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1.
Int J Prev Med ; 11: 1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32042398

RESUMO

BACKGROUND: The aim of this study is to identify the information and communication technologies used by health professionals to assist in training and updating of technical and scientific knowledge about crack, exchange of experiences, and development of programs to prevent consumption and treatment of addicts. METHODS: The qualitative methodology was used, constructed an intentional sample by criteria and applied research techniques through semi-structured interviews, triangulation of the analysis, and key informants. The study resulted in the presentation of differences between the way key informants and health professionals sought information. RESULTS: Internet was the preferred source; however, key informants sought information on sites of scientific journals and reference centers, while health professionals did free searches on the internet to consume information. CONCLUSIONS: The literature does not reflect a broad scope of the specific area, but relates the problem of access to health information to other characteristics. The sources of information about crack are focused on digital technologies, the internet and its specific tools. It also finds that health professionals are not being capacitate solidly on the subject of study.

2.
Rev Saude Publica ; 49: 70, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26465662

RESUMO

OBJECTIVE To analyze temporal trends of the prevalence of alcohol and tobacco use among Brazilian students.METHODS We analyzed data published between 1989 and 2010 from five epidemiological surveys on students from the 6th to the 12th grade of public schools from the ten largest state capitals of Brazil. The total sample consisted of 104,104 students and data were collected in classrooms. The same collection tool - a World Health Organization self-reporting questionnaire - and sampling and weighting procedures were used in the five surveys. The Chi-square test for trend was used to compare the prevalence from different years.RESULTS The prevalence of alcohol and tobacco use varied among the years and cities studied. Alcohol consumption decreased in the 10 state capitals (p < 0.001) throughout 21 years. Tobacco use also decreased significantly in eight cities (p < 0.001). The highest prevalence of alcohol use was found in the Southeast region in 1993 (72.8%, in Belo Horizonte) and the lowest one in Belem (30.6%) in 2010. The highest past-year prevalence of tobacco use was found in the South region in 1997 (28.0%, in Curitiba) and the lowest one in the Southeast in 2010 (7.8%, in Sao Paulo).CONCLUSIONS The decreasing trend in the prevalence of tobacco and alcohol use among students detected all over the Country can be related to the successful and comprehensive Brazilian antitobacco and antialcohol policies. Despite these results, the past-year prevalence of alcohol consumption in the past year remained high in all Brazilian regions.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Estudantes/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/tendências , Brasil/epidemiologia , Estudos Transversais , Humanos , Prevalência , Análise Espaço-Temporal , Inquéritos e Questionários , Uso de Tabaco/tendências
3.
BMC Public Health ; 15: 706, 2015 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-26209238

RESUMO

BACKGROUND: In Brazil, crack cocaine use remains a healthcare challenge due to the rapid onset of its pleasurable effects, its ability to induce craving and addiction, and the fact that it is easily accessible. Delayed action on the part of the Brazilian Government in addressing the drug problem has led users to develop their own strategies for surviving the effects of crack cocaine use, particularly the drug craving and psychosis. In this context, users have sought the benefits of combining crack cocaine with marijuana. Our aim was to identify the reasons why users combine crack cocaine with marijuana and the health implications of doing so. METHODS: The present study is a qualitative study, using in-depth interviews and criteria-based sampling, following 27 crack cocaine users who combined its use with marijuana. Participants were recruited using the snowball sampling technique, and the point of theoretical saturation was used to define the sample size. Data were analyzed using the content analysis technique. RESULTS: The interviewees reported that the combination of crack cocaine use with marijuana provided "protection" (reduced undesirable effects, improved sleep and appetite, reduced craving for crack cocaine, and allowed the patients to recover some quality of life). CONCLUSIONS: Combined use of cannabis as a strategy to reduce the effects of crack exhibited several significant advantages, particularly an improved quality of life, which "protected" users from the violence typical of the crack culture. Crack use is considered a serious public health problem in Brazil, and there are few solution strategies. Within that limited context, the combination of cannabis and crack deserves more thorough clinical investigation to assess its potential use as a strategy to reduce the damage associated with crack use.


