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1.
J Forensic Nurs ; 15(4): 231-241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31764527

RESUMO

INTRODUCTION: Clients on methadone maintenance treatment (MMT) have high attrition rates that are attributed to personal and system-related factors. To develop supportive interventions for these clients, it is imperative to understand social demographic characteristics and challenges that clients in the MMT program face. OBJECTIVES: This article aims to describe (a) the sociodemographic characteristics and clinical profiles of clients in a MMT program, (b) factors that impact their positive clinical outcomes, and (c) the study's implications for practice. METHODS: A retrospective review of 101 randomly selected electronic medical records representing one third of all the records were examined for sociodemographic characteristics, clinical profiles, and outcomes. Descriptive statistics were used to analyze these variables. Interviews with 18 healthcare providers focusing on their experiences of caring for clients in the MMT program were analyzed thematically. RESULTS: The average age of clients on MMT is 35.5 years. Clients had early exposure to alcohol and drugs, and at the time of enrollment to the program, they presented with complex healthcare needs, borne from chronic use, and exposure to adverse traumatic events. Personal and systemic factors impact clients' recovery. These include poverty, homelessness, and inadequate healthcare services. Understanding sociodemographic characteristics, clinical profiles, and clients' challenges is central to the development of supportive interventions that enhance retention to care and recovery.


Assuntos
Analgésicos Opioides/uso terapêutico , Metadona/uso terapêutico , Tratamento de Substituição de Opiáceos , Centros de Tratamento de Abuso de Substâncias , Adulto , Distribuição por Idade , Canadá/epidemiologia , Feminino , Necessidades e Demandas de Serviços de Saúde , Pessoas em Situação de Rua , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Meio Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto Jovem
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1134-1138, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594160

RESUMO

Objective: To understand the serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3), and thyroxine (T4) and identify the related influencing factors of thyroid dysfunction in drug users. Methods: From June to August 2018, a face-to-face questionnaire survey was conducted in 788 male drug users in a drug rehabilitation center in Jiangsu province to collect their socio-demographic information. Then, venous blood sample was collected from each participant for the detection of various hematological indicators, such as thyroid hormones. Results: The abnormal rates of T3, T4, FT3, FT4 and TSH were 4.57%, 1.27%, 0.51%, 0.38% and 0.89%, respectively, in the male drug users. HCV infection was an influencing factor for abnormal T3 level in the male drug users (OR=8.52, 95%CI: 2.36-30.74, P=0.001). And serum T3 (P<0.001) and T4 (P=0.048) levels increased with increasing HCV viral load. Conclusions: HCV infection was an influencing factor for the abnormality of serum T3 level in drug users. Therefore, thyroid-related knowledge should be added in the health education for drug users, and the monitoring of thyroid function should be strengthened for drug users infected with HCV.


Assuntos
Usuários de Drogas , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/sangue , Hormônios Tireóideos/sangue , China , Humanos , Masculino , Tireotropina , Tiroxina , Tri-Iodotironina
3.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1293-1299, out.-dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022445

RESUMO

Objective: The study's purpose has been to analyze the relationship of multiprofessional care offered in a Psychosocial Care Center for Alcohol and other Drugs [Centros de Atenção Psicossocial Álcool e outras Drogas (CAPS-AD)] with the number of hospitalizations directly related to the consumption of drugs by crack users. Methods: It is a documentary study with a quantitative approach, which was through the assessment of 213 medical records of crack users of a CAPS-AD, concerning the socioeconomic profile, individual care, in group and hospital admissions. Data were processed on SPSS, version 22. Results: It was observed the predominance of men (76.5%), within the age group from 11 to 47 years old, who were single (60.8%), and had incomplete elementary education (53.5%). The most statistically significant interventions were nursing, psychiatry, medical clinic and nursing technician care, as well as groups of physical activity, art therapy and relapse prevention. Conclusion: Therefore, it is necessary to provide continuous and comprehensive assistance to the crack user, with a multiprofessional team acting in a complementary manner aiming to minimize drug related hospitalizations


