Denise Leite Vieira

Álcool e adolescentes: estudo para implementar políticas municipais

OBJETIVO: Tracar um perfil de estudantes em relacao ao consumo de alcool e comportamentos de risco. METODOS: Participaram do estudo 1.990 alunos, com idade entre 11 e 21 anos, de ambos os sexos, matriculados em escolas publicas e privadas de Paulinia, SP, 2004. Um questionario de auto-preenchimento foi respondido em sala de aula, sem a presenca do professor. Analisou-se a percepcao da disponibilidade e facilidade de acesso as bebidas alcoolicas, contexto do beber e consequencias do consumo. RESULTADOS: A prevalencia de uso de alcool na vida foi de 62,2%. Em relacao aos ultimos 30 dias, 17,3% dos alunos relataram pelo menos um episodio de abuso agudo. Os adolescentes reportaram que adquiram facilmente bebidas alcoolicas de estabelecimentos comerciais e tambem em contextos sociais com parentes e amigos. Apenas 1% dos menores de idade relatou que tentou, mas nao conseguiu comprar bebida alcoolica. Como consequencias negativas do consumo nos ultimos 12 meses, os estudantes relataram ter passado mal por ter bebido (17,9%), arrependimento por algo que fizeram sob o efeito do alcool (11%), blackout (9,8%) e ter brigado apos beber (5%). Mais da metade (55%) dos estudantes conhecia alguem que sofreu acidente de trânsito provocado por motorista embriagado. CONCLUSOES: Os dados revelaram alta prevalencia de consumo de alcool entre os adolescentes estudados e facil acesso as bebidas alcoolicas, inclusive por menores de idade. Os jovens se colocaram em risco e apresentaram consequencias negativas do consumo de alcool. Ha necessidade de acoes imediatas em relacao as politicas publicas para o consumo de alcool no Brasil.

Evidence of association between early alcohol use and risk of later problems

OBJECTIVES To investigate the relationship between age of onset, alcohol consumption patterns and related problems. METHOD In 2004, one self-administered questionnaire was completed by 1,990 students from the 5th to 11th grades of schools in Paulínia-SP. Data collection was conducted at the classroom without the presence of the teacher. The participation in the study was voluntary and anonymous. RESULTS Prevalence of lifetime alcohol use was 62.2%. The mean age of first use of alcohol was 12.35 (sd=2.72) and ranged between 5 and 19 years of age. In 78% of the cases, the first use occurred before the age of 15, and more than 22% of the students reported having tried alcohol before 10 years of age. There were significant differences regarding current pattern of use: those who started earlier consumed more drinks per occasion (p=0.013) and had more drunkenness episodes in the last 30 days (p=0.05). A relationship between the age of first alcohol use and the use of tobacco (p=0.017) and other drugs (p=0.047) was observed. CONCLUSIONS Adolescents first use alcohol in early ages, what impacts the current consumption patterns. This study emphasizes the need of actions regarding public alcohol policies in Brazil in order to prevent or delay the initiation of alcohol use and its related problems.

Longitudinal outcomes among a cohort of crack users after 12 years from treatment discharge.

ABSTRACT Follow-ups of crack consumption are scarce in literature. The aim of this article was to investigate the evolution of a cohort of crack users and identify longitudinal outcomes. For the study, 131 consecutive crack users who were admitted to treatment (1992–1994) were interviewed. After 12 years, 107 participants were assessed. Among them, 43 were abstainers, 22 were crack users, 13 had been arrested, 2 were missing, and 27 were dead. The study showed dynamic changes of crack use patterns over time and a high involvement in illegal activities (p = 0.00) among drug users. Discontinuation of care and stigmatization of crack users has been discussed.