Assuntos
Comportamento Aditivo/psicologia , Cannabis , Transtornos Relacionados ao Uso de Cocaína/psicologia , Cocaína Crack , Fumar Maconha/psicologia , Adulto , Comportamento Aditivo/epidemiologia , Brasil , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Comorbidade , Comportamento Perigoso , Feminino , Humanos , Masculino , Fumar Maconha/epidemiologia , Pesquisa Qualitativa
4.
Rev. saúde pública (Online) ; 49: 70, 2015. tab, graf
Artigo em Inglês | LILACS | ID: biblio-962155

RESUMO

OBJECTIVE To analyze temporal trends of the prevalence of alcohol and tobacco use among Brazilian students. METHODS We analyzed data published between 1989 and 2010 from five epidemiological surveys on students from the 6th to the 12th grade of public schools from the ten largest state capitals of Brazil. The total sample consisted of 104,104 students and data were collected in classrooms. The same collection tool - a World Health Organization self-reporting questionnaire - and sampling and weighting procedures were used in the five surveys. The Chi-square test for trend was used to compare the prevalence from different years. RESULTS The prevalence of alcohol and tobacco use varied among the years and cities studied. Alcohol consumption decreased in the 10 state capitals (p < 0.001) throughout 21 years. Tobacco use also decreased significantly in eight cities (p < 0.001). The highest prevalence of alcohol use was found in the Southeast region in 1993 (72.8%, in Belo Horizonte) and the lowest one in Belem (30.6%) in 2010. The highest past-year prevalence of tobacco use was found in the South region in 1997 (28.0%, in Curitiba) and the lowest one in the Southeast in 2010 (7.8%, in Sao Paulo). CONCLUSIONS The decreasing trend in the prevalence of tobacco and alcohol use among students detected all over the Country can be related to the successful and comprehensive Brazilian antitobacco and antialcohol policies. Despite these results, the past-year prevalence of alcohol consumption in the past year remained high in all Brazilian regions.


OBJETIVO Analisar a tendência temporal da prevalência de uso de álcool e tabaco por estudantes brasileiros. MÉTODOS Foram analisados, entre 1989 e 2010, dados de cinco inquéritos epidemiológicos com estudantes do sexto ano do ensino fundamental ao terceiro do ensino médio, matriculados em escolas públicas nas 10 maiores capitais do Brasil. A amostra foi de 104.104 estudantes e os dados foram coletados em sala de aula. O instrumento de coleta - questionário de autopreenchimento da Organização Mundial da Saúde - e os procedimentos de amostragem e ponderação foram os mesmos nos cinco inquéritos. Teste de Qui-quadrado de tendências foi utilizado para comparar as prevalências entre os anos. RESULTADOS A prevalência de uso de álcool e tabaco variou nos anos e entre as capitais estudadas. O uso de álcool diminuiu em todas as 10 capitais (p < 0,001), em 21 anos. Houve também diminuição significativa do uso de tabaco em oito capitais (p < 0,001). A maior prevalência de uso de álcool foi observada na região Sudeste, em 1993 (72,8% em Belo Horizonte), e a menor, em Belém (30,6%), em 2010. A maior prevalência de uso do tabaco no último ano foi na região Sul, em 1997 (28,0% em Curitiba) e a menor na região Sudeste, em 2010 (7,8% em São Paulo). CONCLUSÕES A tendência de queda na prevalência de tabagismo e uso de álcool entre estudantes, observada em todo o País, pode estar relacionada com políticas antitabaco e antiálcool bem-sucedidas e abrangentes. Apesar destes resultados, a prevalência de uso de álcool no último ano continuou elevada em todas as regiões brasileiras.


Assuntos
Humanos , Adolescente , Estudantes/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Uso de Tabaco/epidemiologia , Brasil/epidemiologia , Consumo de Bebidas Alcoólicas/terapia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Análise Espaço-Temporal , Uso de Tabaco/terapia
5.
Clinics (Sao Paulo) ; 68(4): 489-94, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23778342

RESUMO

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Comportamento do Adolescente , Distribuição por Idade , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Assunção de Riscos , Instituições Acadêmicas , Distribuição por Sexo , Fatores Socioeconômicos , Sexo sem Proteção/estatística & dados numéricos
6.
Clinics ; 68(4): 489-494, abr. 2013. tab
Artigo em Inglês | LILACS | ID: lil-674241

RESUMO

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously. .