Objetivo: Analisar a relação do cuidado multiprofissional ofertado em um Centro de Atenção Psicossocial para Álcool e Outras Drogas (CAPS AD) com o número de internação hospitalar relacionada diretamente com o consumo de drogas em usuários de crack. Métodos: Estudo documental com abordagem quantitativa, realizado com 213 prontuários de usuários de crack de um CAPS AD, referente ao perfil socioeconômico, atendimentos individuais, em grupo e internação hospitalar. As informações foram processadas no SPSS versão 22. Resultados: Observou-se predomínio de homens (76,5%), com idade entre 11 a 47 anos, solteiros (60,8%) que possuíam ensino fundamental incompleto (53,5%). Os atendimentos com maior significância estatística foram enfermagem, psiquiatria, clínica médica e técnico em enfermagem, bem como grupos de atividade física, arteterapia e prevenção de recaída. Conclusão: É necessário realizar assistência contínua e integral ao usuário de crack, com equipe multiprofissional atuando de forma complementar para minimizar as internações referentes ao consumo da droga


Objetivo: Analizar la relación del cuidado multiprofesional ofrecido en un Centro de Atención Psicosocial para Alcohol y Otras Drogas (CAPS AD) con el número de internación hospitalaria relacionado directamente con el consumo de drogas en usuarios de crack. Métodos: Estudio documental con abordaje cuantitativo, realizado con 213 historiales de usuarios de crack de un CAPS AD, referente al perfil socioeconómico, atendimientos individuales, en grupo e internación hospitalaria. Las informaciones fueron procesadas en el SPSS versión 22. Resultados: Se observó predominio de hombres (76,5%), con edad entre 11 y 47 años, solteros (60,8%) con enseñanza primaria incompleta (53,5%). Los atendimientos con mayor relevancia estadística fueron enfermería, psiquiatría, clínica médica y técnico en enfermería, así como grupos de actividad física, arteterapia y prevención de recaída. Conclusión: Es necesario realizar asistencia continua e integral al usuario de crack, con equipo multiprofesional actuando de forma complementaria para minimizar las internaciones referentes al consumo de drogas


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/estatística & dados numéricos , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Fumar Cocaína/terapia , Serviços de Saúde Mental
4.
Asia Pac J Public Health ; 31(6): 548-558, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31516020

RESUMO

This study was conducted to identify factors associated with the utilization of treatment and rehabilitation services by drug abusers. Around 14.7% of drug abusers self-reported as having used treatment and rehabilitation services at any point in their lifetime (90.8% male and 9.2% female). The dependent variable of having "ever used" the services was positively associated with receiving support of family and friends, knowing of an existing treatment and rehabilitation program, having ever been involved in an outreach program activity, experiencing self-treatment, and having a positive perception of the efficacy of the program. Among the 10 cities examined, the findings showed unequal utilization of treatment and rehabilitation services, implying the need to better monitor the use of the services and to develop a community-based treatment that both enables drug abusers to confront barriers to the utilization of treatment and rehabilitation services and also reintegrates drug abusers to the community.


Assuntos
Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Feminino , Humanos , Indonésia , Masculino , Inquéritos e Questionários , Adulto Jovem
6.
J Addict Nurs ; 30(3): 177-184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31478965

RESUMO

BACKGROUND: Opioid dependence accompanied by polysubstance use is a chronic illness with severe somatic, psychological and social consequences for those affected. International studies have shown that healthcare provision is inadequate for this population because of stigmatization and lack of expertise among medical professionals. It must be assumed that this is also the case in acute care settings of hospitals in German-speaking areas of Switzerland. To date, there are few studies addressing these patients' experiences that could provide data for targeted interventions. AIMS: This qualitative study explored this patient population's perspective in terms of their experiences and needs regarding care provision in acute hospitals. The results should offer potential adaptations to care provision for this vulnerable group of individuals. METHODS: Twelve individuals with opioid dependence using polysubstances were interviewed in two urban substitution centers. The data analysis of the material obtained was undertaken using qualitative content analysis according to Mayring. RESULTS: As a whole, individuals with opioid dependence using polysubstances are not dissatisfied with care provided in acute hospitals as long as their relationship with health professionals is positive. Substitution medication is critically important to their treatment, but this group's experiences with its management during hospitalization continue to show widespread stigmatization along with inadequate knowledge and interprofessional collaboration and a failure to integrate these patients and their expertise into treatment and care. CONCLUSIONS AND FUTURE DIRECTIONS: The treatment of individuals with substance-related disorders in acute hospitals requires staff with somatic and psychiatric training. In this regard, the principles of evidence-based models of reducing harm and multiprofessional treatment teams should be seen as particularly well suited and promising.


