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Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 41-49, jan.-dez. 2021. graf, tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1146053


Objetivo: Caracterizar o perfil dos adolescentes usuários de crack em tratamento no CAPS ADIII de Pelotas/ Rio Grande do Sul. Método: estudo descritivo de abordagem quantitativa realizado com 14 adolescentes usuários de crack em tratamento no CAPS ADIII. A coleta de dados ocorreu por meio de entrevistas utilizando o instrumento Teen Addiction Severity Index. Na análise dos dados empregou-se a estatística descritiva através de frequência simples. Resultados: a maioria é do sexo masculino, entre 13 e 17 anos, solteiros, negros. O início do uso de drogas variou de oito e 17 anos. Apresentam ensino fundamental incompleto e abandono escolar. Identificou-se o uso de cocaína/crack e a relação com atividades ilegais. Constatou-se a existência de conflitos familiares. O uso de substancias também é identificado entre os amigos próximos. Conclusão: os resultados apontam para a necessidade de investimentos em ações de promoção à saúde e prevenção ao uso de substâncias

Objective: To characterize the profile of adolescent user of crack in treatment in the CAPS ADIII in Pelotas/Rio Grande do Sul. Method: a descriptive study with a quantitative approach performed with 14 teenage users of crack treatment in the CAPS ADIII. The data collection occurred through interviews using the Teen Addiction Severity Index. In the data analysis was employed descriptive statistics through simple frequency. Results: the majority are male, between 13 and 17 years old, single, black. The onset of drug use ranged from eight to 17 years. They present incomplete elementary education and drop out of school. It was identified the use of cocaine/crack and the relation with illegal activities. The existence of family conflicts was verified. Substance use is also identified among close friends. Conclusion: the results point to the need for investments in actions to promote health and prevent substance use

Objetivo: Caracterizar el perfil del adolescente usuario de crack en tratamiento en el CAPS ADIII de Pelotas/Rio Grande do Sul. Método: estudio descriptivo de abordaje cuantitativo realizado con 14 adolescentes usuarios de crack en tratamiento en el CAPS ADIII. La recolección de datos ocurrió a través de entrevistas utilizando el instrumento Teen Addiction Severity Index. En el análisis de los datos se empleó la estadística descriptiva a través de frecuencia simple. Resultados: la mayoría es del sexo masculino, entre 13 y 17 años, solteros, negros. El inicio del uso de drogas varía de ocho a 17 años. Se presenta una enseñanza fundamental incompleta y abandono escolar. Se identificó el uso de cocaína/crack y la relación con actividades ilegales. Se constató la existencia de conflictos familiares. El uso de sustancias también se identifica entre los amigos cercanos. Conclusión: los resultados apuntan a la necesidad de inversiones en acciones de promoción a la salud y prevención del uso de sustancias

Humanos , Masculino , Feminino , Adolescente , Cocaína Crack , Grupo com Ancestrais do Continente Africano , Promoção da Saúde , Serviços de Saúde Mental , Evasão Escolar , Cocaína , Saúde do Adolescente , Prevenção de Doenças , Conflito Familiar , Usuários de Drogas
BMC Oral Health ; 20(1): 299, 2020 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-33129288


BACKGROUND: The present study aimed to assess dental professionals' attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs). METHODS: The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study. RESULTS: Thirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p <  0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs. Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment. CONCLUSIONS: Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users' expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.

Usuários de Drogas , Atitude , Atitude do Pessoal de Saúde , Assistência Odontológica , Humanos , Relações Interprofissionais , Motivação , Noruega
Stud Health Technol Inform ; 275: 236-237, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33227780


Information and Communication Technologies (ICT) are broadly used to support people's daily needs. Individuals addicted to psychoactive drugs sometimes present social exclusion as well as, limitations to the usage of ICT such as Internet, devices and applications. The aim of this paper is to present the findings of a pilot study related to the use of Information and Communication Technologies by Drug Addicts. A survey was conducted on 204 users of psychoactive substances. According to the results, the majority of the drug addicts seem to use ICT on a daily basis, showing their preference on Smartphones compared to other devices. The Internet access and the usage of Social Media and Communication Networks by addicted individuals is quite high, probably because they are willing to reintegrate into the society through Social Networks. Age is often related to the usage of ICT on Drug Addicts.