Assuntos
Adolescente , Feminino , Humanos , Masculino , Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Comportamento do Adolescente , Distribuição por Idade , Brasil/epidemiologia , Preservativos , Métodos Epidemiológicos , Assunção de Riscos , Instituições Acadêmicas , Distribuição por Sexo , Fatores Socioeconômicos , Sexo sem Proteção/estatística & dados numéricos
7.
Clinics ; 68(4): 489-494, abr. 2013. tab
Artigo em Inglês | Sec. Munic. Saúde SP, EMS-Acervo | ID: sms-9335

RESUMO

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously. .(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Comportamento do Adolescente , Distribuição por Idade , Brasil/epidemiologia , Preservativos , Métodos Epidemiológicos , Assunção de Riscos , Instituições Acadêmicas , Distribuição por Sexo , Fatores Socioeconômicos , Sexo sem Proteção/estatística & dados numéricos
8.
J Pediatr ; 163(2): 363-8, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23434122

RESUMO

OBJECTIVES: To test the hypothesis that first alcohol use during childhood is associated with heavy drinking patterns during adolescence and with parental drinking patterns and parental rules about alcohol consumption. STUDY DESIGN: A national cross-sectional survey of 17,371 high-school students. Students were drawn from 789 public and private schools in all the Brazilian state capitals using a multistage probabilistic sampling method and a self-report questionnaire. Weighted data were analyzed through logistic regression testing for differences on the associated factors for first use of alcohol during childhood. Survival analysis and Cox proportional hazard models were used to confirm results. RESULTS: Among the 82% alcohol lifetime users, 11% had first used alcohol before age 12 years. The lack of perception of possible punishment by parents is associated with childhood alcohol use (OR 2.22, 95% CI 1.67-2.95). Adolescents who first used alcohol during childhood compared with those who only used alcohol at later ages are more likely to engage in binge drinking behaviors (OR 1.57, 95% CI 1.17-2.10), to have a pattern of heavy alcohol use (OR 1.98, 95% CI 1.26-3.09), and to have recently used illegal drugs (OR 1.74, 95% CI 1.39-2.16). According to hazard ratios, students with an earlier age of onset were more likely to have used tobacco and any illegal drug in the past year. CONCLUSIONS: Childhood alcohol may be a risk factor for the most dangerous patterns of alcohol use in adolescence and is associated with parental alcohol use. Parental rules about child alcohol use must be clear because perception of punishment might delay the age of first alcohol use.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/etiologia , Adolescente , Fatores Etários , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Análise Multivariada , Estudos Retrospectivos
9.
BMC Public Health ; 13: 19, 2013 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-23302375

RESUMO

BACKGROUND: In the past, clinical study participants have suffered from the experiments that they were subjected to. Study subjects may not understand the study process or may participate in clinical studies because they do not have access to medical care. The objectives of the present study were 1. to analyze the motives that might cause a volunteer to participate as a study subject; 2. to identify the social-demographic profile of this study subjects; and 3. to determine whether the motives to volunteer as a study subject are in accordance with the established legal and ethical principles for research in Brazil. METHODS: Mixed-methods research was used (a qualitative-quantitative approach). A sample of 80 volunteers underwent a semi-structured interview, which was based on a survey script that was elaborated from discussions with key informants. The sample was randomly selected from a database of clinical study volunteers that was provided by Brazilian clinical study centers. The interviews were recorded and transcribed. Descriptive statistics were used for content analysis, including contingency tables with hypothesis testing. RESULTS: The motivations for clinical study participation were linked to types of benefit. The most frequently encountered motivations were financial gain and therapeutic alternative. Altruism was not a common motivator, and when altruism was present, it was observed as a secondary motivator. All participants reported that they understood the Informed Consent Statement (ICS). However, only two parts of the form were remembered by all of the volunteers: the section on being able to leave the study at any point and the section that stated that there would be some responsible professional at their disposal for the entirety of the study. CONCLUSIONS: The present study shows that study participants are primarily motivated by personal benefit when volunteering to participate in clinical studies. Whether these study participants had an integral understanding of the ICS is not clear.