Assuntos
Atitude Frente a Saúde , Transtornos Relacionados ao Uso de Opioides/enfermagem , Doença Aguda , Adulto , Assistência à Saúde/estatística & dados numéricos , Medo , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Transtornos Relacionados ao Uso de Opioides/psicologia , Relações Profissional-Paciente , Estereotipagem , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Suíça
7.
J Addict Nurs ; 30(3): 211-218, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31478969

RESUMO

BACKGROUND: Cannabis is the most commonly used illicit drug in most western countries. In Ireland, it now accounts for most new presentations to substance use treatment services. Cannabis use for most of these people commenced during adolescence. Although a significant amount of research has been conducted on the effects of cannabis on physical and mental health, less is known about the experiences of young cannabis users. OBJECTIVE: The aim of this study was to understand more about the experience of young, treatment-seeking, cannabis users. METHODS: This descriptive qualitative study interviewed eight adolescents who were attending outpatient treatment services for cannabis misuse in Dublin, Ireland. Data were analyzed using thematic analysis. RESULTS: Six themes were identified incorporating the early onset of cannabis and heavy use, involvement in criminality including drug dealing to pay for cannabis, ambivalence, experience of treatment, and damage to relationships. These themes are discussed in light of emerging literature. CONCLUSION: Young cannabis users in treatment can clearly identify many negative aspects of their cannabis use but are particularly ambivalent toward cannabis. Reluctance to aim for abstinence is common.


Assuntos
Atitude Frente a Saúde , Uso da Maconha/terapia , Adolescente , Idade de Início , Crime/psicologia , Crime/estatística & dados numéricos , Tráfico de Drogas/psicologia , Feminino , Humanos , Irlanda , Masculino , Uso da Maconha/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Centros de Tratamento de Abuso de Substâncias
8.
BMC Health Serv Res ; 19(1): 656, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31500620

RESUMO

BACKGROUND: In Thailand, two community-based drug treatment approaches are common. The first one is the traditional community-based treatment program (FAST) which brings the principles of community therapy as a guideline for treatment. The second one is the military hospital-based drug treatment program (PMK), derived from the basic military training, the Buddhist Twelve Steps, CBT and the Minnesota Rehabilitation Model. This study aimed to investigate and compare the efficacy of PMK vs. FAST. METHOD: The experiment was conducted from January-March 2016 at the rehabilitation center for patients with drug addiction in Thailand. Quasi-experimental methods were introduced, and ASSIST, WHOQOL-BRIEF-THAI and self-efficacy interview form were applied. After completing the drug rehabilitation program at a total duration of 120 days, the researcher continued at follow up times at 3 and 6 months. RESULTS: Compared with baseline scores, both programs significantly reduced the severity of drugs and increased self-efficacy at 6-month follow-up. PMK had better improved scores in the relationship and environment dimensions of quality of life at 3-month follow-up (P = 0.026, 0.006). The mean quality of life scores in PMK at 3 and 6 months showed better results than mean scores at baseline (P = < 0.001). CONCLUSION: Both community-based programs in Thailand significantly reduced the severity of drugs and increased self-efficacy scores at 6-month follow-up. PMK and FAST has not shown any significant difference in treatment outcome results in the aspects of self-efficacy and reduced severity of drugs used. However, PMK had significant positive effects on the quality of life.


Assuntos
Qualidade de Vida , Autoeficácia , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Hospitais Militares , Humanos , Masculino , Pessoa de Meia-Idade , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tailândia , Resultado do Tratamento
9.
Int. j. clin. health psychol. (Internet) ; 19(3): 181-188, sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184964

RESUMO

Background/Objective: Previous studies have shown that childhood abuse is associated with symptoms of depression. This study aims to examine the prevalence of childhood abuse or neglect and its correlation with depression among a sample of Chinese people who use methamphetamine. Method: People who use methamphetamine (MA) (N = 1,173) were recruited from government-operated drug rehabilitation centres in Anhui province, China. Participants were assessed using the short form of Childhood Trauma Questionnaire and the Beck Depression Inventory-II for childhood abuse or neglect and depression symptoms. Results: A total of 44.6% of people who use MA reported moderate/severe childhood abuse or neglect, and 56.9% of this sample were diagnosed with depression. Emotional abuse, sexual abuse, emotional neglect and physical neglect were revealed to increase the risk of depression. Multivariable regression analyses showed that depression scores were significantly predicted by gender, duration of drug use, sexual abuse and emotional neglect (model R2 = .08, p < .001). The interaction between emotional neglect and duration of drug use on the depression was statistically significant. Conclusions: These analyses indicate that sexual abuse and emotional neglect increase the severity of depression in individuals who use MA in drug rehabilitation centres of China