Usuários de Drogas , Tecnologia da Informação , Comunicação , Humanos , Internet , Projetos Piloto , Inquéritos e Questionários
Int J Drug Policy ; 83: 102958, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33183679


SARS-CoV-2, the virus that causes COVID-19, has changed the world as we know it, and continues to do so. How COVID-19 affects people who use drugs, the environments in which they live, and capacities of response, warrants immediate attention. This special issue begins to map how COVID-19 is altering the health of people who use drugs, including in relation to patterns of drug use, service responses, harms that may relate to drug use, interventions to reduce risk of harms, COVID-19 health, and drug policies. We emphasise the need to envisage COVID-19 and its effects as a matter of intersecting 'complex adaptive systems': that is, the impacts of COVID-19 extend beyond the virus and related illness conditions to encompass multiple social, cultural, economic, policy and political effects; and these affect the health of people who use drugs directly as well as indirectly by altering the risk and enabling environments in which they live. We synthesize emergent evidence on the impact of COVID-19 on the health of people who use drugs. A key concern we identify is how to sustain policy and service delivery improvements prompted by COVID-19. We need to maintain an ethos of emergent adaptation and experimentation towards the creation of safer environments in relation to the health of people who use drugs.

Infecções por Coronavirus , Usuários de Drogas/estatística & dados numéricos , Nível de Saúde , Pandemias , Pneumonia Viral , Humanos , Política Pública , Transtornos Relacionados ao Uso de Substâncias/complicações
JAMA Netw Open ; 3(10): e2016228, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33052402


Importance: Although hospitalizations for injection drug use-associated infective endocarditis (IDU-IE) have increased during the opioid crisis, utilization of and mortality associated with receipt of medication for opioid use disorder (MOUD) after discharge from the hospital among patients with IDU-IE are unknown. Objective: To assess the proportion of patients receiving MOUD after hospitalization for IDU-IE and the association of MOUD receipt with mortality. Design, Setting, and Participants: This retrospective cohort study used a population registry with person-level medical claims, prescription monitoring program, mortality, and substance use treatment data from Massachusetts between January 1, 2011, and December 31, 2015; IDU-IE-related discharges between July 1, 2011, and June, 30, 2015, were analyzed. All Massachusetts residents aged 18 to 64 years with a first hospitalization for IDU-IE were included; IDU-IE was defined as any hospitalization with a diagnosis of endocarditis and at least 1 claim in the prior 6 months for OUD, drug use, or hepatitis C and with 2-month survival after hospital discharge. Data were analyzed from November 11, 2018, to June 23, 2020. Exposure: Receipt of MOUD, defined as any treatment with methadone, buprenorphine, or naltrexone, within 3 months after hospital discharge excluding discharge month for IDU-IE. Main Outcomes and Measures: The main outcome was all-cause mortality. The proportion of patients who received MOUD in the 3 months after hospital discharge was calculated. Multivariable Cox proportional hazard regression models were used to examine the association of MOUD receipt with mortality, adjusting for sex, age, medical and psychiatric comorbidities, and homelessness. In the secondary analysis, receipt of MOUD was considered as a monthly time-varying exposure. Results: Of 679 individuals with IDU-IE, 413 (60.8%) were male, the mean (SD) age was 39.2 (12.1) years, 298 (43.9%) were aged 18 to 34 years, 419 (72.3) had mental illness, and 209 (30.8) experienced homelessness. A total of 134 individuals (19.7%) received MOUD in the 3 months before hospitalization and 165 (24.3%) in the 3 months after hospital discharge. Of those who received MOUD after discharge, 112 (67.9%) received buprenorphine. The crude mortality rate was 9.2 deaths per 100 person-years. MOUD receipt within 3 months after discharge was not associated with reduced mortality (adjusted hazard ratio, 1.29; 95% CI, 0.61-2.72); however, MOUD receipt was associated with reduced mortality in the month that MOUD was received (adjusted hazard ratio, 0.30; 95% CI, 0.10-0.89). Conclusions and Relevance: In this cohort study, receipt of MOUD was associated with reduced mortality after hospitalization for injection drug use-associated endocarditis only in the month it was received. Efforts to improve MOUD initiation and retention after IDU-IE hospitalization may be beneficial.

Causas de Morte , Usuários de Drogas/estatística & dados numéricos , Endocardite/induzido quimicamente , Endocardite/mortalidade , Transtornos Relacionados ao Uso de Opioides/mortalidade , Dependência de Ópio/mortalidade , Abuso de Substâncias por Via Intravenosa/mortalidade , Adolescente , Adulto , Estudos de Coortes , Endocardite/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Adulto Jovem
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193593