Assuntos
Ensaios Clínicos Fase I como Assunto , Ensaios Clínicos Fase III como Assunto , Experimentação Humana/estatística & dados numéricos , Consentimento Livre e Esclarecido/psicologia , Motivação , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pesquisa Qualitativa , Fatores Socioeconômicos , Adulto Jovem
11.
Rev. bras. farmacogn ; 22(1): 21-28, Jan.-Feb. 2012. tab
Artigo em Inglês | LILACS | ID: lil-607599

RESUMO

Medicinal plants (MP) have been used world-wide for the treatment or prevention of health conditions and due to their natural origin; they have been historically considered harmless. Semi-structured interviews were carried out with an intentional sample of twenty plant vendors in the city of Diadema to explore their knowledge and beliefs on the safety and efficacy of MP. Different levels of perceptions about the safety of MP were found, varying from "completely safe" to "completely harmful". The majority of the interviewees declared that "if herbs have an effect, they are also likely to have a side effect", depending on many factors such as dosage, concomitant use of other drugs, characteristics of the plant material and consumer related factors, specially those related to pregnant women, children and elderly people. Thirty-nine unexpected events related to 21 species of MP were reported. One case of serious gastrointestinal disease related to the consumption of a contaminated "slim mixture" was also described. Adverse events and other problems that result from MP are relatively uncommon, but they are almost certainly underreported and occur more often than acknowledged. This study strengthens the call for further research and educational efforts into this complex area.

12.
Rev. saúde pública ; 45(6): 1168-1175, dez. 2011.
Artigo em Português | LILACS | ID: lil-606865

RESUMO

OBJETIVO: Compreender a fissura do usuário de crack, bem como descrever os comportamentos desenvolvidos sob fissura e estratégias utilizadas para seu controle. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo com amostra intencional por critérios de 40 usuários e ex-usuários de crack em São Paulo, SP, nos anos de 2007 e 2008. Os entrevistados foram recrutados pela técnica da bola de neve e submetidos à entrevista semi-estruturada em profundidade, até a saturação teórica. Após transcrição literal, seguiu-se a análise do conteúdo das entrevistas para elaboração de inferências e hipóteses alicerçadas nessas narrativas. ANÁLISE DOS RESULTADOS: Os entrevistados estavam igualmente distribuídos quanto ao sexo, possuíam idade entre 18 e 50 anos, abrangeram todos os níveis de escolaridade e a maior parte possuía poucos recursos financeiros. Além da fissura sentida na abstinência de crack e da fissura induzida por pistas ambientais e emocionais, constatou-se um tipo de fissura que faz parte do próprio efeito do crack. Esta última apareceu como forte fator mantenedor dos binges de consumo, que foram os maiores responsáveis pelo rebaixamento de valores do usuário, sujeitando-o a práticas arriscadas para a obtenção da droga. Os métodos mais citados para a obtenção de crack ou dinheiro para comprá-lo foram: prostituição, manipulação de pessoas, endividamento, troca de pertences por crack e roubo. Foram relatadas estratégias para o alívio da fissura e táticas farmacológicas e comportamentais para evitar o seu desenvolvimento, como: comer, ter relação sexual, jogar futebol, trabalhar, evitar o contexto social de uso de crack e usar drogas que causam sonolência. CONCLUSÕES: Os binges de consumo de crack são causados pela fissura induzida durante o uso da droga. As medidas criadas pelo próprio usuário para lidar com a sua fissura melhoram sua relação com o crack e podem ser ferramenta importante para o aprimoramento do tratamento.


OBJECTIVE: To understand crack cocaine craving among users and describe craving behaviors and coping strategies. METHODOLOGICAL PROCEDURES: Qualitative study with a non-random criterion sample consisting of 40 current and former crack cocaine users conducted in São Paulo, southeast Brazil, in 2007 and 2008. Respondents were selected using snowball sampling technique. In-depth semi-structured interviews were conducted until theoretical saturation was attained. All interviews were transcribed and content analysis was performed to construct inferences and hypotheses based on the narratives. ANALYSIS OF RESULTS: The respondents showed a similar gender distribution, were 18 to 50 years of age, and had different levels of education. Most were from low-income background. In addition to craving resulting from crack cocaine withdrawal and environmental and emotional cue effects, it was found that crack cocaine itself triggers craving. The latter appeared to be a strong trigger of binge episodes. Binge episodes made them lose their moral values, and act dangerously to get more drug. The most common ways reported to get crack cocaine or money to buy it were: prostitution, manipulation of other people, go into debt, sell personal belongings to buy drug and theft. The respondents reported strategies to overcome their cravings as well as pharmacological and behavioral approaches to prevent cravings such as eating, having sex, playing soccer, working, avoiding social situations of crack use and taking depressants. CONCLUSIONS: Crack cocaine binges are caused by a craving induced by the effects of crack cocaine itself. Users develop self-control strategies to cope with their cravings that may help improve their drug use and treatment effectiveness.


