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1.
In. Maharajh, Hari D. ; Merrick, Joav. Social and cultural psychiatry experience from the Caribbean Region. New York, Nova Science Publishers Inc, 2010. p.269-276. (Health and human development).
Monografia em Inglês | MedCarib | ID: med-17528

RESUMO

There is little disagreement that the drug cocaine extracted from the plant Erythroxylon coca has had an extraordinary effect in the transformation of economies, lifestyles and governance. Those at the higher levels who are active in the trade, often with the consent of governments are untouchable and accumulate vast amounts of wealth and prestige, while the working class, those to whom it is peddled is further pushed downwards into the poverty line and death through drug-seeking behaviour. Not only has cocaine use resulted in social transformation but has had deleterious effects on the mental and physical health of nations. This chapter traces the history, introduction, development, culture, methods of use and effects of the use of cocaine in Trinidad and Tobago and its worldwide implications. Cocaine remains a scourge to mankind.


Assuntos
Humanos , Coca , Cocaína/economia , Cocaína/história , Cocaína Crack , Trinidad e Tobago
2.
Rev. panam. salud p£blica ; 18(4/5): 303-313, Oct.- Nov. 2005. tab
Artigo em Inglês | MedCarib | ID: med-17038

RESUMO

OBJECTIVE: The paper reviews data on drug use in relation to the spread of human immunodeficiency virus and AIDS in South America and the Caribbean. METHODS: Information was gathered by thoroughly reviewing major bibliographic databanks, web sites of international institutions and regional networks working with substance misuse or human immunodeficiency virus and AIDS, and abstracts from conferences and meetings. RESULTS: Although some gaps remain, a growing body of evidence documents the significant role of injected cocaine in the Brazilian and Southern Cone epidemics. The Caribbean and the Andean areas have thus far been changing in Southern Cone epidemics. The Caribbean and the Andean areas have thus far been spared in large part from the spread of injection drug use and its consequences, but the situation has been changing in Southern Cone countries towards a higher prevalence of harmful injection habits. Additional challenges have been posed by the increasing availability of heroin in the Andean Area and the abuse of crack cocaine and its impact on the sexual transmission of human innunodeficiency virus in many cities. Harm reduction strategies have been established in most areas of Brazil and are gaining momentum in Argentina. Other countries in the Region still face serious limitations due to restrictive legislation and lack of broader support. CONCLUSION: Greater participantion of Latin American and the Caribbean countries is research protocols and continued debate on both successful and failed experiences should be encouraged in order to minimize existilng barriers to the full adoption of effective measures to curb the human immunodeficiency virus and AIDS epidemic in this Region(AU)


Assuntos
Humanos , HIV , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Região do Caribe , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/terapia , HIV/efeitos dos fármacos , América do Sul/epidemiologia , Cocaína
3.
WEST INDIAN MED. J ; 46(Suppl 2): 22, Apr. 1997.
Artigo em Inglês | MedCarib | ID: med-2310

RESUMO

The study attempted to evaluate the influence of hormonal status (gender and oestrous cycle) on learning in male and female rats and to determine whether this difference was affected by dopamine agonists (cocaine and amphetamine). Rats were exposed to foot-shocks in a Y-maze. Exploratory and avoidance behaviours were tested on two trials, 24 hours following conditioning (Trial 1) and 2 weeks subsequently (Trial 2). Amphetamine (1mg/kg/ml) stimulated exploratory behaviour, whereas cocaine (1mg/kg/ml) had a depressant effect at Trial 1. Avoidance learning of a potentially dangerous environment was significantly less in oestrous than in diestrous and male rats. These results provide evidence that hormonal status influences learning. Cocaine and amphetamine given in a single low doses did not produce any significant effects on avoidance learning(AU)


Assuntos
Ratos , 21003 , Aprendizagem/efeitos dos fármacos , Anfetamina/farmacologia , Cocaína/farmacologia , Aprendizagem da Esquiva/efeitos dos fármacos
4.
West Indian med. j ; 46(Suppl.2): 40, Apr.1997.
Artigo em Inglês | MedCarib | ID: med-2453

