Trends in drug use among students in Brazil: analysis of four surveys in 1987, 1989, 1993 and 1997.

The consumption of psychotropic drugs among Brazilian secondary school students was examined by comparing data from four surveys using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence. Students filled out the form in their classrooms without the presence of teachers. The target population consisted of 10-18-year-old students (on average, 15,000 students responded to each survey) in Brazil's ten largest state capitals: Belém, Belo Horizonte, Brasília, Curitiba, Fortaleza, Porto Alegre, Recife, Rio de Janeiro, Salvador, and São Paulo. Among the legal drugs, lifetime use (use at least once during life) of tobacco was increased in seven cities (the exceptions were Brasília, Porto Alegre and Rio de Janeiro). There was also a significant increase in frequent use of alcohol (six times or more per month) in 6 of the cities, from an average of 9.2% in 1987 to 15.0% in 1997. With respect to illegal drugs, there was a significant increase in lifetime use of marijuana (a 3-fold increase from 2.8% in 1987 to 7.6% in 1997). Cocaine use increased 4-fold over the survey period (0.5% in 1987 to 2.0% in 1997). Lifetime use of cocaine significantly increased in eight capitals (except Recife and Rio de Janeiro). However, frequent cocaine use increased in only three capitals (Belém, Fortaleza and Porto Alegre), from an average of 1.0% in 1987 to 3.6% in 1997. Lifetime use of medications such as anxiolytics and amphetamines increased 2-fold on average over the survey period. Comparing the four studies, the main conclusion is that there were significant increases in the frequencies for lifetime use, frequent use and heavy use of many drugs.

Concepts of dependence among Brazilian alcohol- and drug-dependent patients.

Studies suggest that the concepts that drug dependent persons have about their problems could influence adherence to treatment and outcome. The objective of this study was to compare these concepts in different groups of patients. Three groups of drug-dependent patients (diagnosed according to DSM-III-R criteria) were compared: 64 dependent on alcohol only, 56 dependent only on other drugs and 39 dependent on both alcohol and drugs. They were asked: "What do you think about your problem?" and the responses were qualitatively analyzed and classified into themes. For the whole sample, the main themes mentioned were: the function of alcohol and drugs in their lives (50%), the etiology of dependence (32%) and reasons for initial use (21%). Patients dependent on alcohol associated their use with coping, while patients dependent on other drugs reported pleasure seeking. In regard to etiology, most patients classified their dependence as a habit. Patients dependent on alcohol tended to attribute an organic etiology to their problem, while those dependent on other drugs most frequently considered moral aspects as important. This study suggests that there are differences between these three groups in the appraisal of their problem. Professionals interested in treatment matching need to take these findings into account, as they may influence compliance and treatment outcome.

Use of drugs among street children in Brazil.

The purpose of this study has been to assess drug consumption among children in five Brazilian state capitals during 1993. The sample was composed of street children who were given assistance in institutions, and data was collected by means of anonymous individual interviews. Five hundred sixty five boys and girls were interviewed: 74.3% reported having used drugs (not including alcohol and tobacco) at least once in their life. Solvents, followed by marijuana, were the most cited drugs. Important regional differences were observed concerning other drugs. Consumption of cocaine, including crack, seems restricted to the southeast region, whereas psychotropic medication was consumed more in the northeast of the country. Drug initiation among these children seems to be a consequence of street life and is part of their group lifestyle.

Pharmaceutical care to patients treated with antidepressants.

Depression is considered one of the ten most disabling conditions on the planet, causing physical, personal and social limitations. Antidepressants are the most commonly used drug treatment for eliminating or controlling the symptoms of depression. A variety of factors can contribute to treatment abandonment, particularly severe side effects. The present article is aimed to provide information and guidelines on the development of a pharmacotherapy follow-up program for patients treated with antidepressant medication. According to this practice, the pharmacist evaluates whether the three following requirements of a proper pharmacotherapy are being observed: need, effectiveness and safety. If one of these requirements is not met, the pharmacist seeks to solve the problem, by intervening in the pharmacotherapy, within the scope of his/her skills. Pharmaceutical care is aimed to improve adherence to treatment and minimize side effects, as well as the occurrence of drug interactions. Thus, the present article presents and discusses the main strategies of pharmaceutical care to achieve the proposed objectives.

Crack use in São Paulo.

Documented crack use emerged in São Paulo, Brazil, from 1991 onward. Therefore, it is a recent behavior among drug users. The present work draws a profile of São Paulo crack users, employing an ethnographic approach. Twenty-five crack users were interviewed on selected social and demographic characteristics, on the drug itself and its consumption, and on the consequences of this use. Crack cocaine is harmful for the user, leading within a short period to a condition of dependence. The crack users reported ultimately lapsing into "marginality" due to social isolation, neglect of bodily needs, and breakdown of family ties and other relationships.

Trends in drug use among students in Brazil: analysis of four surveys in 1987, 1989, 1993 and 1997

The consumption of psychotropic drugs among Brazilian secondary school students was examined by comparing data from four surveys using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence. Students filled out the form in their classrooms without the presence of teachers. The target population consisted of 10-18-year-old students (on average, 15,000 students responded to each survey) in Brazil's ten largest state capitals: Belém, Belo Horizonte, Brasília, Curitiba, Fortaleza, Porto Alegre, Recife, Rio de Janeiro, Salvador, and São Paulo. Among the legal drugs, lifetime use (use at least once during life) of tobacco was increased in seven cities (the exceptions were Brasília, Porto Alegre and Rio de Janeiro). There was also a significant increase in frequent use of alcohol (six times or more per month) in 6 of the cities, from an average of 9.2 percent in 1987 to 15.0 percent in 1997. With respect to illegal drugs, there was a significant increase in lifetime use of marijuana (a 3-fold increase from 2.8 percent in 1987 to 7.6 percent in 1997). Cocaine use increased 4-fold over the survey period (0.5 percent in 1987 to 2.0 percent in 1997). Lifetime use of cocaine significantly increased in eight capitals (except Recife and Rio de Janeiro). However, frequent cocaine use increased in only three capitals (Belém, Fortaleza and Porto Alegre), from an average of 1.0 percent in 1987 to 3.6 percent in 1997. Lifetime use of medications such as anxiolytics and amphetamines increased 2-fold on average over the survey period. Comparing the four studies, the main conclusion is that there were significant increases in the frequencies for lifetime use, frequent use and heavy use of many drugs.