoactiva ilegal (SPAI). Las sustancias que presentaron mayor prevalencia de consumo en esta población fueron: la marihuana (51,2 %), el bazuco (44,6 %) y la cocaína (11,3 %). Se encontró que 28,6 % de los habitantes de calle consumen SPAI más de tres veces por día y que la principal vía de administración es fumada (54,7 %). La mitad de los entrevistados manifestó haber estado internado alguna vez en un centro de rehabilitación. Discusión Las cifras del presente estudio muestran que el consumo de SPAI afecta de manera significativa la población habitante de calle, siendo la marihuana y el bazuco las de mayor uso, situación compleja si se tiene en cuenta su fácil acceso y los graves efectos degenerativos que causan en la salud física y mental de quienes las consumen. Por esto es necesario apoyar iniciativas encaminadas a intervenir este fenómeno social.(AU)

Objective To determine the prevalence of self-reported use of illegal psychoactive substances in a homeless population of the city of Cali. Method Descriptive study of prevalence of period. The target population was 763 homeless people registered during 2010 in the database provided by a temporary shelter facility in the city of Cali. Statistical analysis was performed using R version 3.2.0. Research safe according to the resolution 8430 of 1993. Results 76.9 % of the homeless population recognizes that they consume some type of illegal psychoactive substance (IPAS). The substances with a higher prevalence of use in this population were: marijuana (51.2 %), the crack cocaine (44.6 %) and cocaine (11.3 %). 28.6 % of homeless people were found to consume IPAS more than three times a day and that the main route of administration is smoke (54.7 %). 50% of respondents reported having been hospitalized at some time in a rehabilitation center. Discussion The results in this study show that the problem of PASI consumption significantly affects the population of homeless people, with marijuana and crack cocaine being the most commonly used, which is a complex situation if the easy access of these substances and the severe physical and mental degenerative effects the cause in those who consume them are taken into account. Therefore it is necessary to support initiatives aimed at intervening in this social phenomenon.(AU)

Complicações gastrintestinais em usuários de cocaína/crack: revisão da literatura / Gastrointestinal complications among users of cocaine / crack-a literature review

O consumo de cocaína/crack atinge todos os extratos sociais e grande parcela da população, principalmente os jovens. Esse abuso leva à ampla gama de complicações sistêmicas. No trato gastrintestinal, pode se expressar por manifestações como perfuração gastroduodenal aguda, colite isquêmica, infarto, isquemia intestinal e, raramente, hemorragia maciça. Seu mecanismo fisiopatológico parece ser o vasoespasmo ou vasoconstrição, que pode levar à isquemia, inclusive com necrose transmural. É importante a atenção e vigilância para o abuso de cocaína/crack ao deparar com paciente com dor abdominal inexplicável. (AU)

Cocaine/crack have being consumed by a large portion of the population especially by youth and reaching all social levels. This abuse leads to a wide range of systemic complications. In the gastrointestinal tract, the drug can lead to manifestations such as acute gastroduodenal perforation, ischemic colitis, infarction, intestinal ischemia and, rarely, massive hemorrhage. The most accepted pathophysiological mechanism is vasospasm or vasoconstriction which can lead to ischemia, including transmural necrosis. It is important that physicians to be aware and search recent history of abuse of crack / cocaine when faced with a patient with unexplained abdominal pain. (AU)