Antecedentes/Objetivo: Estudios previos han demostrado que el abuso infantil está asociado a síntomas depresivos. El objetivo es investigar la prevalencia del abuso infantil entre consumidores de metanfetaminas en muestras chinas y su correlación con la depresión. Método: Se reclutan consumidores de metanfetamina (MA) del centro de rehabilitación de drogas del gobierno chino (N = 1.173). Los participantes fueron evaluados utilizando la forma corta del Childhood Trauma Questionnaire y el Inventario de Depresión de Beck-II para abuso infantil o negligencia y síntomas depresivos, respectivamente. Resultados: El 44,6% de los consumidores de MA reportaron abuso infantil moderado/grave, de los cuales el 56,9% fueron diagnosticados con depresión leve a grave. El abuso emocional, abuso sexual, abandono emocional y negligencia física fueron asociados al incremente del riesgo de depresión. El análisis de regresión multivariada indica que la depresión se predice de manera significativa según el sexo, la duración del consumo de drogas, el abuso sexual y el grado de negligencia emocional (R2 = 0,08; p <  0,001). El efecto de la negligencia emocional y del tiempo de consumo de drogas sobre la depresión fue significativo. Conclusiones: El abuso sexual y el abandono emocional aumentan la gravedad de la depresión en pacientes de centros de rehabilitación de drogas en China


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Abuso Sexual na Infância/psicologia , Depressão/psicologia , Metanfetamina , Transtornos Relacionados ao Uso de Substâncias , Prevalência , Fatores de Risco , Centros de Tratamento de Abuso de Substâncias , Fatores Socioeconômicos
10.
Med Care ; 57(10): 815-821, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31415341

RESUMO

BACKGROUND: Any opioid-related hospitalization is an indicator of opioid-related harm and should ideally trigger carefully monitored decreases in opioid prescribing after inpatient stays in many, if not most, cases. However, past studies on opioid prescribing after hospitalizations have largely been limited to overdose related visits. It is unclear whether prescribing is different for other opioid-related indications such as opioid dependence and abuse and how that may compare with hospitalizations for overdose. OBJECTIVE: To examine opioid-prescribing patterns before and after opioid-related hospitalizations for all opioid-related indications, not limited to overdose. RESEARCH DESIGN: Retrospective cohort analysis of Veterans Health Administration (VHA) administrative claims from 2011 to 2014. SUBJECTS: VHA patients who were hospitalized between fiscal years 2011 and 2014 and had at least 1 prescription opioid medication filled through the VHA pharmacy before their hospitalization. MEASURES: Opioid dispensing trajectories after hospitalization by opioid-related indication (ie, opioid dependence and/or abuse vs. overdose) compared with prescribing patterns for non-opioid-related hospitalizations. RESULTS: Overall, opioid dosage dropped significantly (66% for dependence/abuse, 42% for overdose, and 3% for nonopioid diagnoses; P<0.001) across all 3 categories when comparing dose 57-63 days after admission to 57-63 days before hospitalization. However, 47% of the patients remained on the same dose or increased their opioid dose at 60 days after an opioid-related hospitalization. After adjusting for covariates, patients with a primary diagnosis of dependence/abuse had higher odds of having their dose discontinued compared with those with overdose: odds ratio (OR) 2.17 (1.19-3.96). Patients with admissions for opioid dependence and/or abuse had a statistically significant higher prevalence of depression, posttraumatic stress disorder, anxiety, and substance use disorders compared with those with an opioid overdose hospitalization. CONCLUSIONS: Opioid prescribing and patient risk factors before and after opioid-related hospitalizations vary by indication for hospitalization. To reduce costs and morbidity associated with opioid-related hospitalizations, opioid deintensification efforts need to be tailored to indication for hospitalization.