RESUMO

Alkaloidal cocaine (COPC) is widely sold in the West Indies in a form suitable for smoking. These little rocks called "crack", addictive in high doses (typically 120 mg), produce a rapid, intense, high and a very compelling type of COC dependence. The bioavailability and the metabolism of the smoked form (half-life of 56 min versus 78 and 80 min, respectively, after IV and IN COC administration) conduce to low levels of metabolites in serum and in urine. Clinical and forensic toxicology laboratories are more and more solicited for testing major cocaine metabolite: benzoylecgonine (BZE). The Enzyme Multiplied Immunossay Technique (EMIT) is a fast, simple and reliable technology. However, the assay cut off concentration for BZE of the commercially available kit: (EMIT dau Cocaine Metabolite Immunoassay) is too high (300ng/ml) for serum or urine detectable levels of BZE in cocaine smokers. We proposed a modified EMIT assay to make this technique suitable for level of detection. The immunoassay was applied to ROCHE COBAS MIRA Plus analyser. The increase of the sample volume up to 25 ul and the use of calibration standards 0 to 300 ng/ml conduce to a lower detection limit of 50ng/ml. The within run precision of the assay was less than 10 percent. The results were confirmed by gas chromatography mass spectrometry. The increase of sensitivity was near 30 percent. No false positive results were observed. The presented modification demonstrates the application of currently available EMIT Immunoassay to rapid and reliable testing for BZE in cocaine smokers. (AU)


Assuntos
Humanos , Detecção do Abuso de Substâncias , Cocaína Crack/urina , Técnica de Imunoensaio Enzimático de Multiplicação , Cocaína/urina
5.
New York; PJD Publications Limited; 1997. 12 p. tab.
Monografia em Inglês | MedCarib | ID: med-16228

RESUMO

Deep seated mycoses were the most common findings in cocaine addicts who died of AIDS in Trinidad, West Indies with Candida species, Histoplasma capsulatum and Aspergillus species being the most common. Contaminated smoke either from crack cocaine, marijuana or hemp was the suspected risk factor for the acquisition of Histoplasma capsulatum and Aspergillus infection. Pneumocysitis carinii was seen in 50 percent of cases. Pulmonary infections were a feature in all cases in the study and massive hepato-splenomegaly were the most common pathological findings in Histoplasmosis. In regions where Histoplasma capsulatum is endemic, the findings of massive Hepatosplenomegaly in patients should alert the physicians to the possibility of the Acquired Immune Deficiency Syndrome as a differential diagnosis. Efforts should be made to expeditiously identify and treat these organism since they contribute significantly to the morbidity and mortality of cocaine addicts afflicted with AIDS. Prophylaxis for these specific infectious organisms should also be considered (AU)


Assuntos
Humanos , Síndrome de Imunodeficiência Adquirida , América Latina/epidemiologia , Cocaína , Infecções por HIV , Países em Desenvolvimento
6.
Kingston; s.n; 1995. 76 p.
Tese em Inglês | MedCarib | ID: med-3007

RESUMO

Within recent years, drug abuse has become a priority health problem affecting individuals and threatening the social, political and legal institutions of the region. Sadly, children, including those at school are the main victims of the consequences of drug abuse. A survey was conducted among 200 students, grades 9-11, in 4 new secondary schools in the metropolitan area of Jamaica. Through a self administered questionnaire, the study sought information on the lifetime and current prevalence of licit and illicit drugs, students' perception of the ease of obtaining these drugs, the risk involved and their attitude towards drug use. The findings revealed that there were increases in the lifetime and current prevalence in the use of cannabis, cocaine, crack, psychedelics, opiates, tobacco and alcohol. Students reported increased accessibility to these drugs and less risk involved in drug use, and many reported that they did not disapprove of trying drugs, including cocaine and crack. The highest prevalence of drug use was with alcohol, followed by tobacco and inhalants, and more males reported drugs use than females. These were compared generally to the findings of the NCDA (1987) school survey. The author concluded that drug abuse has increased in this category of students, and made recommendations including, re-evaluation of the drug abuse prevention programmes in schools; strengthening of peer counselling in schools; banning of tobacco and alcohol advertisments, and of smoking in public places and to create a data base on drug abuse for the region. (AU)


Assuntos
Humanos , Adolescente , Feminino , Masculino , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Instituições Acadêmicas/estatística & dados numéricos , Automedicação/tendências , Alcoolismo/epidemiologia , Tabagismo , Estudantes/estatística & dados numéricos , Comportamento do Adolescente , Transtornos Relacionados ao Uso de Substâncias/etiologia , Centros de Tratamento de Abuso de Substâncias , Cocaína/efeitos adversos , Jamaica/epidemiologia
8.
The Valley; s.n; Feb. 28, 1994. 5 p.
Não convencional em Inglês | MedCarib | ID: med-5012
10.
In. Anon. Prevalence and patterns of substance abusers: neurobehavioural and social dimensions: programme and abstracts. Kingston, University of the West Indies (Mona). Neuroscience, Adolescent and Drug Research Programme, 1994. p.18.
Monografia em Inglês | MedCarib | ID: med-3520