OBJETIVOS: Evaluar la efectividad de una intervención comunitaria de formación profesional para jóvenes en riesgo de exclusión social, en la salud autopercibida, la autoestima y el consumo de sustancias (alcohol, tabaco y cannabis). Evaluar la satisfacción de los participantes. MÉTODOS: Diseño: estudio de intervención pre-post. Emplazamiento: tres barrios de renta baja de Barcelona durante 2013-2017. Participantes: 185 participantes, de 21 años de media y predominio masculino (65,5%). Intervención: programa de 4 meses de formación profesional de diferentes disciplinas e itinerarios orientados a la inserción laboral. Mediciones principales: análisis bivariado (McNemar) para datos apareados, comparando la salud autopercibida, autoestima y consumos pre-post intervención. Modelos de regresión de Poisson para las variables resultado, ajustando por variables explicativas. Además, se evaluó la satisfacción con el programa a través de un cuestionario y una discusión grupal. RESULTADOS: la salud autopercibida era elevada antes de la intervención (87,7% hombres y 82,1% mujeres) y se mantuvo tras ella (90,6% y 83,9% respectivamente). Los niveles elevados de autoestima previos a la intervención (92,8% en hombres y 92,9% mujeres) aumentaron tras ella (95,5% y 100% respectivamente), de forma significativa en las mujeres (p < 0,05). El consumo de sustancias no varió tras la intervención. La satisfacción con el programa fue elevada. CONCLUSIÓN: la intervención parece haber mejorado la autoestima en las mujeres, un colectivo con elevado desempleo y normalmente infrarrepresentado en los programas formativos. Esta intervención no incidió en el consumo de sustancias. Los programas de inserción laboral para jóvenes pueden promover factores beneficiosos para la salud mental

OBJECTIVES: To evaluate the effectiveness of a community occupational training intervention for young people at risk of social exclusion on self-perceived health, self-esteem and substance use (alcohol, tobacco and cannabis). To assess participant's satisfaction. METHODS: Design: Quasi-experimental before-after study. Setting: Three low-income neighbourhoods in Barcelona during 2013-2017. Participants: 185 participants with an average age of 21 years and mainly males (65.5%). Intervention: Four-month programme on specific occupational skills and itineraries oriented towards occupational integration. Most important measurements: Bivariate analysis (McNemar test) for paired data to compare self-rated health and self-esteem pre-intervention and post-intervention. Poisson regression models for result variables, adjusting for explanatory variables. In addition, satisfaction with the programme was evaluated by means of a questionnaire and group discussion. RESULTS: Pre-intervention self-rating was good (87.7% men and 82.1% women) and remained good post-intervention (90.6% and 83.9% respectively). Pre-intervention self-esteem was good (92.8% in men and 92.9% in women) and increased after the intervention (95.5% and 100% respectively). This was statistically significant in women (P<0.05). Substance use was unaltered after the intervention. Satisfaction with the programme was high. CONCLUSION: The intervention appears to have improved self-esteem among young women, who are an important group among the unemployed, as they are usually underrepresented in training and professional programmes. Programmes that foster young people moving into working life may also promote factors beneficial to mental health

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Participação da Comunidade , Capacitação Profissional , Populações Vulneráveis/psicologia , Autoimagem , Transtornos Relacionados ao Uso de Substâncias/psicologia , Usuários de Drogas/psicologia
J Mycol Med ; 30(4): 101046, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33067115


We present an uncommon case of isolated basal ganglia mucormycosis in a patient without any known cause of immunosuppression, but with a history of drug injection. The patient presented a good clinical and radiological response to antifungal treatment without aggressive surgical debridement (liposomal amphotericin B combined with isavuconazole for 4 weeks followed by isavuconazole as maintenance therapy for 10 months).

Infecções Fúngicas do Sistema Nervoso Central/etiologia , Mucormicose/etiologia , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/microbiologia , Anfotericina B/administração & dosagem , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico , Infecções Fúngicas do Sistema Nervoso Central/tratamento farmacológico , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Cocaína , Transtornos Relacionados ao Uso de Cocaína/complicações , Transtornos Relacionados ao Uso de Cocaína/tratamento farmacológico , Transtornos Relacionados ao Uso de Cocaína/microbiologia , Quimioterapia Combinada , Usuários de Drogas , Humanos , Imagem por Ressonância Magnética , Masculino , Abuso de Maconha/complicações , Abuso de Maconha/tratamento farmacológico , Abuso de Maconha/microbiologia , Pessoa de Meia-Idade , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Nitrilos/administração & dosagem , Piridinas/administração & dosagem , Abuso de Substâncias por Via Intravenosa/diagnóstico por imagem , Abuso de Substâncias por Via Intravenosa/tratamento farmacológico , Triazóis/administração & dosagem
Zhonghua Gan Zang Bing Za Zhi ; 28(10): 893-896, 2020 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-33105938


HCV prevalence among people who inject drugs (PWID) is up to 67%. PWID is a population that needs priority attention to achieve the World Health Organization's goal of eliminating viral hepatitis as a public health threat by 2030. Although the SVR of HCV patients treated with direct-acting antiviral drugs (DAAs) can reach over 95%, especially in medical practice, there are still major obstacles to PWID treatment, because PWID is usually accompanied with concurrent infection, multiple-genotype infections, low compliance, substance abuse, methadone maintenance therapy, and risky behavior and re-infection conditions. Therefore, physicians often concern that these factors will affect the treatment efficacy, and refuse to provide hepatitis C treatment in PWID. This article reviews the relevant studies status and effects of hepatitis C treatment in PWID with different infection states and special behavior characteristics, and further highlights that the multidisciplinary cooperation for hepatitis C treatment in PWID is safe and effective, and can ensure treatment compliance.