Assuntos
Analgésicos Opioides/administração & dosagem , Hospitalização/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Estados Unidos , United States Department of Veterans Affairs
11.
South Med J ; 112(7): 406-411, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31282972

RESUMO

OBJECTIVES: Smoking is deadly and exacerbates comorbid health conditions, especially among those with co-occurring substance use disorders. Tennessee does not require substance abuse treatment facilities to concurrently provide tobacco-cessation treatment options or limit smoking on facility property as a standard for licensure. This study examines the relation between Tennessee facility region and availability of pharmacotherapeutic options for tobacco cessation, and the relation between the facilities' region and facility smoking policy. METHODS: This study is descriptive, cross-sectional, and exploratory in its design. Study findings are from a secondary analysis of data acquired from the 2016 edition of the National Directory of Drug and Alcohol Abuse Treatment Facilities published by the Substance Abuse and Mental Health Services Administration. RESULTS: The number of substance abuse treatment facilities providing pharmacotherapy options in west Tennessee (7.8%) are statistically significantly lower as compared with substance abuse treatment facilities in both middle (24.6%) and east (39.2%) Tennessee. A statistically significantly higher percentage of facilities in west Tennessee (23.5%) with policies that permit smoking without restriction as compared with the number of facilities in east Tennessee (6.8%) also was found, whereas the facilities in west Tennessee (60.8%) have a policy that permits smoking in designated areas that is significantly lower than the number of facilities in east Tennessee (81.1%). CONCLUSIONS: Tobacco-cessation options are a preventive intervention that can be easily incorporated into a treatment facility's standard of practice and should be made available within the context of all substance abuse treatment facilities. Failure to provide concurrent tobacco-cessation options during substance abuse treatment contradicts the purpose of medical treatment. Medically oriented substance abuse facilities are exemplary settings for offering pharmacotherapeutic options to concurrently treat tobacco use. It is suggested that interdisciplinary clinicians in the field of substance abuse advocate for the implementation of concurrent tobacco cessation treatment in their organization.


Assuntos
Acesso aos Serviços de Saúde , Agentes de Cessação do Hábito de Fumar/uso terapêutico , Centros de Tratamento de Abuso de Substâncias , Abandono do Uso de Tabaco/métodos , Estudos Transversais , Humanos , Política Organizacional , Tennessee
12.
Rev Esp Salud Publica ; 932019 Jul 17.
Artigo em Espanhol | MEDLINE | ID: mdl-31313757

RESUMO

OBJECTIVE: The incorporation of gender variable in drug addiction studies provides information about the presence of differences in the therapeutic success rates between men and women. Is therefore essential to carry out studies to analyse the efficacy of differentiated treatments to improve their success. The objective of this study is to observe differences in success rates among women and men undergoing therapy for drug dependence at an addiction centre during two different periods, before 2005, in which they are treated together and after 2005, in which they are treated in separate groups. METHODS: The method was as follows: profiling of the individuals in treatment, analysis of the relationship between successful therapy and the independent variables, T-tests of independent samples and, finally, a logistic regression analysis of the period after 2005 when women and men were separated. RESULTS: Improved success rates were observed among women after 2005 compared with the previous period (Odds of success in women before 2005=2,00; after 2005=7,08). Success rates among men did not change significantly (Odds of success in men before 2005=2,78; after 2005=2,75). Women's success rates were higher than men's (24,4 times more probable on average) for all types of substance abuse and increased for shorter types of treatment, whereas success rates with longer treatments tended to be similar for both men and women (20,5 more likely). CONCLUSIONS: The study shows improved success rates for drug-dependent women when they are treated separately from men, once the specific problems of drug addiction in women are taken into account.


Assuntos
Serviços de Saúde Mental/organização & administração , Psicoterapia de Grupo/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Análise de Regressão , Espanha , Centros de Tratamento de Abuso de Substâncias , Resultado do Tratamento , Adulto Jovem
13.
Salud Publica Mex ; 61(4): 461-469, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31314209

RESUMO

OBJECTIVE: Monitor drug use through wastewater metabolite measurement. MATERIALS AND METHODS: Wastewater samples were obtained from 31 wastewater treatment plants and 95 sites with specific populations (38 schools, 42 units of addiction treatment and 15 penitentiaries). Using ultra high liquid chromatography, we measured nine metabolites from six drugs. RESULTS: Eight out of nine drug metabolites were identified in the samples. Marijuana (THC-COOH), cocaine (benzoylecgonine) and methamphetamine were identified in schools, centers of addiction treatment and penitentiaries. Nuevo Laredo, Culiacan and Torreon had the highest consumption of cocaine, marijuana, amphetamine and methamphetamine. CONCLUSIONS: Monitoring drug use through wastewater is feasible in Mexico and could constitute a surveillance system to identify changes in the time.


