RESUMO
Healthcare professionals are exposed to stressful situations that may favor substance use vulnerability. This systematic review aims to synthesize the risk and protective factors associated with use, abuse, and dependence of alcohol, tobacco, psychoactive drugs, and cannabis in healthcare professionals. Following PRISMA recommendations, a systematic search was performed in PsycINFO, Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library. The search yielded 1523 studies, of which 19 were selected. The identified risk factors were demographic factors (i.e. male gender, and single/divorced marital status), psychopathological factors, social factors, positive attitudes toward drugs, unhealthy lifestyle habits, the COVID-19 pandemic, and the coexistence of the use of several substances. The protective factors were demographic factors (i.e. ethnicity and having dependent children), healthy lifestyle habits, and workplace anti-drug policies (i.e. restriction of tobacco use). These findings highlight the need for preventive actions against drug use in healthcare professionals to improve their health and reduce the possible negative impact on their healthcare practice. Knowledge of modifiable risk and protective factors allows their incorporation as components in preventive actions, and non-modifiable factors (e.g. demographic variables) may contribute to the detection of groups of greater vulnerability to propose selective prevention actions in this population.
RESUMO
The objective was to analyze the changes in cannabis use during lockdown considering sex, age, living situation and level of addiction. This descriptive and non-probabilistic study used a convenience sample of 208 participants with ages between 18-57 years (64.3% men; mean age = 31.39 years), that reported consuming cannabis. The frequency of distinct typologies of cannabis use was analyzed and the level of addiction with the Cannabis Abuse Screening Test (CAST). An online survey was used to collect the variables under study. A total of 25% consumers increased their spliff (marijuana mixed with tobacco) consumption, 11.9% increased their joint (marijuana cigarette) consumption and 11.8% increased their hashish spliff consumption. Men had higher levels of cannabis addiction, however, during lockdown they reduced their marijuana spliff consumption while both men and women increased their joint consumption. Marijuana spliff consumption showed a greater increase in the 25-29 age group, in those living with people other than relatives or a partner, alone, or with a partner and was reduced mainly in those living with parents or other relatives. The living alone 18-24 years old group, and the living with parents 35-44 years old group showed higher levels of cannabis addiction (CAST). The rate of dependent consumers who increased their marijuana spliff consumption (49%) doubled compared to consumers with no addiction and moderate addiction. Regarding joints, consumption was 1.5 times higher than for moderate addiction consumers and three times higher than those with no addiction. The risk of cannabis addiction increased in certain groups during lockdown.
El objetivo fue analizar el consumo de cannabis durante el confinamiento según sexo, edad, situación de convivencia y nivel de adicción. Estudio descriptivo no probabilístico con una muestra de conveniencia de 208 participantes con edades entre 18-57 años (64,3% hombres; edad media = 31,39 años) que reportaron consumir cannabis. Se analizó la frecuencia de distintas tipologías de consumo de cannabis y el nivel de adicción con el Cannabis Abuse Screening Test (CAST). La recogida de datos se realizó mediante encuesta online. El 25% de consumidores aumentó su consumo de porros de marihuana mezclada con tabaco; el 11,9% de cigarros de marihuana; y el 11,8% de porros de hachís mezclado con tabaco. Los hombres presentaron mayor nivel de adicción al cannabis. Sin embargo, redujeron su consumo de porros durante el confinamiento. Hombres y mujeres incrementaron su consumo de cigarros de marihuana. El consumo de porros se incrementó mayormente en el grupo de 25-29 años, entre quienes convivían con personas distintas a familiares y pareja, vivían solas, o en pareja; y se redujo entre quienes vivían con progenitores o familiares. Mostraron mayor nivel de adicción al cannabis (CAST) el grupo entre 18-24 años que vive solo y el grupo entre 35-44 años que convive con sus progenitores. Los consumidores con dependencia que incrementan su consumo de porros (49%) fue dos veces superior respecto a los grupos sin adicción y con adicción moderada. El consumo de cigarros de marihuana (20,8%) fue 1,5 veces superior que para adicción moderada y más del triple que para sin adicción. El riesgo de adicción a cannabis aumentó en ciertos grupos durante el confinamiento.