Antivirais , Usuários de Drogas , Hepatite C , Abuso de Substâncias por Via Intravenosa , Antivirais/uso terapêutico , Hepatite C/tratamento farmacológico , Humanos , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/tratamento farmacológico
PLoS Med ; 17(10): e1003239, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33048929


BACKGROUND: Cycles of incarceration, drug abuse, and poverty undermine ongoing public health efforts to reduce overdose deaths and the spread of infectious disease in vulnerable populations. Jail diversion programs aim to divert low-level drug offenders toward community care resources, avoiding criminal justice costs and disruptions in treatment for HIV, hepatitis C virus (HCV), and drug abuse. We sought to assess the health benefits and cost-effectiveness of a jail diversion program for low-level drug offenders. METHODS AND FINDINGS: We developed a microsimulation model, calibrated to King County, Washington, that captured the spread of HIV and HCV infections and incarceration and treatment systems as well as preexisting interventions such as needle and syringe programs and opiate agonist therapy. We considered an adult population of people who inject drugs (PWID), people who use drugs but do not inject (PWUD), men who have sex with men, and lower-risk heterosexuals. We projected discounted lifetime costs and quality-adjusted life years (QALYs) over a 10-year time horizon with and without a jail diversion program and calculated resulting incremental cost-effectiveness ratios (ICERs) from the health system and societal perspectives. We also tracked HIV and HCV infections, overdose deaths, and jail population size. Over 10 years, the program was estimated to reduce HIV and HCV incidence by 3.4% (95% CI 2.7%-4.0%) and 3.3% (95% CI 3.1%-3.4%), respectively, overdose deaths among PWID by 10.0% (95% CI 9.8%-10.8%), and jail population size by 6.3% (95% CI 5.9%-6.7%). When considering healthcare costs only, the program cost $25,500/QALY gained (95% CI $12,600-$48,600). Including savings from reduced incarceration (societal perspective) improved the ICER to $6,200/QALY gained (95% CI, cost-saving $24,300). Sensitivity analysis indicated that cost-effectiveness depends on diversion program participants accessing community programs such as needle and syringe programs, treatment for substance use disorder, and HIV and HCV treatment, as well as diversion program cost. A limitation of the analysis is data availability, as fewer data are available for diversion programs than for more established interventions aimed at people with substance use disorder. Additionally, like any model of a complex system, our model relies on simplifying assumptions: For example, we simplified pathways in the healthcare and criminal justice systems, modeled an average efficacy for substance use disorder treatment, and did not include costs associated with homelessness, unemployment, and breakdown in family structure. CONCLUSIONS: We found that diversion programs for low-level drug offenders are likely to be cost-effective, generating savings in the criminal justice system while only moderately increasing healthcare costs. Such programs can reduce incarceration and its associated costs, and also avert overdose deaths and improve quality of life for PWID, PWUD, and the broader population (through reduced HIV and HCV transmission).

Criminosos/educação , Usuários de Drogas/educação , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Análise Custo-Benefício , Usuários de Drogas/psicologia , Programas Governamentais , Infecções por HIV/epidemiologia , Custos de Cuidados de Saúde/tendências , Hepatite C/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Avaliação de Resultados em Cuidados de Saúde/economia , Qualidade de Vida , Abuso de Substâncias por Via Intravenosa/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Washington/epidemiologia
An. psicol ; 36(3): 443-450, oct. 2020.
Artigo em Espanhol | IBECS | ID: ibc-195660


El propósito de este estudio es presentar el perfil psicopatológico y las diferencias entre hombres y mujeres que inician tratamiento residencial para las adicciones. La muestra se compuso de 142 pacientes (116 hombres y 26 mujeres), que cumplimentaron el EuropASI y MMCMI-III. Se analizan variables socio-demográficas, patrón de consumo y otras características, así como patrones, trastornos de personalidad y síndromes clínicos. El grupo de hombres presenta alta prevalencia en el patrón de personalidad antisocial (31%). Las mujeres, en el depresivo (23,1%), dependiente (26,9%) y antisocial (26,9%), solo en el dependiente las diferencias son estadísticamente significativas. En los síndromes clínicos los hombres presentan prevalencia en dependencia de sustancias (86,2%), trastorno de ansiedad (60,3%) y dependencia de alcohol (45,7%), las mujeres en el trastorno de ansiedad (76,9%), dependencia de alcohol (69,2%), sustancias (53,8%) y distímico (46,2%). Aparecen diferencias significativas estadísticamente en el trastorno ansioso, distímico y dependencia de alcohol, donde las mujeres se muestran más afectadas. En el síndrome clínico trastorno de pensamiento los hombres puntúan más alto y las mujeres más altas en depresión, en ambos casos las diferencias son estadísticamente significativas. Se comentan las implicaciones que estos resultados tienen en la evaluación y mejora de los tratamientos