Assuntos
/análise , Detecção do Abuso de Substâncias/métodos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Águas Residuárias/química , Cannabis/química , Cromatografia Líquida de Alta Pressão , Cidades/epidemiologia , Cocaína/análogos & derivados , Cocaína/análise , Serviços de Saúde Comunitária/estatística & dados numéricos , Dronabinol/análogos & derivados , Dronabinol/análise , Estudos de Viabilidade , Heroína/análise , Humanos , Metanfetamina/análise , México/epidemiologia , Morfina/análise , N-Metil-3,4-Metilenodioxianfetamina/análise , Projetos Piloto , Instituições Acadêmicas/estatística & dados numéricos , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Fatores de Tempo , Purificação da Água
14.
Rev. enferm. UFSM ; 9: [21], jul. 15, 2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1024204

RESUMO

Objetivo: analisar a trajetória percorrida pelos adolescentes usuários de crack até o início do tratamento no Centro de Atenção Psicossocial Álcool e Drogas (CAPS AD). Método: trata-se de um estudo exploratório descritivo com abordagem qualitativa. Participaram usuários, familiares e profissionais atuantes no CAPS AD. Os dados foram coletados por meio de entrevistas semiestruturadas, organizados e tratados pelo software Nvivo 11 e, posteriormente, submetidos a Análise Temática. Resultado: a partir da análise dos dados emergiram as seguintes categorias: a forma como o adolescente usuário de crack chega ao CAPS AD; Motivos que levam o adolescente usuário de crack para tratamento no CAPS AD e Serviços utilizados pelos adolescentes usuários de crack até chegar ao CAPS AD. Considerações finais: mostra-se importante o investimento nos serviços e ações desenvolvidas pela Rede de Atenção Piscossocial (RAPS), dando-lhes maior visibilidade e acesso aos jovens.


Aim: to analyze the trajectory experienced by adolescent crack users until the beginning of their treatment in the Psychosocial Care Center for Alcohol and Drugs (CAPS AD). Method: This is a descriptive exploratory study, with a qualitative approach. Users, their relatives and workers from CAPS AD participated in the study. Data were collected through semi-structured interviews, organized and treated by Nvivo 11 software and, subsequently, submitted to Thematic Analysis. Result: From data analysis, the following categories emerged: The way the adolescent crack user arrives at CAPS AD; Reasons that lead the adolescent crack user to seek treatment at CAPS AD and Services used by adolescent crack users until they arrive at CAPS AD. Final considerations: it is important to invest in services and actions developed by the Psychosocial Care Network (RAPS), giving them greater visibility and access to young people.


Objetivo: analizar la trayectoria de los adolescentes usuarios de crack hasta empezar el tratamiento en el Centro de Atención Psicosocial Alcohol y Drogas (CAPS AD). Método: se trata de un estudio exploratorio, descriptivo, de base cualitativo. Participaron del estudio usuarios, familiares y profesionales actuantes en el CAPS AD. Los datos fueron recolectados por medio de entrevistas semiestructuradas y ordenados y tratados por el software Nvivo 11 y, posteriormente, sometidos al Análisis Temático. Resultado: a partir del análisis de los datos surgieron las siguientes categorías: la forma que el adolescente, usuario de crack, llega al CAPS AD; los motivos que llevan el adolescente, usuario de crack, a tratarse en el CAPS AD; y los servicios utilizados por los adolescentes, usuarios de crack, hasta llegar al CAPS AD. Consideraciones finales: se reveló importante la inversión en los servicios y acciones desarrolladas por la Red de Atención Psicosocial (RAPS), dando a esos mayor visibilidad y acceso a los jóvenes.


