Gabriela Arantes Wagner

Alcohol and drug use among university students: gender differences

OBJECTIVE This study compared the pattern of alcohol, legal and illegal drugs use among students of the Universidade de São Paulo (Brazil) in 1996 and 2001. METHOD Samples of 2.564 (1996) and 2.837 (2001) students answered a questionnaire proposed by the World Health Organization, which characterizes the consumption of alcohol, legal and illegal drugs in lifetime, in the last 12 months and in the last 30 days. RESULTS Men showed a significant increase in lifetime use of tobacco (44.8% to 50.9%), marijuana (33.7% to 39.5%) and hallucinogens (6.6% to 14.1%) between 1996 and 2001. No significant change was observed among women between 1996 and 2001 in tranquilizer use. Concerning the consumption reported in the last 12 months, both genders displayed significant increases in the consumption of marijuana (22.3% to 27.1% for men and 12.9% to 16.9% for women), amphetamines (1.9% to 5.0% for men and 3.4% to 5.6% for women), and inhalants (9.8% to 15.7% for men and 5.4% to 10.6% for women). The greatest gender difference was observed in consumption reported in the last 30 days with significant increases in male use of tobacco (19.6% to 23.5%), marijuana (15.8% to 20.5%), amphetamines (1.1% to 3.2%), and inhalants (4.0% to 7.9%). Substance use reported in the last 30 days remained stable among women between the 2 surveys. CONCLUSION Rates of substance use among university students increased. These gender differences in substance consumption should be taken into account in the development of preventive and treatment strategies for undergraduate university students.

Drug consumption among medical students in São Paulo, Brazil: influences of gender and academic year.

OBJECTIVE To analyze alcohol, tobacco and other drug use among medical students. METHOD Over a five-year period (1996-2001), we evaluated 457 students at the Universidade de São Paulo School of Medicine, located in São Paulo, Brazil. The students participated by filling out an anonymous questionnaire on drug use (lifetime, previous 12 months and previous 30 days). The influence that gender and academic year have on drug use was also analyzed. RESULTS During the study period, there was an increase in the use of illicit drugs, especially inhalants and amphetamines, among the medical students evaluated. Drug use (except that of marijuana and inhalants) was comparable between the genders, and academic year was an important influencing factor. DISCUSSION Increased inhalant use was observed among the medical students, especially among males and students in the early undergraduate years. This is suggestive of a specific behavioral pattern among medical students. Our findings corroborate those of previous studies. CONCLUSION Inhalant use is on the rise among medical students at the Universidade de São Paulo School of Medicine. Because of the negative health effects of illicit drug use, further studies are needed in order to deepen the understanding of this phenomenon and to facilitate the development of preventive measures.