The aim of this study is to present the psychopathological profile and the differences between men and women who start an addition residential treatment. The sample included 142 patients (116 were men and 26 women). We analysed socio-demographic variables, consumption pattern as well as personality disorders and clinical syndromes using EuropASI and MCMI-III as evaluating instruments. Men group showed a high prevalence at antisocial personality disorder (31%). On the other hand, women did so at depressive (23,1%), dependent (26,9%) and antisocial (26,9%) patterns, finding statistically significant differences only at the dependent disorder. At clinical syndromes men showed a relevant prevalence when analysing substances dependence (86,2%), anxiety disorder (60,3%) and alcohol dependence (45,7%), and women group at anxiety disorder (76,9%), alcohol dependence (69,2%), substances (53,8%) and dysthymic (46,2%). We found statistically significant differences at anxiety disorder, dystymic and alcohol dependence where women appeared to be more affected. At thought clinical syndrome men raised higher scores, and women did so at depression, being both differences statistically significant. The results are discussed and their clinical implications analysed

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Saúde Mental , Transtornos Mentais/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Usuários de Drogas/psicologia , Transtornos Mentais/induzido quimicamente , Transtornos Relacionados ao Uso de Substâncias/complicações , Escalas de Graduação Psiquiátrica , Estatísticas não Paramétricas , Distribuição por Sexo , Fatores Socioeconômicos , Fatores Sexuais , Espanha/epidemiologia
Nursing (Säo Paulo) ; 23(269): 4683-4694, out.2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1145366


Objetivos: Conhecer as vivências de usuários de um Centro de Atenção Psicossocial de álcool e de drogas em Minas Gerais. Método: Pesquisa exploratória, descritiva e de abordagem qualitativa. A amostra foi composta por 18 participantes determinada pela técnica de saturação. A coleta de dados foi realizada por entrevista semiestruturada com questões norteadoras, gravadas, transcritas, e por meio da técnica de análise de conteúdo, resultou em quatro categorias. Resultado: A maior dificuldade em aderir ao tratamento é o rompimento dos vínculos familiares e as fragilidades sociais. O acolhimento interfere na adesão e abandono do tratamento. Relatam ainda a falta de estrutura do ambiente coletivo e de atividades recreativas. Conclusão: Tem-se como ponto facilitador para adesão ao tratamento o acolhimento, a escuta ativa e a família. Como incipiente tem-se a infraestrutura física do local, as atividades de lazer e as oficinas terapêuticas.(AU)

Objectives: To know the experiences of users of a Psychosocial Care Center for alcohol and drugs in Minas Gerais. Method: This is an exploratory, descriptive and qualitative approach. The sample was composed by 18 participants determined by the saturation technique. The data collection was done through a semi-structured interview with four guiding questions, recorded, transcribed, and through the technique of content analysis, resulted in four categories. Results: Revealed that the greatest difficulty in adhering to treatment is the disruption of family ties correlated with social difficulties such as social exclusion and street dwelling. For most, the way in which the host occurs interferes with adherence and abandonment of treatment. They also report the lack of structure of the collective environment and recreational activities. Conclusion: Users reported as a facilitator for adherence to treatment, welcoming, active listening of professionals and the family as an essential support. It has as incipient the infrastructure of the establishment, the leisure activities and the therapeutic workshops.(AU)

Objetivos: Conocer las experiencias de los usuarios de un Centro de Atención Psicosocial para el consumo de alcohol y drogas en Minas Gerais. Método: Este es un enfoque exploratorio, descriptivo y cualitativo. La muestra estuvo compuesta por 18 participantes determinados por la técnica de saturación. La recolección de datos se realizó a través de una entrevista semiestructurada con cuatro preguntas de guía, grabadas, transcritas y mediante la técnica de análisis de contenido, que dio como resultado cuatro categorías. Resultados: Reveló que la mayor dificultad para adherirse al tratamiento es la interrupción de los lazos familiares relacionados con dificultades sociales como la exclusión social y la vivienda en la calle. Para la mayoría, la forma en que se produce el huésped interfiere con la adherencia y el abandono del tratamiento. También denuncian la falta de estructura del entorno colectivo y las actividades recreativas. Conclusión: Los usuarios informaron como facilitadores de la adherencia al tratamiento, la bienvenida y la escucha activa de los profesionales y la familia como un apoyo esencial. Tiene como incipiente la infraestructura del establecimiento, las actividades de ocio y los talleres terapéuticos.(AU)

Humanos , Enfermagem Psiquiátrica , Saúde Mental , Usuários de Drogas , Serviços de Saúde Mental , Acolhimento , Cooperação e Adesão ao Tratamento/psicologia
Medicine (Baltimore) ; 99(35): e21360, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871863