Assuntos
Humanos , Adolescente , Enfermagem , Cocaína Crack , Centros de Tratamento de Abuso de Substâncias , Reabilitação Psiquiátrica
15.
Implement Sci ; 14(1): 66, 2019 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221201

RESUMO

BACKGROUND: Effective leadership for organizational change is critical to the implementation of evidence-based practices (EBPs). As organizational leaders in behavioral health organizations often are promoted from within the agency for their long-standing, effective work as counselors, they may lack formal training in leadership, management, or practice change. This study assesses a novel implementation leadership training designed to promote leadership skills and successful organizational change specific to EBP implementation. METHODS: We conducted a pre-post outcome evaluation of the Training in Implementation Practice Leadership (TRIPLE), delivered via three in-person, half-day training sessions, with interim coaching and technical support. Sixteen mid-level leaders (75% female, 94% Caucasian, mean age 37 years) from 8 substance abuse treatment agencies participated. Professional roles included clinical managers, quality improvement coordinators, and program directors. Participants completed surveys prior to the first and following the final session. At both time points, measures included the Implementation Leadership Scale, Implementation Climate Scale, and Organizational Readiness for Implementing Change Scale. At post-test, we added the Training Acceptability and Appropriateness Scale (TAAS), assessing participant satisfaction with the training. Qualitative interviews were conducted 6 to 8 months after the training. RESULTS: Most participants (86% and 79%, respectively) reported increased implementation leadership skills and implementation climate; paired samples t tests indicated these pre-post increases were statistically significant. Implementation leadership scores improved most markedly on the Proactive and Knowledgeable subscales. For implementation climate, participants reported the greatest increases in educational support and recognition for using EBP. Post-test scores on the TAAS also indicated that participants found the training program to be highly acceptable and appropriate for their needs. Qualitative results supported positive outcomes of training that resulted in both increased organizational implementation as well as leadership skills of participants. CONCLUSIONS: This training program represents an innovative, effective, and well-received implementation strategy for emerging behavioral healthcare leaders seeking to adopt or improve the delivery of EBPs. Reported implementation leadership skills and implementation climate improved following the training program, suggesting that TRIPLE may have helped fulfill a critical need for emerging behavioral healthcare leaders.


Assuntos
Prática Clínica Baseada em Evidências/organização & administração , Pessoal de Saúde/educação , Capacitação em Serviço , Liderança , Inovação Organizacional , Competência Profissional , Centros de Tratamento de Abuso de Substâncias , Adulto , Feminino , Humanos , Masculino
16.
Curr Med Sci ; 39(3): 472-482, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31209821

RESUMO

The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (n=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=0.033) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Dessensibilização e Reprocessamento através dos Movimentos Oculares/métodos , Dependência de Heroína/terapia , Mentalização/fisiologia , Motivação/fisiologia , Adulto , Agressão/psicologia , China , Seguimentos , Dependência de Heroína/psicologia , Dependência de Heroína/reabilitação , Humanos , Masculino , Saúde Mental , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Inventário de Personalidade , Centros de Tratamento de Abuso de Substâncias , Inquéritos e Questionários
17.
AIDS Behav ; 23(11): 3175-3183, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31154559

RESUMO

Social media can potentially serve as a platform to coordinate medical care among fragmented health sectors. This paper describes procedures of using social media to enhance antiretroviral therapy (ART) and methadone maintenance treatment (MMT) providers' virtual network for integrated service for HIV-positive people who inject drugs (PWID) in Vietnam. A total of 88 ART and MMT treatment providers participated in person group sessions followed by online virtual support to improve service integration. In-person reunions were held to reinforce Facebook participation and network activities. Content analysis was used to identify keywords and topic categories of the online information exchange. Both MMT and ART providers were actively engaged in online communications. Referral and treatment adherence were the two most frequently discussed topic areas by both the MMT and ART providers. Frequent cross-agency connections were observed. Online provider networks and communities could be built and useful to support treatment providers to improve service integration.


Assuntos
Antirretrovirais/uso terapêutico , Prestação Integrada de Cuidados de Saúde/métodos , Infecções por HIV/psicologia , Redução do Dano , Acesso aos Serviços de Saúde , Metadona/uso terapêutico , Mídias Sociais , Centros de Tratamento de Abuso de Substâncias/organização & administração , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Atitude do Pessoal de Saúde , Infecções por HIV/tratamento farmacológico , Humanos , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Vietnã
18.
Int J Clin Pharm ; 41(4): 972-980, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31197547

