O adolescente e o uso de drogas

Universidade Federal de São Paulo (UNIFESP) Departamento de Psicobiologia Unidade de Dependência de DrogasUniversidade Estadual do Rio de Janeiro Núcleo de Estudos e Pesquisas em Atenção ao Uso de DrogasUNIFESP, Depto. de Psicobiologia Unidade de Dependência de DrogasSciEL

How smokers may react to cigarette taxes and price increases in Brazil: data from a national survey

Background: Despite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban. However, tax and pricing policies have been developed slowly and only very recently were stronger measures implemented. This study investigated the expected responses of smokers to hypothetical price increases in Brazil.Methods: We analyzed smokers' responses to hypothetical future price increases according to sociodemographic characteristics and smoking conditions in a multistage sample of Brazilian current cigarette smokers aged >= 14 years (n = 500). Logistic regression analysis was used to examine the relationship between possible responses and different predictors.Results: in most subgroups investigated, smokers most frequently said they would react to a hypothetical price increase by taking up alternatives that might have a positive impact on health, i.e., they would try to stop smoking (52.3%) or smoke fewer cigarettes (46.8%). However, a considerable percentage responded that they would use alternatives that would reduce the effect of price increases, such as the same brand with lower cost (48.1%). After controlling for sex age group (14-19, 20-39, 40-59, and >= 60 years), schooling level (>= 9 versus 20 versus <= 20), and stage of change for smoking cessation (precontemplation, contemplation, and preparation), lower levels of dependence were positively associated with the response I would try to stop smoking (odds ratio [OR], 2.19). Young age was associated with I would decrease the number of cigarettes (OR, 3.44). A low schooling level was strongly associated with all responses.Conclusions: Taxes and prices increases have great potential to stimulate cessation or reduction of cigarette consumption further among two important vulnerable populations of smokers in Brazil: young smokers and those of low educational level. the results from the present study also suggest that seeking illegal products may reduce the impact of increased taxes, but does not eliminate it.National Anti-Drug Secretariat (SENAD)Universidade Federal de São Paulo, Dept Psychiat, Natl Inst Alcohol & Drug Policies INPAD, São Paulo, BrazilOswaldo Cruz Fdn Fiocruz, Natl Sch Publ Hlth, Ctr Studies Tobacco & Hlth, Rio de Janeiro, BrazilUT Southwestern Sch Hlth Profess, Dallas, TX USAUT Sch Publ Hlth, Dallas, TX USAUniv Nottingham, Div Epidemiol & Publ Hlth, UK Ctr Tobacco Control Studies, Nottingham NG7 2RD, EnglandUniversidade Federal de São Paulo, Dept Psychiat, Natl Inst Alcohol & Drug Policies INPAD, São Paulo, BrazilNational Anti-Drug Secretariat (SENAD): 017/2003Web of Scienc

Guidelines of the Brazilian Association of Studies on Alcohol and Other Drugs (ABEAD) for diagnoses and treatment of psychiatric comorbidity with alcohol and other drugs dependence