HIV prevalence is higher among Men who have Sex with Men (MSM), owing to their unsafe sexual behavior. Further, MSM indulge in behaviors such as consumption of alcohol/oral drugs and/or injecting during/before sex that poses the risk of unsafe behaviors, thereby increasing their vulnerability to HIV. The study aims to analyze the factors associated with HIV infection among the multi-risk MSM using any substances with those MSM who do not use substances.Community-based cross-sectional survey design using probability-based sampling between October 2014 and November 2015.For the nation-wide Integrated Biological and Behavioral Surveillance (IBBS), 23,081 MSM were recruited from 4067 hotspots in 108 districts across India. Information on demographics, sexual behaviors, substance use, sexual partners, and awareness on HIV and its management was collected from the consented respondents using computer-assisted personal interview (CAPI) by trained personnel. Blood samples were tested for HIV. Statistical analyses were done, to study the associations between substance use and its influence on high-risk sexual behaviors and HIV infection.One in 3 MSM (33.88%) in India were substance users, thus exhibiting "multi-risk" (MR) behaviors. Significantly higher HIV prevalence (3.8%, P < .05) was reported among MR-MSM, despite 97.2% of them being aware of HIV. Higher HIV prevalence among MSM exhibiting homosexual behavior for ≤1 year is of specific concern, as this accounts to recent infections and indicates the increased vulnerability of the infection among the new entrants.Substance-use resulting in high-risk sexual behavior was significantly associated with higher HIV prevalence among MR-MSM. Integrated targeted interventions focusing on safe sex and safe-IDU practices among MR-MSM are required to end the disease transmission.

Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual/etnologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Conscientização , Estudos Transversais , Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/psicologia , Homossexualidade Masculina/etnologia , Humanos , Índia/epidemiologia , Masculino , Prevalência , Assunção de Riscos , Comportamento Sexual/psicologia , Parceiros Sexuais/classificação , Adulto Jovem
Drug Alcohol Depend ; 217: 108302, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32961453


BACKGROUND: Little is known regarding what people who use drugs (PWUD) know about COVID-19 related issues and changes in the drug market due to COVID-19. We therefore conducted a survey to explore these issues. METHODS: In a cross-sectional study, we interviewed 226 PWUD from three Norwegian cities in May/June 2020. Participants completed an interview-administrated questionnaire. Three separate multiple binary logistic regression models were estimated with the outcomes (no/yes): 1. Familiarity with COVID-19 symptoms, 2. Awareness of COVID-19 services tailored towards PWUD and, 3. Willingness to take a COVID-19 test. RESULTS: The mean age was 44.1 years and 73 % were males. Fifty-four percent were injectors, and heroin/other opioids (35.8 %) and cocaine/amphetamine (25.2 %) were the most common main drugs used. Overall, 54.9 % were in opioid maintenance treatment (OMT). The majority (65.9 %) stated they knew the COVID-19 symptoms. Almost all the participants (91.2 %) reported they would take a COVID-19 test if experiencing relevant symptoms. The majority (63.7 %) were not aware of COVID-19 services available to PWUD. OMT patients were more likely to be familiar with COVID-19 symptoms (aOR = 3.4, 95 % CI 1.7; 6.8), and to be aware of COVID-19 services (aOR = 2.7, 95 % CI 1.1; 6.3). Overall, 35.4 % reported reduced drug availability, mainly for tranquilizers, while 61.5 % reported increased drug prices, mainly for cannabis. CONCLUSION: Drug treatment may play an important role in COVID-19 prevention, as those in OMT were more likely to be aware of symptoms and of availability of services.

/epidemiologia , Usuários de Drogas/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Cidades/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Adulto Jovem
J Cardiovasc Magn Reson ; 22(1): 70, 2020 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-32981526


BACKGROUND: Cocaine is an addictive, sympathomimetic drug with potentially lethal effects. We have previously shown with cardiovascular magnetic resonance (CMR) the presence of cardiovascular involvement in a significant percentage of consecutive asymptomatic cocaine addicts. CMR with feature-tracking analysis (CMR-FT) allows for the quantification of myocardial deformation which may detect preclinical involvement. Therefore, we aimed to assess the effects of cocaine on the left ventricular myocardium in a group of asymptomatic cocaine users with CMR-FT. METHODS: In a cohort of asymptomatic cocaine addicts (CA) who had been submitted to CMR at 3 T, we used CMR-FT to measure strain, strain rate and dyssynchrony index in CA with mildly decreased left ventricular ejection fraction (CA-LVEFd) and in CA with preserved ejection fraction (CA-LVEFp). We also measured these parameters in 30 age-matched healthy subjects. RESULTS: There were no differences according to age. Significant differences were seen in global longitudinal, radial and circumferential strain, in global longitudinal and radial strain rate and in radial and circumferential dyssynchrony index among the groups, with the lowest values in CA-LVEFd and intermediate values in CA-LVEFp. Longitudinal, radial and circumferential strain values were significantly lower in CA-LVEFp with respect to controls. CONCLUSIONS: CA-LVEFp show decreased systolic strain and strain rate values, with intermediate values between healthy controls and CA-LVEFd. Signs suggestive of dyssynchrony were also detected. In CA, CMR-FT based strain analysis can detect early subclinical myocardial involvement.