Drug use in college students: a 13-year trend

OBJETIVO: Analizar la tendencia del uso de drogas entre universitarios en 1996, 2001 y 2009. METODOS: estudio epidemiologico transversal con 9.974 universitarios del municipio de Sao Paulo, Sureste de Brasil, cuya muestra fue seleccionada por estratificacion y conglomerados. Se adopto instrumento de investigacion de auto llenado, anonimo, que caracterizo el uso de drogas por tres medidas: uso en la vida, en los ultimos 12 meses y en los ultimos 30 dias. Para comparar las frecuencias de uso de drogas entre las investigaciones, se utilizo la metodologia de comparaciones multiples con correccion de Bonferroni. RESULTADOS: Hubo reduccion de la frecuencia de estudiantes que relataron consumo de drogas entre 1996 y 2009. Hubo disminucion del uso de inhalantes y aumento en el uso de anfetaminicos en todas las medidas evaluadas [4,6% para 8,7% en la vida, de 2,4% para 4,5% en los ultimos 12 meses y de 1,9% a 3,3% en los ultimos 30 dias]. Los alumnos de las Ciencias Humanas relataron uso de drogas con mayor frecuencia [48,6% en la vida, 29,0% en los ultimos 12 meses y 20,9% en los ultimos 30 dias]. CONCLUSIONES: Entre los 13 anos de estudio, hubo aumento de uso en la vida de cigarro, alucinogenos, anfetaminas y tranquilizantes; asi como aumento en el uso de anfetaminas en los ultimos 12 meses y disminucion en el uso de alcohol. Con relacion a los ultimos 30 dias, hubo aumento en el uso de anfetaminas.OBJECTIVE To analyze drug use trends among college students in 1996, 2001 and 2009. METHODS A cross-sectional epidemiological study with a multistage stratified cluster sample with 9,974 college students was conducted in the city of São Paulo, southeastern Brazil. An anonymous self-administered questionnaire was used to collect information on drug use assessed in lifetime, the preceding 12 months and the preceding 30 days. The Bonferroni correction was used for multiple comparisons of drug use rates between surveys. RESULTS There were changes in the lifetime use of tobacco and some other drugs (hallucinogens [6.1% to 8.8%], amphetamines [4.6% to 8.7%], and tranquilizers [5.7% to 8.2%]) from 1996 to 2009. Differences in the use of other drugs over the 12 months preceding the survey were also seen: reduced use of inhalants [9.0% to 4.8%] and increased use of amphetamines [2.4% to 4.8%]. There was a reduction in alcohol [72.9% to 62.1%], tobacco [21.3% to 17.2%] and marijuana [15.0% to 11.5%] use and an increase in amphetamine use [1.9% to 3.3%] in the preceeding 30 days. CONCLUSIONS Over the 13-year study period, there was an increase in lifetime use of tobacco, hallucinogens, amphetamines, and tranquilizers. There was an increase in amphetamine use and a reduction in alcohol use during the preceding 12 months. There was an increase in amphetamine use during the preceding 30 days.

Binge drinking associations with patrons' risk behaviors and alcohol effects after leaving a nightclub: sex differences in the "Balada com Ciência" portal survey study in Brazil

The purpose of the present study was to investigate the potential associations of binge drinking detected at the exit of nightclubs and risk behaviors and alcohol effects just after leaving the venue in a representative sample of Brazilian nightclub patrons according to sex. For this purpose, a portal survey study called Balada com Ciência was conducted in 2013 in the megacity of São Paulo, Brazil, using a two-stage cluster sampling survey design. Individual-level data were collected in 2422 subjects at the entrance and 1822 subjects at the exit of 31 nightclubs, and breath alcohol concentration (BrAC) was measured using a breathalyzer. The following day, 1222 patrons answered an online follow-up survey that included questions about risk behaviors and alcohol effects practiced just after leaving the nightclub. Weighted logistic regressions were used to analyze binge drinking associated with risk behaviors by sex. For both sexes, the most prevalent risk behaviors practiced after leaving a nightclub were drinking and driving (men=27.9%; women=20.4%), the use of illicit drugs (men=15.8%; women=9.4%) and risky sexual behavior (men=11.4%; women=6.8%). The practice of binge drinking increased the behavior of illicit drug use after leaving the nightclub by 2.54 times [95% CI: 1.26-5.09] among men who drank and increased the risk of an episode of new alcohol use by 5.80 times [95% CI: 1.50-22.44] among women who drank. Alcoholic blackouts were more prevalent among men [OR=8.92; 95% CI: 3.83-20.80] and women [OR= 5.31; 95% CI: 1.68-16.84] whose BrAC was equivalent to binge drinking compared with patrons with a lower BrAC. Public policies aiming to reduce patrons’ BrAC at the exit of nightclubs, such as staff training in responsible beverage service and legislation to prevent alcohol sales to drunk individuals, would be useful to protect patrons from the risk behaviors associated with binge drinking in nightclubs.

