Bioethical analysis to the therapeutic use of Cannabis: Integrative review.

INTRODUCTION:: Despite being considered as a contravention under some countries' legislation, the therapeutic use of Cannabis sativa has been growing in Brazil, due to the promising results observed in many pathologies. Such a scenario has fostered the need to deepen discussions on the subject and possibly revise legislation governing the substance use and access. OBJECTIVES:: Identify the types of stigma related to the therapeutic use of Cannabis and describe the strategies people use to overcome stigma. METHODS:: This integrative review was carried out in the databases PubMed, Scopus, CINAHL, MEDLINE, PsycINFO, Web of Science, and Cochrane Library, with 565 articles being retrieved. Triads' cross-check were done, first maintaining the "cannabis" and "therapeutic use" pair, added by "stigma," "bioethics," "ethics," "social consequences," and "legal consequences." The final selection resulted in six articles. ETHICAL CONSIDERATION:: However, the ethical issues that pervade and regulate decisions on this subject must be considered. RESULTS:: Different dimensions and types of stigma related to the therapeutic use of Cannabis have been identified. The bioethical principle of autonomy was an expression of citizenship and human rights, mitigating internal conflicts related to self-stigma and the effects of external stigma on the person's life. CONCLUSION:: It was possible to identify the types of stigma related to the therapeutic use of Cannabis is an internal dimension represented (self-stigma) and an external dimension, represented (social and structural stigmas) and to identify strategies adopted to face this stigma: skills training group for users, elaboration of laws and specific programs to clarify the therapeutic use of Cannabis with a greater social scope, and support for family members. Thus, contributing to the building of people's autonomy in a broader context of decision-making autonomy and executive autonomy will provide the development of people's capacity to perform complex tasks of self-management and, consequently, to continue promoting and preserving their decision-making process and their capacity to plan and perform tasks associated with managing their lives and their treatments.

Instrumentos relacionados ao consumo de drogas em adolescentes: revisão integrativa / Instruments related to drug use in adolescents: an integrated review

RESUMO Objetivo: identificar os instrumentos validados e relacionados ao o consumo de drogas em adolescentes. Método: revisão integrativa que incluiu estudos sobre a elaboração e validação ou avaliação das propriedades psicométricas de instrumentos para a análise do consumo de drogas por adolescentes nas línguas portuguesa, inglesa e espanhola. Busca realizada nas bases de dados: MEDLINE, LILACS, SCOPUS, CINAHL, COCHRANE e Web of Science. Para tal, cruzaram-se os descritores "Estudos de Validação", "Estudos de validação como assunto", "adolescente" e "transtornos relacionados ao uso de substâncias psicoativas". Foram resgatados 743 artigos e após o processo de seleção e análise do rigor metodológico, um total de 11 compuseram esta revisão. A coleta de dados foi realizada com auxílio de instrumento validado e os resultados foram categorizados com base nos objetivos dos testes. Resultados: identificaram-se dez instrumentos: cinco questionários, um inventário e quatro escalas. Os instrumentos abordaram o risco, uso/abuso de substâncias psicoativas e questões relativas ao tratamento. Dois apresentaram maior confiabilidade: ASTEQ-COUNSELOR e o DCI-A-SF. Conclusão: foram sumarizadas informações sobre dez instrumentos validados e voltados para o consumo de drogas em adolescentes. Estes permitem a mensuração e a identificação do consumo de drogas e de aspectos relacionados ao tratamento para problemas decorrentes do uso dessas substâncias. Duas ferramentas foram tidas como as mais confiáveis por apresentaram melhores valores de alfa para os itens individualmente e em conjunto, ASTEQ-COUNSELOR e o DCI-A-SF. Dispor de instrumentos de mensuração confiáveis auxilia a pesquisa e a práxis do enfermeiro.