Transtornos Relacionados ao Uso de Cocaína/complicações , Usuários de Drogas , Imagem Cinética por Ressonância Magnética , Volume Sistólico/efeitos dos fármacos , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda/efeitos dos fármacos , Adulto , Doenças Assintomáticas , Estudos de Casos e Controles , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sístole , Disfunção Ventricular Esquerda/induzido quimicamente , Disfunção Ventricular Esquerda/fisiopatologia
BMC Infect Dis ; 20(1): 702, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32972393


BACKGROUND: Hepatitis C virus (HCV) infections in people who inject drugs (PWID) can now be treated and cured. However, the impact that HCV treatment has on drug-user health, practices and wellbeing is not known. The aim of this research was to understand the non-clinical impact that HCV treatment has in PWID and their reasons for accessing and completing treatment. METHODS: Participants aged 25-67 years who had injected opioids or stimulants (currently or in the past) and had completed direct-acting antiviral treatment were recruited from seven European countries. Participants completed a 30-min online survey administered face-to-face between September 2018 and April 2019. The questionnaire responses were used to assess the mental and physical impact of having completed treatment. RESULTS: Of the 124 participants who completed the survey questionnaire, 75% were male, 69% were over 45 years old and 65% were using opioids and/or stimulants at the start of HCV treatment. Participants reported improvements in the following areas after completing HCV treatment: outlook for the future (79%); self-esteem (73%); ability to plan for the future (69%); belief in their abilities (68%); confidence (67%); empowerment (62%); energy levels (59%); and ability to look after themselves (58%). The most common reasons for starting HCV treatment were: becoming aware of treatments that were well tolerated (77%) and effective (75%); and understanding the potentially severe consequences of HCV (75%). CONCLUSIONS: The benefits of HCV treatment go beyond clinical outcomes and are linked to improved drug-user health and wellbeing. Sharing information about well-tolerated and effective HCV treatments, and raising awareness about the potentially severe consequences of untreated HCV are likely to increase the number of PWID who are motivated to access and complete HCV treatment in future.

Usuários de Drogas , Hepatite C/tratamento farmacológico , Abuso de Substâncias por Via Intravenosa , Adolescente , Adulto , Idoso , Antivirais/uso terapêutico , Atitude Frente a Saúde , Usuários de Drogas/psicologia , Usuários de Drogas/estatística & dados numéricos , Emoções , Emprego , Europa (Continente) , Feminino , Hepatite C/psicologia , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
Leg Med (Tokyo) ; 47: 101780, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32882537


New psychoactive stimulants appeared in Hungary in 2010 as in several other European countries. We present our findings from cases where new psychoactive and conventional stimulants (we listed amphetamine, methamphetamine and MDMA as conventional drugs) have been detected in biological specimens between 2010 and 2019. MATERIALS: Biological samples (including urine, blood and body tissues), sent to the Department of Forensic Medicine, University of Pécs, South-West Hungary, in the period 2010-2019. METHOD: High performance liquid chromatography coupled with diode array detection (HPLC-DAD); supercritical fluid chromatography coupled to tandem mass spectrometry (SFC-MS/MS). RESULTS: During the nine-year period between 2010 and 2019, we found new stimulants in 973 (21.1%) cases, and conventional stimulants in 658 (14.2%) cases (out of 4604 analyses -100%- of samples sent to the laboratory for toxicology screening). 594 (12.9%) of all cases were post mortem analyses. The new drugs we've detected could be classified into three groups based on their chemical structure: cathinones (in 960 from our cases), substituted phenethylamines (8), and tryptamines (5). The most frequently identified new psychoactive stimulants were (in the order of decreasing frequency): pentedrone (262), mephedrone (188), N-ethylhexedrone (126), methylenedioxypyrovalerone (MDPV; 98), α-pyrrolidinopentiophenone (alpha-PVP; 93), 4-CMC (35). CONCLUSION: The new substances were detected in highest proportion in 2011; by 2018, the number of conventional drugs exceeded the new stimulants in our cases. According to the data of the Hungarian seizures, the decrease was predictable: from 2015, the seizures of traditional stimulants exceeded the seizures of new stimulants. In 2019 the new stimulants were dominated again among the detected substances in the samples.