RESUMO

Background Mental health problems are common in people with substance misuse problems. However, there is a paucity of evidence regarding prescribing of psychotropic medications for people with comorbid mental health and substance misuse problems. Objective To explore the views of service users attending an addiction service on the appropriateness of psychotropic medications prescribed for their co-existing mental health problems. Setting A specialist addiction service in the North of England. Method A phenomenological approach was adopted. Semi-structured interviews were conducted with twelve service users. Data were analysed using thematic framework analysis. Main outcome measure Service users' views concerning the appropriateness of their prescribed psychotropic medications. Results The following themes captured service users' views on the appropriateness of their medications: benefits from medicines, entitlement to medicines, and assessment and review. Service users mostly described benefits from their medications (including those prescribed outside guideline recommendations) and there was also an awareness of the adverse effects they experienced from them. It appears that people with substance misuse problems have a particularly strong sense of their own needs and seek to influence prescribing decisions. Service users further described varied practices regarding assessment and review of their medications with evidence of regular reviews while others identified suboptimal or inadequate practices. Conclusion Most service users described improved functioning as a result of their prescribed psychotropic medications. Prescriptions that are inappropriate in terms of their usual indications may well be justified if they assist in stabilising service users and moving them on to recovery.


Assuntos
Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Conhecimento do Paciente sobre a Medicação , Pacientes/psicologia , Psicotrópicos/uso terapêutico , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Idoso , Comorbidade , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
Alcohol Alcohol ; 54(4): 439-445, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31053855

RESUMO

AIMS: To evaluate the long-term treatment outcome (up to 5 years) with respect to different drinking goals of patients. METHODS: Alcohol-dependent individuals (n = 349) were recruited from three alcohol treatment units. They were interviewed using the Addiction Severity Index (ASI). They were sub-grouped according to their goal at treatment entry: abstinence, low- risk drinking and no decided goal. RESULTS: Patients with abstinence as a goal at treatment entry reported at 2.5 years follow-up a higher abstinence rate, a more pronounced reduction in alcohol consumption, reduction in total number of DSM-IV criteria, higher frequency of low-risk drinking and fewer diagnoses of alcohol dependence compared to the groups who had low risk drinking as a goal or no decided goal. This improvement remained basically unchanged in all three groups at 5 years follow-up, suggesting long-term stability after the treatment interventions. CONCLUSIONS: The findings suggest that: (1) alcohol-dependent patients who have abstinence as their own drinking goal have a more favorable treatment outcome than those who have low-risk drinking as a goal or no decided goal. (2) Abstinence as a drinking goal should be considered for those who have a longer duration (for example more than 10 years) of their alcohol-related problems. (3) Patients who have no decided goal should be recommended abstinence as a drinking goal.


Assuntos
Abstinência de Álcool/psicologia , Abstinência de Álcool/tendências , Alcoolismo/psicologia , Alcoolismo/terapia , Metas , Centros de Tratamento de Abuso de Substâncias/tendências , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Alcoolismo/epidemiologia , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Autorrelato , Suécia/epidemiologia , Fatores de Tempo , Resultado do Tratamento
20.
Drug Alcohol Depend ; 199: 144-150, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31054421

RESUMO

BACKGROUND: The current study aimed to contribute to the understanding of the session to session relationship between craving and drinking during the course of treatment via the incorporation into the analysis of both a) motivation to avoid alcohol and 2) pretreatment change, given that half of all individuals entering treatment change their drinking prior to the first session. METHODS: Sixty-three treatment-seeking participants received 12 weeks of CBT for alcohol dependence and completed assessments of approach inclinations, avoidance inclinations and drinking behaviors at the end of each session. RESULTS: Consistent with our hypothesis, motivations to avoid alcohol and pretreatment change significantly interacted with craving to predict both number of drinking days and heavy drinking days during the interval between sessions. Specifically, among lower pretreatment changers, motivation to avoid alcohol moderated the effect of craving on number of drinking days and number of heavy drinking days, such that craving positively predicted drinking among those lower on motivations to avoid only. In contrast, among higher pretreatment changers, cravings positively predicted drinking among those higher on motivations to avoid alcohol. CONCLUSIONS: These findings highlight the importance of measuring both desire to consume and desire to avoid consuming alcohol simultaneously, and suggest that ambivalence may function differently depending on whether one is initiating (low pretreatment change) versus maintaining change (high pretreatment change).


Assuntos
Alcoolismo/psicologia , Alcoolismo/terapia , Terapia Cognitivo-Comportamental/métodos , Fissura/fisiologia , Motivação/fisiologia , Adolescente , Adulto , Afeto/fisiologia , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Centros de Tratamento de Abuso de Substâncias/métodos , Resultado do Tratamento , Adulto Jovem
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