Conceptions and practices of an integrative treatment for substance use disorders involving Amazonian medicine: traditional healers' perspectives

Objective: The harmful use of psychoactive substances represents one of today's largest public health problems. Yet, in spite of its global relevance, current treatment for substance use disorders (SUDs) is still not entirely successful. The purpose of this study was to investigate alternative treatments and conceptions from traditional Amazonian medicine adapted to SUDs. Methods: We conducted semi-structured interviews with 13 practicing experts at a well-established addiction treatment center in the Peruvian Amazon and performed qualitative content analysis on the collected data. Main categories were deductively defined and corresponding subcategories inductively developed. Results: Our findings revealed characteristic features and consequences, causes and antecedents, and treatment methods of SUDs as the main categories. Overall, concepts of disease etiology bore resemblance with contemporary biopsychosocial models of SUDs. The Amazonian therapeutic means however differed markedly from current Western ones. The main methods involved dietary retreats, healing ceremonies, and purging rituals. The integral application of Amazonian methods, as well as their traditional implementation according to prescribed ritual protocols, were emphasized by the experts as crucial for efficacy and safety of treatment delivery. Conclusion: We suggest further scientific attention to these therapies, including clinical studies, for which our results provide conceptual underpinnings. Findings from this research expand the cross-cultural understanding of SUDs and, in the long run, may enhance its treatment options.

De las ciudadanías formales a las vindicaciones sociales por el derecho al agua en la ciudad: relaciones complejas entre agua, hábitat y ciudad / From formal citizenships to social claims for right to water in the city: complex relationships between water, habitat and city / Das cidadanias formales as reivindicações sociais pelo direito à água na cidade:relações complexas entre água, habitat e a cidade

El presente artículo de revisión es el resultado de la investigación titulada "Prácticas sociales del agua en Bogotá. Tras la adversa cultura del agua y los estilos de vida bogotanos (1850-1888)". En este texto se encontrará una revisión conceptual a la problemática sobre los usos sociales del agua en torno a las categorías hábitat y significaciones del agua en la ciudad. El despliegue de estos conceptos propone una metodología basada en el análisis documental dirigida a la rehistorización de las prácticas de los bogotanos en torno a los usos sociales del agua, de la higiene y de sus costumbres con relación a la ciudadanía y al discurso de la civilización.

This article presents the first steps of a research project entitled "Social practices of water in Bogotá. After the adverse water culture and Bogotan lifestyles (1850-1888)". Here is initially a conceptual reviewing to the approach of social uses of water around the habitat categories and meanings of water in the city, fundamental categories that will serve to track, along with a documentary analysis methodology accounts of foreign travelers in the nineteenth century, the practices of the Bogotan citizens of this time around the social uses of water, hygiene and customs in relation to citizenship and the discourse of civilization.

Este artigo recolhe os primeiros avanços de pesquisa intitulado "Práticas sociais da água em Bogotá. Após a cultura adversa da água e os estilos de vida de Bogotá (1850-1888)". Aqui é feita inicialmente uma revisão conceitual para a abordagem dos usos sociais da agua em torno das categorias de habitats e os significados da água na cidade, categorías fundamentais que serão usados para rastrear, juntamente com uma metodologia de análise documental dos relatos de viajantes estrangeiros no século XIX, as práticas dos bogotanos desta época sobre os usos sociais da agua, higiene e seus hábitos em relação a cidadania e ao o discurso da civilização.