Alcohol Use among Older Adults: SABE Cohort Study, São Paulo, Brazil

In recent years, Brazil has demonstrated a new demographic pattern characterized by a reduction in both birth and mortality rates and a significant increase in the number of older adults. The purpose of the present study was to describe the frequency of alcohol intake in a representative sample community of older adults in the city of São Paulo, Brazil, followed over a six-year period. A prospective Saúde, Bem-Estar e Envelhecimento (SABE [Health, Wellbeing and Aging]) cohort study conducted in 2000 and 2006 in City of São Paulo, Brazil. 2,143 individuals aged 60 years or older selected through multi-stage sampling in the year 2000 (41.4% male and 58.6% women) and 1,115 individuals belonging to the follow-up cohort evaluated in 2006. The frequency of alcohol intake in the previous three months was obtained through self-reports of interviewees. The results demonstrate that in 2000, alcohol consumption was less than one day a week among 79.7% of the sample, one to three days a week among 13.0% and four or more days a week among 7.3%. In agreement with findings on other populations, consumption four or more days a week was more frequent among the male gender as well as those with greater schooling and income and good self-rated health (p<0.05). The longitudinal analysis demonstrated an increase in the frequency of alcohol consumption one to three times a week among the individuals in the 2006 follow-up study. In the present population-based sample, alcohol intake was low and the frequency of moderate alcohol consumption increased over the years. The present study can assist understanding the changes in alcohol intake among older adults throughout time and the ageing process.

Uso prescrito de cloridrato de metilfenidato e correlatos entre estudantes universitários brasileiros

BACKGROUND: The prevalence of prescribed use of methylphenidate (MPH) and its correlates are not well-known in Brazil. OBJECTIVE: To estimate the prevalence of prescribed use of MPH and its correlates in a sample of Brazilian college students. METHODS: Twelve-thousand seven hundred and eleven college students filled out a drug use questionnaire. They were divided into two groups based on the lifetime use of MPH: MPH users (MPHU) and MPH non-users (MPHNU). Quasi-binomial regression models were carried out in order to evaluate the correlation among MPHU and other variables. RESULTS: A lifetime use of MPH was reported from 0.9% of college students (MPHU). Being from the Midwest (PR = 4.8, p < 0.01) and South (PR = 5.2, p < 0.05), living in students housing (PR = 5.8, p < 0.001), prescribed use of amphetamines (PR = 8.9, p < 0.001) and benzodiazepines (< 3 weeks: PR = 4.4, p < 0.001; ≥ 3 weeks: PR = 6.7, p < 0.001), and harmful use of alcohol (PR = 4.0, p < 0.05) were correlated with MPHU. DISCUSSION: The association of alcohol and drug use with prescribed use of MPH among college students suggests the importance of screening drinking patterns and use of other drugs among students with ADHD symptoms.

Treatment of depression in older adults beyond fluoxetine

This review aimed to discuss the importance of the comprehensive treatment of depression among older adults in Brazil. The abuse of selective serotonin reuptake inhibitors, including fluoxetine hydrochloride, as antidepressants has been considered a serious public health problem, particularly among older adults. Despite the consensus on the need for a comprehensive treatment of depression in this population, Brazil is still unprepared. The interface between pharmacotherapy and psychotherapy is limited due to the lack of healthcare services, specialized professionals, and effective healthcare planning. Fluoxetine has been used among older adults as an all-purpose drug for the treatment of depressive disorders because of psychosocial adversities, lack of social support, and limited access to adequate healthcare services for the treatment of this disorder. Preparing health professionals is a sine qua non for the reversal of the age pyramid, but this is not happening yet.