RESUMO
OBJECTIVE: Cannabis is an illegal drug whose use has increased in recent years, especially among adolescents. Despite its popularity, its use and abuse brings with it health consequences, being greater if consumption occurs in the adolescent stage, since the brain is in full development. The objective of this systematic review was to determine the effects of cannabis use on cognitive functions of attention and memory in adolescent population. METHODS: A systematic review of the literature was carried out in the main search portals (Pubmed, Web of Science, SciELO, Cochrane) referring to the last 10 years, following the PRISMA criteria. The systematic search strategy was carried out in the period from March to May 2021, applying the PICO method and the PEDro scale to guarantee the methodological quality of the included studies. RESULTS: Both attention and memory are affected by cannabis use; however, memory functions improve with abstinence, not being so for attention. Memory deficits are an indicator of therapeutic abandonment of addiction treatment. In relation to psychosocial interventions aimed at improving memory, the contingency management, educational interventions and motivational interviewing have not been shown to be effective on the effects of substances. Working memory training offers positive results, although not clinically significant. Finally, memory deficits are an indicator of therapeutic abandonment of pharmacological treatment for cannabis addiction. Therefore, research is needed aimed both at reducing the side effects of drugs on memory processes and at establishing to what extent memory deficits associated with cannabis use can facilitate therapeutic abandonment. CONCLUSIONS: More research is necessary, considering the dual consumption of cannabis-tobacco and the effects that both substances may have jointly and separately on attention and memory processes.
OBJETIVO: El cannabis es una droga ilegal cuyo consumo se ha visto incrementado en los últimos años, especialmente en población adolescente. A pesar de su popularidad, su uso y abuso trae consigo consecuencias para la salud, siendo mayores si el consumo se produce en la etapa adolescente, ya que el cerebro se encuentra en pleno desarrollo. El objetivo de esta revisión sistemática fue determinar los efectos del consumo de cannabis en las funciones cognitivas de atención y memoria en población adolescente. METODOS: Se llevó a cabo una revisión sistemática de la literatura en los principales portales de búsqueda (Pubmed, Web of Science, SciELO, Cochrane) referida a los últimos diez años, siguiendo los criterios PRISMA. La estrategia de búsqueda sistemática se realizó en el periodo de tiempo comprendido entre los meses de marzo a mayo de 2021, aplicándose el método PICO y la escala PEDro para garantizar la calidad metodológica de los estudios incluidos. RESULTADOS: Tanto la atención como la memoria se ven afectadas por el consumo de cannabis; sin embargo, la memoria mejora su funcionamiento con la abstinencia, no ocurriendo lo mismo con la atención. Los déficits de memoria son un indicador de abandono terapéutico del tratamiento para la adicción. En relación con las intervenciones psicosociales orientadas a la mejora de la memoria, tanto el manejo de contingencias como las intervenciones educativas y la entrevista motivacional no se han mostrado efectivas sobre los efectos de las sustancias. El entrenamiento en la memoria de trabajo ofrece resultados positivos, aunque clínicamente no significativos. Finalmente, los déficits de memoria son un indicador de abandono terapéutico del tratamiento farmacológico para la adicción al cannabis, por lo que se precisa investigación orientada tanto a reducir los efectos secundarios de los fármacos sobre los procesos mnésicos como a establecer en qué medida los déficits de memoria asociados al consumo de cannabis pueden facilitar el abandono terapéutico. CONCLUSIONES: Se precisa mayor investigación, considerando el consumo dual de cannabis-tabaco y los efectos que ambas sustancias pueden tener, conjuntamente y por separado, sobre los procesos de atención y memoria.
Assuntos
Cannabis , Drogas Ilícitas , Abuso de Maconha , Adolescente , Humanos , Cannabis/efeitos adversos , Abuso de Maconha/complicações , Abuso de Maconha/epidemiologia , Espanha , Transtornos da Memória/complicaçõesRESUMO
The practice of physical activity (PA) is a healthy habit that offers health benefits. In contrast, the lack thereof may be associated with an increase in diseases, even at an early age. The objective of this study was to analyze the association between unhealthy behaviors, such as tobacco consumption and problematic internet use, and the practice of PA in adolescents. Protective factors (physical activity and sport) and risk factors (leading a sedentary life, tobacco use, and problematic internet use) were evaluated. Other variables such as sex, the intensity of physical activity, and being a member of a sports federation were also evaluated. The sample consisted of a total of 1222 Spanish adolescents. Univariate descriptive analysis and multiple linear regression were used, and confirmatory factor analyses and structural models were also estimated. The results confirm a significant positive association between physical activity, intensity, and being a member of a sports federation, as well as between cigarette consumption and internet use. It is advisable to implement public policies that promote the practice of sports as a direct investment in health, preventing the consumption of tobacco and other habits that are harmful to the health of adolescents.