Líquidos Corporais/química , Estimulantes do Sistema Nervoso Central/análise , Crime , Usuários de Drogas/estatística & dados numéricos , Drogas Ilícitas/análise , Psicotrópicos/análise , Detecção do Abuso de Substâncias/métodos , Cromatografia Líquida de Alta Pressão/métodos , Humanos , Hungria/epidemiologia , Espectrometria de Massas em Tandem/métodos , Fatores de Tempo
Artigo em Inglês | MEDLINE | ID: mdl-32867216


Owing to the increasing prevalence of hidden drug abuse in Hong Kong, yet scarce relevant current local research, this study seeks to carry out an in-depth investigation into the experience of hidden drug abusers, paying particular attention to their relevance to social capital and social networks. Seventy-three abusers attending drug treatment programs were interviewed, and a thematic analysis was performed. The results indicate hidden drug abuse is popular in Hong Kong. Apart from the decline of public, large-scale discos and the change of the types of drugs abused to date, one important contributing factor is the drug supply and transaction networks, which are extensive and multilocused, but secretive, with high closure levels. This kind of network is supported by bonding, bridging, and linking social capital as well as by providing convenient supply modes and offering drug abusers psychological comfort and safety. These factors encourage the hidden drug abuse to prevail and allow drug abusers to remain unidentifiable.

Usuários de Drogas/psicologia , Capital Social , Rede Social , Transtornos Relacionados ao Uso de Substâncias , Hong Kong/epidemiologia , Humanos , Drogas Ilícitas/provisão & distribução , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
BMC Public Health ; 20(1): 1288, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32843008


BACKGROUND: It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased. METHODS: We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over 3 years. RESULTS: Of 2285 participants, 1032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2 to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over 3 years. CONCLUSIONS: The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.

Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Vigilância da População , Gestão de Riscos/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Ucrânia/epidemiologia
BMC Public Health ; 20(1): 1220, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778084


BACKGROUND: While previous research has identified how criminalization of HIV non-disclosure can have deleterious effects on those living with HIV, the perspectives of people who use drugs - a population disproportionately affected by HIV- should be more meaningfully considered in these discussions. METHODS: Using constant comparative techniques, data from 60 interviews with men and women living with and without HIV and who use drugs in Vancouver were analyzed to explore their perceptions about Canada's HIV non-disclosure legal framework. RESULTS: Participants' perspectives on the framework involved three themes: understandings of HIV risk; HIV-related stigma; and their own experiences with HIV. While several participants favored the punitive character of the legal framework, these arguments were premised on misinformed and stigmatized assumptions regarding HIV. CONCLUSIONS: The paper concludes by discussing the challenges and opportunities for resisting HIV stigma and misconceptions about HIV within the context of personal accounts that, at times, support criminalization of non-disclosure.

Revelação/legislação & jurisprudência , Usuários de Drogas/psicologia , Infecções por HIV/epidemiologia , Adulto , Idoso , Canadá/epidemiologia , Usuários de Drogas/estatística & dados numéricos , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estigma Social
Artigo em Inglês | MEDLINE | ID: mdl-32751337


Background: Heavy drug users was a global consensus high-risk population of HIV infection. However, the specific impact of drug on HIV infection has not yet been established. Depressants and stimulants were most widely used drugs in mainland China, and mix use of the two drugs was also serious. We assessed the HIV infection rate and trends in heavy drug users by analyzing data from the National Dynamic Management and Control Database for Drug Users (NDMCDDU). Methods: All heavy drug users with HIV test results in NDMCDDU from 2008 to 2016 were grouped into depressants only group (DOG), stimulants only group (SOG), and both depressants and stimulants group (DSG). We used joinpoint regression to examine trends of HIV infection rates. Multivariable logistic regression was used to examine factors related to HIV infection. Results: A total of 466,033 heavy drug users with 9522 cases of HIV infection were included in this analysis. HIV infection rate was estimated at 2.97% (95% CI 2.91-3.04%) of 265,774 users in DOG, 0.45% (95% CI 0.42-0.49%) of 140,895 users in SOG, and 1.65% (95% CI 1.55-1.76%) of 59,364 users in DSG. In DOG, a U-shaped curve of HIV infection rate decreased from 3.85% in 2008 to 2.19% in 2010 (annual percent change (APC) -12.9, 95% CI -19.3--6.0, p < 0.05), then increased to 4.64% in 2016 (APC 8.3, 95% CI 6.1-10.4, p < 0.05) was observed. However, SOG and DSG showed consistent increases from 0.15% in 2008 to 0.54% in 2016 (APC 8.2, 95% CI 4.8-11.8, p < 0.05) and from 0.78% in 2008 to 2.72% in 2016 (APC 13.5, 95% CI 10.7-16.4, p < 0.05), respectively. HIV infection rate of DOG in the southwest region presented a U-shaped trend. All groups showed significant increases in HIV infection in east and central regions. Conclusions: The U-shaped curve for HIV infection rate among DOG users and consistent increases among SOG and DSG users implies drug abuse is still a critical focus of HIV infection in China. It is urgently needed to reassess the effectiveness of current strategies on HIV prevention and control among drug users.

Usuários de Drogas , Epidemias , Infecções por HIV , Abuso de Substâncias por Via Intravenosa , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/epidemiologia