Uso de drogas entre alunos universitários: tendências em 13 anos

OBJETIVO: Analizar la tendencia del uso de drogas entre universitarios en 1996, 2001 y 2009. METODOS: estudio epidemiologico transversal con 9.974 universitarios del municipio de Sao Paulo, Sureste de Brasil, cuya muestra fue seleccionada por estratificacion y conglomerados. Se adopto instrumento de investigacion de auto llenado, anonimo, que caracterizo el uso de drogas por tres medidas: uso en la vida, en los ultimos 12 meses y en los ultimos 30 dias. Para comparar las frecuencias de uso de drogas entre las investigaciones, se utilizo la metodologia de comparaciones multiples con correccion de Bonferroni. RESULTADOS: Hubo reduccion de la frecuencia de estudiantes que relataron consumo de drogas entre 1996 y 2009. Hubo disminucion del uso de inhalantes y aumento en el uso de anfetaminicos en todas las medidas evaluadas [4,6% para 8,7% en la vida, de 2,4% para 4,5% en los ultimos 12 meses y de 1,9% a 3,3% en los ultimos 30 dias]. Los alumnos de las Ciencias Humanas relataron uso de drogas con mayor frecuencia [48,6% en la vida, 29,0% en los ultimos 12 meses y 20,9% en los ultimos 30 dias]. CONCLUSIONES: Entre los 13 anos de estudio, hubo aumento de uso en la vida de cigarro, alucinogenos, anfetaminas y tranquilizantes; asi como aumento en el uso de anfetaminas en los ultimos 12 meses y disminucion en el uso de alcohol. Con relacion a los ultimos 30 dias, hubo aumento en el uso de anfetaminas.OBJECTIVE To analyze drug use trends among college students in 1996, 2001 and 2009. METHODS A cross-sectional epidemiological study with a multistage stratified cluster sample with 9,974 college students was conducted in the city of São Paulo, southeastern Brazil. An anonymous self-administered questionnaire was used to collect information on drug use assessed in lifetime, the preceding 12 months and the preceding 30 days. The Bonferroni correction was used for multiple comparisons of drug use rates between surveys. RESULTS There were changes in the lifetime use of tobacco and some other drugs (hallucinogens [6.1% to 8.8%], amphetamines [4.6% to 8.7%], and tranquilizers [5.7% to 8.2%]) from 1996 to 2009. Differences in the use of other drugs over the 12 months preceding the survey were also seen: reduced use of inhalants [9.0% to 4.8%] and increased use of amphetamines [2.4% to 4.8%]. There was a reduction in alcohol [72.9% to 62.1%], tobacco [21.3% to 17.2%] and marijuana [15.0% to 11.5%] use and an increase in amphetamine use [1.9% to 3.3%] in the preceeding 30 days. CONCLUSIONS Over the 13-year study period, there was an increase in lifetime use of tobacco, hallucinogens, amphetamines, and tranquilizers. There was an increase in amphetamine use and a reduction in alcohol use during the preceding 12 months. There was an increase in amphetamine use during the preceding 30 days.

Pharmacist professionals in the prevention of drug abuse: updating roles, and opportunities

The objective of this paper was to prepare and provide resources to pharmacists and other healthcare professionals, enabling them to carry out a critical analysis on drug abuse, acquiring knowledge in several areas that effectively contribute to their personal development in this professional field. Professionals play a crucial role in the reduction and prevention of substances abuse, since they are able to advise patient about illicit drugs, psychotropic medicines and alcohol abuse. There is an urgent need to specialize pharmacists to act in the national public health service and contribute to actions aimed at the surrounding community.

Tendência da mortalidade por intoxicação medicamentosa entre gêneros e faixas etárias no Estado de São Paulo, Brasil, 1996-2012

This study looked into mortality due to medicinal drug poisoning by age, gender and intent among the population of the state of São Paulo. The adjusted time sequence of mortality due to drug poisoning was developed based on data available in the DATASUS Mortality Data System for 1996 to 2012. We checked the variables for magnitude and trends. We found an increase in adjusted mortality starting in 2005, and more so as of 2009, confirmed by a 95% CI for the average annual rate of change. (AARC) We did not find the same trend in overall mortality in the state (AARC = -0.22%, 95% CI = -1.12 - 0.69) for specific, external cause mortality (AARC = -3.14%, 95% CI = -4.75 - -1.49) and for mortality due to accidental drug poisoning (AARC=+9,76%, 95% IC = -12.16 - 37.14). The largest increase was found in intentional self-poisoning with medicinal drugs (AARC = +10.64%, 95% CI = 6.92 - 14.40), and among the younger subjects (largest magnitude). The trend in mortality due to drug poisoning in the State of São Paulo, the importance of intent and mortality among the younger population reiterate the need to implement control measures.