RESUMO

One of the complications of cocaine abuse is central cardiorespiratory failure. However, the site and mechanism of cocaine are unknown. The present study evaluates the effect of cocaine applied topically to the caudal and intermediate areas on the ventrolateral surface of the brainstem. These areas are known to be involved in the CO2 /pH chemosensory drive to respiration and in vasomotor control. Cats were anesthetized with urethane (2.0 g/kg), the trachea cannulated and the ventro-lateral surface of medulla oblongata (VMS) exposed. Cocaine prepared in mock CSF pH 7.4 was applied bilaterally to chemosensitive zones using pledgets. The effect of procaine was also tested. Tidal volume (Vt), respiratory frequency (f), arterial blood pressure (BP) and heart rate (HR) were monitored. Cocaine (62.5 ug/site) produced a significant decrease in minute ventilation (Ve) and blood pressure (BP) (p<0.05); the cuadal area was more sentive. In equimolar doses to cocaine, procaine (50 ug/site) produced small but significant effects on BP with no changes in Ve however, twice the equimolar dose(100 ug/site), produced respiratory responses similar to that of cocaine. Alpha and beta adrenoceptor antagonists prazosin (10 ug.site) and propranolol (16.7 ug/site) respectively, failed to alter the hypotensive or respiratory depressant effect of cocaine. Only animals that were hypotensive before or during physostigmine pretreatment (5 ug.site) experienced cardiorespiratory failure upon administration of cocaine. Carbachol (2.5 ug/site) had no effect on the cocaine induced cardiorespiratory responses. The present data suggest that (1) central cocaine neurotoxicity may result from interaction of cocaine with VMS sites; (2) the mechanism of action of cocaine at these sites is similar to that of procaine and does not appear to involve adrenergic receptors; and (3) pretreatment with the involve adrenergic receptors; and (3) pretreatment with the cholinomimetic physostigmine was effective in protecting animals from cocaine induced respiratory failure, its efficacy being limited to those animals that were not hypotensive during pretreatment. (AU)


Assuntos
21003 , Cocaína/farmacologia , Tronco Encefálico/efeitos dos fármacos , Respiração/efeitos dos fármacos
11.
In. Anon. Prevalence and patterns of substance abusers: neurobehavioural and social dimensions: programme and abstracts. Kingston, University of the West Indies (Mona). Neuroscience, Adolescent and Drug Research Programme, 1994. p.16.
Monografia em Inglês | MedCarib | ID: med-3588

RESUMO

Major clinical disorders have been associated with fetal in utero exposure to cocaine and although factors such as prematurity, other drugs or alcohol used concomitantly, infections and a chaotic environment may all be contributory, the abuse of cocaine has been associated with several neurological complications. Perry et al. (1984) demonstrated a "down-regulation" of placental neurotransmitter receptors in infants with intrauterine exposure to drugs of abuse. Abnormalities or depletion of receptor sites in the fetal brain interfere with normal respiratory control, causing more frequent periods of apnea, and an increase in sudden infant death syndrome (SIDS) in infants of cocaine using mothers has been reported by some authors but not by others. Mahalik et al. (1980) proposed that vasoconstruction secondary to increased catecholamines, and the resulting hypoxia, was a probable contributing factor to the teratogenic potential of cocaine. Fetal vasoconstruction, hypoxia, placental vasoconstriction, abruptio placenta and teratogenicity of the drug itself all play a role in the pathogenesis of embryo-logical defects. The severity of problems is related to the time and extent of exposure. Intracerebral hemorrhages, cerebral infarctions and vasculitis have all been documented. We recently reported 3 infants with craniosynostosis. Other bony anomalies reported include skull defects exencephaly and encephalocele. We have also observed agenesis of the corpus callosum with porencephaly and Dandy-Walker variant malformation in one child. Neural tube defects and cortical atrophy have been observed. Small head circumferences, increased irritability with inability to calm the child, poor cuddling, hypertonicity, tremulousness, abnormal sleep patterns, overall poor stste regulation and attention deficit hyperactivity disorder with associated learning disability has been observed. Little is known of the potential long-term side effects of exposure to cocaine and more work in this area is needed. (AU)


Assuntos
Humanos , Feminino , Criança , Cocaína/efeitos adversos , Exposição Materna , Doenças do Sistema Nervoso/etiologia , Doenças do Recém-Nascido/etiologia , Efeitos Tardios da Exposição Pré-Natal
13.
West Indian med. j ; 42(Suppl. 1): 47, Apr. 1993.
Artigo em Inglês | MedCarib | ID: med-5114