RESUMEN Objetivo: identificar los instrumentos validados y relacionados con el consumo de drogas en los adolescentes. Método: revisión integrativa que incluyó estudios sobre la elaboración y validación o evaluación de las propiedades psicométricas de instrumentos para el análisis del consumo de drogas por adolescentes, en las lenguas portuguesa, inglesa y española. Búsqueda realizada en las bases de datos MEDLINE, LILACS, SCOPUS, CINAHL, COCHRANE y Web of Science. Para eso, se cruzaron los descriptores "Estudios de Validación", "Estudios de validación como asunto", "adolescente" y "trastornos relacionados con el uso de sustancias psicoactivas". Se rescataron 743 artículos y después del proceso de selección y análisis del rigor metodológico se llegó a un total de 11 artículos para esta revisión. La obtención de datos fue realizada con la ayuda del instrumento validado y los resultados fueron categorizados en base a los objetivos de los testes. Resultados: se identificaron diez instrumentos: cinco cuestionarios, un inventario y cuatro escalas. Los instrumentos abordaron el riesgo, uso/abuso de sustancias psicoactivas y asuntos relativos al tratamiento. Dos de ellos presentaron una mayor confiabilidad: ASTEQ-COUNSELOR y el DCI-A-SF. Conclusión: se resumieron informaciones sobre diez instrumentos validados y dirigidos para el consumo de drogas en adolescentes. Éstos permiten la mensuración e identificación del consumo de drogas y de aspectos relacionados con el tratamiento para los problemas decurrentes del uso de tales sustancias. Dos herramientas fueron consideradas como las más confiables por presentar los mejores valores de alfa para los ítems, individualmente y en conjunto, ASTEQ-COUNSELOR y el DCI-A-SF. Disponer de instrumentos de mensuración confiables ayuda en la investigación y praxis del enfermero.

ABSTRACT Objective: to identify validated instruments and related to drug use among adolescents. Method: an integrative review that included studies on elaborating and validating or evaluating the psychometric properties of instruments for analysing drug use by adolescents in Portuguese, English and Spanish. The search was performed in the following databases: MEDLINE, LILACS, SCOPUS, CINAHL, COCHRANE and Web of Science. For this, the descriptors "Validation Studies", "Validation studies as subject", "adolescent" and "disorders related to the use of psychoactive substances" were crossed, resulting in 743 articles retrieved, with a total of 11 composing this review after the selection process and analysis of methodological rigor were performed. The data collection was performed using a validated instrument and the results were categorized based on the objectives of the tests. Results: ten instruments were identified: five questionnaires, one inventory and four scales. The instruments addressed the risk, use/abuse of psychoactive substances and treatment issues. Two showed greater reliability: ASTEQ-COUNSELOR and the DCI-A-SF. Conclusion: information on ten validated instruments was summarized focused on adolescent drug use. These instruments enable measuring and identifying drug use and treatment-related aspects for problems arising from using these substances. Two instruments were considered to be the most reliable because they presented better alpha values for the items individually and together; the ASTEQ-COUNSELOR and the DCI-A-SF. The availability of reliable measurement instruments assists nursing research and praxis.

Fatores que interferem no êxito do tratamento de usuários de crack / Factors affecting the success of the treatment of users of crack

RESUMO Este estudo analisou os aspectos que, segundo os próprios dependentes de crack, interferem no êxito do seu tratamento. Recorte de um trabalho original, o estudo é descritivo, exploratório, observacional e com abordagem qualitativa. A coleta de dados foi realizada com os usuários de crack em tratamento no CAPSad de Camaragibe-PE com uma entrevista semi-estruturada. Para análise dos dados utilizou-se o Alceste que forneceu três classes, tendo a de número três 33% das UCE's sendo utilizada para compor este trabalho. Ela define a família e a religião como fatores interferentes no sucesso do tratamento dos usuários de crack e fundamentais na reinserção social.

ABSTRACT This study examined the concerns that crack addicts themselves, interfere with the success of your treatment. Cut from an original work, the study is descriptive, exploratory, observational and qualitative approach. Data collection was performed with crack users in treatment in CAPSad Camaragibe-PE with a semi-structured interview. Data analysis used the Alceste that provided three classes, with the number three 33% of UCE's being used to compose this work. It defines the family and religion as interfering factors in successful treatment of crack users in fundamental and social reintegration.