OBJETIVO: Comprender el ansia de consumo por el usuario de crack, así como describir las conductas desarrolladas y estrategias utilizadas para su control. PROCEDIMIENTOS METODOLÓGICOS: Estudio cualitativo con muestra intencional por criterios de 40 usuarios y ex-usuarios de crack en Sao Paulo, Sureste de Brasil, en los años de 2007 y 2008. Los entrevistados fueron reclutados por la técnica de la bola de nieve y sometidos a la entrevista semi-estructurada en profundidad, hasta la saturación teórica. Posterior a la transcripción literal, se realizó el análisis de contenido de las entrevistas para elaboración de inferencias e hipótesis cimentadas en estas narrativas. ANÁLISIS DE RESULTADOS: Los entrevistados estaban igualmente distribuidos con respecto al sexo, poseían edad entre 18 y 50 años, abarcaron todos los niveles de escolaridad y la mayor parte poseía pocos recursos financieros. Se identificó sensación de ansia de consumo en la abstinencia de crack, inducida por señales ambientales y emocionales, como efecto de la droga. Esta última apareció como fuerte factor mantenedor de los consumos excesivos, que fueron los mayores responsables por el apocamiento de los valores del usuario, sujetándolos a prácticas arriesgadas para la obtención de drogas. Los métodos más citados para la obtención de crack o dinero para comprarlo fueron: prostitución, manipulación de personas, endeudamiento, cambio de pertenencias por crack y robo. Se relataron estrategias para el alivio del ansia de consumo y tácticas farmacológicas y conductuales para evitar su desarrollo, como: comer, tener relación sexual, jugar fútbol, trabajar, evitar el contexto social de uso de crack y usar drogas que causan somnolencia. CONCLUSIONES: Los consumos excesivos de crack son causados por el ansia de consumo inducido durante el uso de la droga. Las medidas creadas por el propio usuario para lidiar con su ansiedad mejoran su relación con el crack y pueden ser herramienta importante para perfeccionar el tratamiento.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Comportamento Aditivo/psicologia , Transtornos Relacionados ao Uso de Cocaína/psicologia , Cocaína Crack/farmacologia , Adaptação Psicológica , Brasil , Comportamento Perigoso , Entrevista Psicológica , Pesquisa Qualitativa , Comportamento Sexual
13.
Rev Saude Publica ; 45(6): 1168-75, 2011 Dec.
Artigo em Inglês, Português | MEDLINE | ID: mdl-21894428

RESUMO

OBJECTIVE: To understand crack cocaine craving among users and describe craving behaviors and coping strategies. METHODOLOGICAL PROCEDURES: Qualitative study with a non-random criterion sample consisting of 40 current and former crack cocaine users conducted in São Paulo, southeast Brazil, in 2007 and 2008. Respondents were selected using snowball sampling technique. In-depth semi-structured interviews were conducted until theoretical saturation was attained. All interviews were transcribed and content analysis was performed to construct inferences and hypotheses based on the narratives. ANALYSIS OF RESULTS: The respondents showed a similar gender distribution, were 18 to 50 years of age, and had different levels of education. Most were from low-income background. In addition to craving resulting from crack cocaine withdrawal and environmental and emotional cue effects, it was found that crack cocaine itself triggers craving. The latter appeared to be a strong trigger of binge episodes. Binge episodes made them lose their moral values, and act dangerously to get more drug. The most common ways reported to get crack cocaine or money to buy it were: prostitution, manipulation of other people, go into debt, sell personal belonging to buy drug and theft. The respondents reported strategies to overcome their cravings as well as pharmacological and behavioral approaches to prevent cravings such as eating, having sex, playing soccer, working, avoiding social situations of crack use and taking depressants. CONCLUSIONS: Crack cocaine binges are caused by a craving induced by the effects of crack cocaine itself. Users develop self-control strategies to cope with their cravings that may help improve their drug use and treatment effectiveness.