RESUMO

The association between physical and/or sexual abuse and substance abuse in women has frequently been noted. This study sought to identify the frequency with which such a history of child abuse was reported by a group of females admitted to a treatment centre for substance abuse. All women (70) admitted in 1991 and 1992 to the Substance Abuse Prevention and Treatment Centre, Caura, Trinidad, were interviewed about the occurrence of either physical or sexual abuse in childhood or adolescence. All men (95) admitted for alcohol dependence were also interviewed and served as a comparison group. Twenty female clients (28.6 per cent) admitted to being abused as children, 36 (51.4 per cent) denied any history of child abuse while 14 (20 per cent) refused to respond. Subgroups of alcohol- and cocaine-dependent women gave similar frequencies of positive histories of child abuse (26.9 per cent and 29.6 per cent respectively). Only 12.6 per cent of male alcoholic admissions gave a positive history of child abuse and one-third (33.7 per cent) of the sample refused to respond to the question. There is a need to explore the issues relating to the physical and sexual abuse in childhood as it may be a factor in the pathogenesis of substance abuse in women. More detailed sexual assessment tools and treatment directed at the sequelae of child abuse may also be in this population (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transtornos Relacionados ao Uso de Substâncias , Maus-Tratos Infantis , Abuso Sexual na Infância , Alcoolismo , Cocaína , Assédio Sexual
14.
West Indian med. j ; 42(Suppl. 1): 44, Apr. 1993.
Artigo em Inglês | MedCarib | ID: med-5121

RESUMO

In response to concerns expressed about drug abuse among students attending the Cave Hill Campus, a survey was conducted among the entire campus community to determine views about a wide range of health related issues. The survey was conducted by a pretested, self-administered, anonymous questionnaire, and was done on a single day on campus. The sample was chosen as a stratified sample of the campus personnel from the staff and student lists. Thirty-six per cent of the 1 in 4 sample responded to the questionnaire (7.9 per cent of all students, and 14 per cent of all staff). The age, sex, race and religious affiliations of the respondents were representative of the campus community. The numbers of responding students, administrative, academic and clerical staff were sufficient for their conclusions to be considered in the analysis. Staff and students generally considered themselves to be in good health. They were conscious of the bad effects on health of smoking cigarettes, and the use of ganja or cocaine. They also considered being overweight, worry and stress as being bad for health. Drugs were not a regular subject for discussion on the campus. While 3 of 5 respondents said they could recognise cocaine, crack or speed. Less than 1 per cent admitted to the use of any of these drugs and 80 per cent said they had never used cigarettes. Alcohol use was far more frequent, particularly among members of the academic staff, as was the use of cigarettes. Generally, members of the campus community were aware of the lifestyles that were at high risk for HIV, although 30 per cent of respondents considered lesbians as being at high risk. Using "one night stands" as indicative of high-risk sexual behaviour, 28.6 per cent of academics and 14.5 per cent of students said they had had such experiences within the last five years. Respondents reported a reduction in sexual partners compared to the previous year, and five years before. As regards problems which students considered may affect their health, concerns were expressed about stress, overwork, and insufficient money. Academics and students considered drug use as a minor problem among students, while clerical staff were more concerned about this as a problem. Generally, students did not consider themselves to be sexually harassed, although administrative and clerical staff expressed concerns in this regard. The campus emerges as a relatively abstemious one in every regard. However, both students and staff expressed significant concerns about stress and underfunding of students (AU)


Assuntos
Humanos , Adulto , Vigilância Sanitária , Transtornos Relacionados ao Uso de Substâncias , Fatores Sexuais , Fatores Etários , Tabagismo , Cocaína , Abuso de Maconha , Cocaína Crack , Consumo de Bebidas Alcoólicas , HIV , Homossexualidade Feminina , Estresse Fisiológico
15.
West Indian med. j ; 42(Suppl. 1): 27, Apr. 1993.
Artigo em Inglês | MedCarib | ID: med-5149

RESUMO

The aim of this study done in 1988 was to explore the relationship between substance abuse and attitudes of youth towards education, religion and family life in secondary school students, aged 14 to 18 years in Trinidad and Tobago. A random stratified sampling technique resulted in a selection of 30 secondary schools and 2000 students. Data were collected from 1,603 (80 per cent) students, using a self-administered questionnaire completed in the classroom and supervised by trained survey workers. Analysis of the data, using the Chi-square test, indicated a significant association (p<.001) between involvement in substance abuse (defined as regular or occasional usage of alcohol, marijuana or cocaine) and the following factors: grades at school, importance of religious involvement, amount of spending money obtained, confidence placed in parents/peers, parental involvement in alcohol consumption and educational expectations. Generally, the study indicated that youths who were less committed to traditional values, showed a greater tendency to be involved in substance abuse. Involvement also appeared to be associated with low self-esteem and low educational expectations (AU)