Clinical and Demographic Profile of Anesthesiologists Using Alcohol and Other Drugs under Treatment in a Pioneering Program in Brazil

BACKGROUND AND OBJECTIVES Anesthesiologists are the majority in impaired-physician programs that assist physicians who abuse psychoactive substances. The aim of this paper is to show a descriptive study about the clinical and sociodemographic profile of a sample of chemically dependent anesthesiologists treated in a reference program. In addition, the objective is to cite the psychiatric comorbities, the most frequently used drugs and the psychosocial and professional repercussions of substance abuse. METHOD A cross-sectional and prospective study was conducted, and a socio-occupational questionnaire and a structured interview were carried out to diagnose mental and psychoactive substance use disorders, according to the International Classification of Diseases (the ICD-10). The questionnaire and the structured interview were carried out by two skilled researchers. RESULTS Fifty-seven anesthesiologists were interviewed. Most of them were male (77.2%), and the mean age was 36.1 years (SD=8.5%). A high prevalence of abuse of opioid (59.6%), benzodiazepine (3.1%) and alcohol (35.1%) was observed. Opioid users sought treatment earlier than other substance users and usually they were under pressure from their colleagues and the Regional Council of Medicine. The incidence of drug abuse for self-medication was high in this subgroup. CONCLUSIONS Anesthesiologists may present a different profile concerning the risks of opioid use. Opioid abuse usually begins during medical residency or during the first years of clinical practice, which supports the hypothesis that addiction to opioids is an occupational issue among anesthesiologists.

Sexual Behaviours and Condom Use in a Sample of Brazilian Crack Cocaine Smokers

Sexual Behaviours and Condom Use in a Sample of Brazilian Crack Cocaine Smokers Crack cocaine smokers exhibit high levels of risky sexual behaviours. The current study examined a cohort of Brazilian crack cocaine smokers (n=304) admitted to an addiction inpatient care unit, assessing the reasons for risky sexual behaviours and their non-use of condom. Using a drug abuse screening test (DAST) and semi-structured questionnaires to collect socio-demographic data and sexual behaviour characteristics, the study showed that nearly half of the sample, mostly men, never used condoms or used condoms inconsistently. The main reasons for not using condoms included steady partner, disruption of sensitivity, and too much sexual arousal. Gender was the most important variable for discriminating non-use of condoms. In men, the number of partners and race were predictors of condom use. In both genders, more severe dependence was associated with higher rates of non-use of condoms and sexual activity in the last 12 months. Condom use is an important issue for the development and implementation ofgender-targeted, culturally appropriate interventions to promote condom use in crack cocaine smokers.

Social stigma, legal and public health barriers faced by the third gender phenomena in Brazil, India and Mexico: Travestis, hijras and muxes

Aim and Methods: The aim of this article is to provide a narrative literature review of the ‘third gender’ phenomenon in Brazil (Travestis), India (Hijras) and Mexico (Muxes), considering the social stigma, the legal and health aspects of these identities. Results: These three groups share similar experiences of stigmatisation, marginalisation, sexual abuse, HIV infection, infringement of civil rights and harassment accessing health services. Brazil, India and Mexico public services for the third gender conditions are still very scarce and inadequate for the heavy demand from potential users. Discussion and Conclusion: Although all three countries have used legislation to promote provision of comprehensive healthcare services for third gender, there is still strong resistance to implementation of such laws and policies. Brazil, India and Mexico face a huge challenge to become countries where all human rights are respected.

Perfil clínico e demográfico de anestesiologistas usuários de álcool e outras drogas atendidos em um serviço pioneiro no Brasil

BACKGROUND AND OBJECTIVES: Anesthesiologists are the majority in impaired-physician programs that assist physicians who abuse psychoactive substances. The aim of this paper is to show a descriptive study about the clinical and sociodemographic profile of a sample of chemically dependent anesthesiologists treated in a reference program. In addition, the objective is to cite the psychiatric comorbities, the most frequently used drugs and the psychosocial and professional repercussions of substance abuse. METHOD: A cross-sectional and prospective study was conducted, and a socio-occupational questionnaire and a structured interview were carried out to diagnose mental and psychoactive substance use disorders, according to the International Classification of Diseases (the ICD-10). The questionnaire and the structured interview were carried out by two skilled researchers. RESULTS: Fifty-seven anesthesiologists were interviewed. Most of them were male (77.2%), and the mean age was 36.1 years (SD = 8.5%). A high prevalence of abuse of opioid (59.6%), benzodiazepine (3.1%) and alcohol (35.1%) was observed. Opioid users sought treatment earlier than other substance users and usually they were under pressure from their colleagues and the Regional Council of Medicine. The incidence of drug abuse for self-medication was high in this subgroup. CONCLUSIONS: Anesthesiologists may present a different profile concerning the risks of opioid use. Opioid abuse usually begins during medical residency or during the first years of clinical practice, which supports the hypothesis that addiction to opioids is an occupational issue among anesthesiologists.