Assuntos
Comportamento Aditivo/psicologia , Transtornos Relacionados ao Uso de Cocaína/psicologia , Cocaína Crack/farmacologia , Adaptação Psicológica , Adolescente , Adulto , Brasil , Comportamento Perigoso , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Comportamento Sexual , Adulto Jovem
14.
BMC Public Health ; 10: 671, 2010 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-21050465

RESUMO

BACKGROUND: Due to marginalization, trafficking violence, conflicts with the police and organic and social psychological problems associated with the drug, crack is one of the most devastating drugs currently in use. However, there is evidence that some users manage to stay alive and active while using crack cocaine for many years, despite the numerous adversities and risks involved with this behavior. In this context, the aim of the present study was to identify the strategies and tactics developed by crack users to deal with the risks associated with the culture of use by examining the survival strategies employed by long-term users. METHOD: A qualitative research method was used involving semi-structured, in-depth interviews. Twenty-eight crack users fulfilling a pre-defined enrollment criterion were interviewed. This criterion was defined as the long-term use of crack (i.e., at least four years). The sample was selected using information provided by key informants and distributed across eight different supply chains. The interviews were literally transcribed and analyzed via content analysis techniques using NVivo-8 software. RESULTS: There was diversity in the sample with regard to economic and education levels. The average duration of crack use was 11.5 years. Respondents believed that the greatest risks of crack dependence were related to the drug's psychological effects (e.g., cravings and transient paranoid symptoms) and those arising from its illegality (e.g., clashes with the police and trafficking). Protection strategies focused on the control of the psychological effects, primarily through the consumption of alcohol and marijuana. To address the illegality of the drug, strategies were developed to deal with dealers and the police; these strategies were considered crucial for survival. CONCLUSIONS: The strategies developed by the respondents focused on trying to protect themselves. They proved generally effective, though they involved risks of triggering additional problems (e.g., other dependencies) in the long term.


Assuntos
Transtornos Relacionados ao Uso de Cocaína , Cocaína Crack/efeitos adversos , Adulto , Brasil , Transtornos Relacionados ao Uso de Cocaína/complicações , Transtornos Relacionados ao Uso de Cocaína/psicologia , Crime , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores de Risco
15.
Soc Sci Med ; 67(4): 638-46, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18501491

RESUMO

The main objective of the present work is to understand the processes used in emerging Catholic and Protestant religious interventions for recovery from drug dependence, from the vantage point of individuals subjected to them. A qualitative method and an intentional sample selected by criteria were adopted for this investigation, which was conducted in São Paulo, Brazil. An in-depth semi-structured interview was conducted with 57 predominantly male former drug users who fit the criteria: they had been submitted to non-medical religious treatments to treat dependence and were abstinent for at least 6 months. Crisis was found to be the main reason leading interviewees to seek treatment; this includes, losing family, losing employment, and experiencing severe humiliation. Evangelicals most used religious resources exclusively as treatment, showing strong aversion to the role of doctors and to any type of pharmacological treatment. A common feature of Catholic and Protestant groups is the importance ascribed to praying and talking to God, described by subjects as strongly anxiolytic, and a means to control drug craving. Confession and forgiveness, through faith conversion or penitences, respectively, appeal strongly to the restructuring of life and increase of self-esteem. Religious interventions were considered effective by the individuals who underwent them and were seen as attractive for the humane, respectful treatment they delivered. The key aspects of this type of treatment are social support provided by the receiving group, equal treatment, and instant, judgment-free acceptance. The success of these actions, then, is not only due to some "supernatural" aspect, as might be assumed, but also more to the unconditional dedication of human beings to their peers. Given the difficulty in treating drug dependence, religious interventions could be used as a complementary treatment for conventional therapies.