Assuntos
Humanos , Adolescente , Transtornos Relacionados ao Uso de Substâncias , Alcoolismo , Abuso de Maconha , Cocaína , Religião , Fatores Socioeconômicos , Escolaridade , Trinidad e Tobago
16.
West Indian med. j ; 41(Suppl 1): 67, Apr. 1992.
Artigo em Inglês | MedCarib | ID: med-6519

RESUMO

Cocaine use is epidemic in Trinidad and Tobago and is a cause of pressing social and health care concerns. This study reviews some socio-demographic features of the first 100 in-patients for cocaine dependence to the Substances Abuse Treatment Centre (SATC) in 1990. There were no females in this sample and 86 percent were between the ages of 20 and 39 years, 67 percent were either single, separated or divorced and 53 percent were employed at the time of admission. Forty-five per cent had a positive family history of substance abuse and 27 percent had been treated peviously for psychiatric illness other than substance abuse. In this sample, Africans accounted for 52 percent while East Indians contributed 26 percent. Interestingly, 70 percent of the patients admitted to using other drugs beside cocaine while 28 percent used cocaine only. Thirty-four per cent of the sample had been exposed to rehabilitation and treatment facilities prior to their admission to SATC and clinic follow-up with the urine testing revealed that 81 percent had relapsed by the end of six (6) months (AU)


Assuntos
Humanos , Cocaína/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Trinidad e Tobago/epidemiologia
19.
Nassau; s.n; 1992. 20 p. ilus, gra.
Monografia em Inglês | MedCarib | ID: med-3457

RESUMO

Nine years the beginning of the first reported nationwide epidemic of freebase (crack) cocaine abuse, which occurred in the Bahamas, a follow-up study was done to determine the pattern of the epidemic and the effectiveness of control measures. Data included the incidence of new cases at the only psychiatric hospital in the Bahamas and the primary community pschiatric clinic in the nation. Data on police arrests, drug seizures, and results for urine screenings for cocaine abuse came from the reports of the Royal Bahamas Police Force. The number of new cases of crack abuse presenting for treatment fell from 1987 to mid-1991, with a corresponding reduction of load at the treatment facilities. However, hospitalized cocaine abuse cases began rising again in mid-1991. This paper analyzes correlates of the fall and partial resurgences of the epidemic. In 1992, crack is much more difficult to obtain than in the early and middle 1980's. The Bahamian reponse to the epidemic - including 1) demand reduction, 2) supply reduction and 3) reduction of money laundering - played an important role in the decline of new cases. Crack has not been replaced by other illegal drugs, but alcohol has resumed its former place of preference. However, despite a reduction in the rate of new crack abuse cases appearing for treatment, there has been a recent rise in violent, robberies and gang activity. This apparently is due to chronic cocainism, a pattern of long term use of crack and other forms cocaine that is resistant to treatment (AU)


Assuntos
Adulto , Feminino , Humanos , Masculino , Cocaína , Cocaína Crack , Bahamas , Transtornos Relacionados ao Uso de Substâncias
20.
Int J Addict ; 26(7): 729-38, July 1991.
Artigo em Inglês | MedCarib | ID: med-15920

RESUMO

Shortages in the supply of marijuana, which became acute around 1981, caused Rastafari marijuana distributors very reluctantly to disregard religious injunctions against the use of any psychoactive substance except marijuana, and to experiment with the use and distribution of cocaine hydrochloride powder for intranasal administration and, later, for smoking (freebase and crack). This experimentation became ruinous, and many were retired ignominiously from drug distribution. In the crack era they have been succeeded by completely new social, cultural, and economic arrangements. (AU)


Assuntos
Humanos , Canabinoides/provisão & distribuição , Canabinoides/economia , Cocaína/economia , Cocaína/provisão & distribuição , Cocaína Crack/economia , Cocaína Crack/provisão & distribuição , Abuso de Maconha/economia , Abuso de Maconha/prevenção & controle , Grupos Minoritários , Transtornos Relacionados ao Uso de Substâncias/economia , População Urbana , Cidade de Nova Iorque , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Trinidad e Tobago/etnologia
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