Recently, several studies have focused on comorbity psychiatric disorders with alcohol and other substance dependence. The Brazilian Association of Studies on Alcohol and Other Drugs proposed the Brazilian Guidelines project. This study review diagnostic and therapeutic criteria to the most prevalent psychiatric comorbidities. Randomized clinical trials, epidemiological, animal studies and other forms of research are reviewed. The main psychiatric comorbidities are studied based on guidelines adopted by other countries and the literature data resumed. Epidemiological aspects, diagnoses, integrated treatment and service organization, as well as specific psychotherapic and pharmacological treatment are discussed. The Brazilian Association of Studies on Alcohol and Other Drugs Guidelines reassures the importance of adequate diagnoses and treatment regarding alcoholic and drug dependent patients suffering of comorbid psychiatric disorders.O diagnóstico e tratamento de comorbidade psiquiátrica e dependência de álcool e outras substâncias tem sido objeto de inúmeros estudos nos últimos anos. A Associação Brasileira de Estudos do Álcool e Outras Drogas desenvolveu o projeto Diretrizes. Este trabalho visa o desenvolvimento de critérios diagnósticos e terapêuticos atualizados para as comorbidades psiquiátricas mais prevalentes. Ensaios clínicos randomizados, estudos epidemiológicos, com animais e outros estudos são revisados. As principais comorbidades psiquiátricas são estudadas e os dados de literatura resumidos, tendo como referência diretrizes adotadas em outros países. São abordados aspectos epidemiológicos, critérios diagnósticos, tratamento integrado e organização de serviço especializado, assim como especificidades do tratamento psicoterápico e farmacológico. As Diretrizes da Associação Brasileira de Estudos do Álcool e Outras Drogas reforçam a importância da abordagem adequada do dependente químico portador de comorbidade psiquiátrica.Universidade Federal de Santa Catarina Núcleo de PsiquiatriaInstituto de Psiquiatria de Santa CatarinaUniversidade Federal de São Paulo (UNIFESP) Unidade de Pesquisa em Álcool e DrogasSanta Casa de Misericórdia de São Paulo Unidade de Álcool e DrogasUniversidade de São Paulo Faculdade de Medicina Hospital das ClinicasCentro de Atendimento Médico e SocialHospital de Clínicas de Porto AlegreHospital Israelita Albert EinsteinSanta Casa do Rio de Janeiro Setor de Dependência QuímicaUniversidade Gama FilhoUNIFESP, Unidade de Pesquisa em Álcool e DrogasSciEL

Intervenções breves para problemas relacionados ao álcool Brief interventions for alcohol telated problems

Este artigo apresenta os conceitos e pressupostos básicos necessários à compreensão das Intervenções Breves (IBs), com uma revisão da literatura sobre sua efetividade e uma discussão sobre as IBs no Brasil. Os pressupostos teóricos são discutidos, assim como o quadro conceitual representado pelo acrônimo FRAMES, originado pela composição da primeira letra das palavras inglesas: Feedback; Responsibility; Advice; Menu; Empathic e Self-efficacy. São discutidos os resultados dos estudos de revisão sistemática e meta-análise que investigaram a efetividade das IBs e é apresentado um quadro esquemático dos principais resultados. Finalmente, discute-se a história recente da introdução das IBs no Brasil. Enfatiza-se a importância do treinamento de profissionais de saúde e a adoção das IBs nos diferentes contextos assistenciais, considerando sua efetividade comprovada e sua viabilidade econômica.This article presents the concepts and basic premises that are necessary for a better understanding of the Brief Interventions (BIs), with a literature review of its effectiveness and a discussion about BIs in Brazil. The theoretical premises are discussed, as well the concepts represented by the acronym FRAMES: Feedback; Responsibility; Advice; Menu; Empathic and Self-efficacy. Results of systematic reviews and metanalysis about BIs effectiveness are discussed and a summary box with the main studies is presented. Finally, the recent developments about the introduction of BIs in Brazil are commented. The importance of health professionals training and the adoption of BIs within different settings are emphasized considering its demonstrated effectiveness and economic feasibility

Induction and comparison of craving for tobacco, marijuana and crack

Abstract Background The literature findings report that use of multiple substances can produce adverse clinical and behavioral effects, which may affect craving and the results of drug treatment. Also, the understanding of craving construct and its interaction in the use of smoked substances is underexplored. Objectives To induce and compare craving for tobacco, marijuana and crack-cocaine on hospitalized dependents whose drug of choice is crack-cocaine. Methods Quasi-experimental study with a convenience sample consisting of 210 males divided into 3 equal groups (Group-1: craving induced by crack; Group-2: craving induced by tobacco; and Group-3: craving induced by marijuana). All participants met ICD-10 dependence criteria for cocaine/crack, marijuana and tobacco, were aged between 18 and 65 and had used these substances for at least one year. Photos were used to induce craving and self-report instruments to evaluate possible alterations. Results This study showed that craving for tobacco was more intense than for marijuana and crack, when the groups were compared by VAS. Using specific scales, both craving for tobacco and craving for marijuana were more intense than craving for crack. Discussion These results would imply interventions at the initial stages of abstinence with cognitive-behavioural techniques and pharmacotherapy in order to reduce craving