Assuntos
Catolicismo , Protestantismo , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Idoso , Brasil , Feminino , Processos Grupais , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores Socioeconômicos
16.
Rev. latinoam. enferm ; 13(n.esp): 888-895, out. 2005. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: lil-427376

RESUMO

O objetivo foi estimar a prevalência do uso de drogas, álcool, tabaco e o uso não médico de medicamentos psicotrópicos. Este estudo abrangeu as 107 maiores cidades do Brasil; amostra: idades entre 12 e 65 anos. Amostragem em três estágios; setores censitários; domicílios e o respondente. Entrevistadas 8.589 pessoas. O uso na vida de álcool com 68,7 por cento foi próximo aos 70,8 por cento do Chile. O uso na vida de tabaco foi de 41,1 por cento, inferior aos EUA (70,5 por cento). O uso na vida de maconha foi de 6,9 por cento próximo ao da Colômbia (5,4 por cento) e abaixo dos EUA (34,2 por cento). O uso na vida de cocaína foi 2,3 por cento, inferior aos EUA (11,2 por cento). O uso de solventes foi de 5,8 por cento, bem menor que no Reino Unido (20,0 por cento). Os estimulantes tiveram 1,5 por cento de uso na vida e os benzodiazepínicos com 3,3 por cento. Estes achados permitirão a implantação de políticas públicas adequadas à nossa realidade no campo das drogas psicotrópicas.


Assuntos
Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Visita Domiciliar , Drogas Ilícitas , Prevalência , Psicofarmacologia/estatística & dados numéricos , Psicotrópicos/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias , Brasil
17.
Addict Behav ; 30(3): 545-56, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15718070

RESUMO

The prevalence of the use in Brazil of illicit drugs, as well as of alcohol and tobacco, was determined. Further, illicit use of psychotropic medicines, and anabolic steroids were also surveyed. This study was carried out in 107 Brazilian cities with more than 200,000 inhabitants aged 12-65 years. The sampling design adopted was that of sampling per aggregates in three stages: first, the census sectors were selected; second, homes were selected among the sectors; finally, in each home, a respondent was selected in a manner independent of the interviewer. There were 8589 persons interviewed. The questionnaire utilized was that of the SAMHSA (Substance Abuse and Mental Health Services Administration) which was translated and adapted for Brazilian conditions. The lifetime use of alcohol in the 107 major cities of the country was 68.7%, which was close to numbers observed for Chile at 70.8% and the USA at 81.0%. Yet, tobacco lifetime use was 41.1% of the total, which is lower than the prevalence observed in the USA (70.5%). The data on the lifetime use of marijuana in Brazil (6.9%) approximated the findings for Colombia (5.4%), however, being much lower than that observed in the USA (34.2%) and the United Kingdom (25.0%). The prevalence of lifetime use of cocaine was 2.3%, well below the levels for the USA with 11.2% of the total population. The abuse of inhalants was 5.8% of the total, greater than that found in Colombia (1.4%) and about four times less than that in the United Kingdom with 20.0%. Among the medicaments, stimulants had a 1.5% prevalence of lifetime use, and that of benzodiazepines had similar percentages in Brazil (3.3%) and in the USA (5.8%). In this survey, only four individuals reported lifetime use of heroin, which was equivalent to about 0.04% of the sample and much lower than that in the USA with 1.2% and in Colombia reaching 1.5%. These findings will allow the implementation of public policies fitted to the situation with psychotropic drugs in Brazil.


Assuntos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Benzodiazepinas , Brasil/epidemiologia , Criança , Cidades/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Feminino , Humanos , Masculino , Abuso de Maconha/epidemiologia , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Psicotrópicos , Distribuição por Sexo , Fumar/epidemiologia , Fatores de Tempo , Saúde da População Urbana
18.
Rev Lat Am Enfermagem ; 13 Spec No: 888-95, 2005.
Artigo em Português | MEDLINE | ID: mdl-16400456

RESUMO

The objective was to estimate the prevalence of the use of drugs, alcohol, tobacco and the use of non-medical psychotropics. This study enclosed the 107 biggest cities in Brazil; sample: ages between 12 and 65 years. Sampling in three periods: tax sectors; household and the respondent. Were interviewed 8,589 people. The lifetime use of the alcohol was 68.7%, closer to 70.8% in Chile. The lifetime use of the tobacco was of 41.1%, lower than USA (70.5%). The lifetime use of the marijuana was of 6.9% closer to Colombia (5.4%) and lower than USA (34.2%). The lifetime use of the cocaine was 2.3%, lower than USA (11.2%). The lifetime use of solvent was of 5.8%, much lower than the United Kingdom (20.0%). The stimulants have had 1.5% of lifetime use and the anxiolytics with 3.3%. These findings will allow the implantation of adjusted public politics to our reality in the field of the psychotropics drugs.


Assuntos
Psicotrópicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Idoso , Brasil , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde da População Urbana
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