10/06/2015
07/06/2015
Quase metade dos baladeiros bebe antes de entrar na casa noturna
Quase metade dos baladeiros bebe antes de entrar na casa noturna
O famoso "esquenta", conduta conhecida popularmente por pessoas que bebem antes de entrar nas baladas, é realizado por 41,3% dos frequentadores de casas noturnas. A pesquisa entrevistou 2.422 clientes de 31 estabelecimentos na cidade de São Paulo e foi realizado pelo Departamento de Medicina Preventiva da Universidade Federal de São Paulo (Unifesp).
Os pesquisadores selecionaram os clientes aleatoriamente e as casas noturnas mediante suas capacidades e amostragem de clientes. Para a análise do consumo de álcool dos entrevistados foi utilizado um “bafômetro” para medir a concentração de ar expirado, além de uma entrevista individual, tanto na entrada quanto na saída.
A maioria dos indivíduos que beberam antes de entrar nas casas noturnas apresentou sinais de intoxicação em decorrência do álcool na saída das baladas. Foi observado também maior prevalência deste comportamento em indivíduos do sexo masculino, com histórico de abuso de álcool e comportamento sexual de risco.
Zila Sanchez, responsável pela pesquisa, ressalta que este comportamento não é característico apenas dos frequentadores de casas noturnas no Brasil, ocorrendo também nos Estados Unidos e em países da Europa. Na visão da pesquisadora, o “esquenta” é um comportamento de risco e influência no padrão de consumo dentro da balada. “Diferentemente do que se pensa, o esquenta não leva a economia de dinheiro, pois na prática quem fez esquenta terminou a noite mais alcoolizado e consumiu mais doses dentro da balada”, afirmou Zila.
Outro estudo desenvolvido pelo mesmo departamento e baseado no mesmo público, mostrou que o “esquenta” é o principal fator associado ao binge drinking, popularmente conhecido como “porre” ou como hábito de beber em excesso durante um período.
Algumas atrações que ocorrem nas baladas, como a oferta de bebida gratuita (open bar), diversidade de pistas de dança e som muito alto também foram observados como fatores do alto consumo de bebida.
Reportagem de: A Tribuna. Saiba mais aqui.
05/06/2015
Longitudinal Study of Adolescent Brain and Cognitive Development (ABCD)
Longitudinal Study of Adolescent Brain and Cognitive Development (ABCD)
What is the ABCD Study?
The ABCD is a landmark study being conducted by the National Institutes of Health (NIH) on the effects of adolescent substance use on the developing brain. Lessons learned from this project will guide future tobacco, alcohol and drug prevention and treatment efforts.
Why Do We Need the ABCD Study?
Alcohol, marijuana, tobacco and other drugs are widely used by youth, and this use can pose short and long-term health and safety risks, including during development. Because brain development continues into the twenties, it is unclear how substance use among youth will affect them later in life.
- Evidence suggests that substance use has long term effects on the developing brain.
- Advances in neuroimaging allow us to study the brain in greater detail.
- Adolescents today are drinking more alcohol when they binge, and have access to higher potency marijuana and greater varieties of nicotine delivery devices than previous generations.
- Changes in state and local policies, particularly with respect to marijuana, may impact public health.
How will ABCD Be Implemented?
Unique in its scope and duration, the ABCD will recruit 10,000 youth before they begin using alcohol, marijuana, nicotine and other drugs, and follow them over 10 years into early adulthood to assess how substance use affects the trajectory of the developing brain. ABCD researchers will use advanced brain imaging as well as psychological and behavioral research tools to evaluate brain structure and function and track substance use, academic achievement, IQ, cognitive skills, and mental health over time.
What Questions Will ABCD Address?
The size and complexity of the ABCD study will allow scientists to address key questions:
- What is the impact of occasional versus regular use of marijuana, alcohol, tobacco and other substances, alone or in combination, on the structure and function of the developing brain?
- How does the use of specific substances impact the risk for using other substances?
- What are the brain pathways that link adolescent substance use and risk for mental illnesses?
- What impact does substance use have on physical health, psychological development, information processing, learning and memory, academic achievement, social development, and other behaviors?
- What factors (prenatal exposure, genetic, familial, demographic, etc.) influence the development of substance use and its consequences?
Who is Leading ABCD?
The ABCD study is led by the Collaborative Research on Addiction at NIH (CRAN) – National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the National Cancer Institute (NCI) with the Eunice Kennedy Shriver National Institute of Child Health and Human Development – in collaboration with the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, National Institute of Minority Health and Health Disparities, the Office of Research on Women’s Health and the Office of Behavioral and Social Sciences Research.
For more information, visit: http://addictionresearch.nih.gov/adolescent-brain-cognitive-development-study
03/06/2015
Injection of crack cocaine: a case report
Rev. Bras. Psiquiatr. vol.37 no.1 São Paulo Jan./Mar. 2015
Injection of crack cocaine: a case report
Addiction Unit (PROAD), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo - SP - Brazil
A 26-year-old American man was referred to our service for methadone replacement therapy and treatment of crack/cocaine addiction. His addiction history started with use of opioids in early adolescence. As his tolerance escalated, he began injecting cocaine with morphine, also known as “speedball.” Since he started methadone replacement therapy and discontinued morphine use, he reported a substantial increase in cocaine injection, as well as crack injection, the latter motivated by lower prices and wider availability. He fulfills DSM-5 diagnosis criteria for severe dependence on both opioids and cocaine. A multidisciplinary team managed his case.
In 2013, the United Nations Office on Drugs and Crime estimated the number of injecting drug users (IDU) worldwide at 14 million.1 The prevalence of crack cocaine injection (CCI) is unknown; however, some local studies have assessed it and observed variable frequencies. A PubMed search using the terms “injection crack AND intravenous crack” yielded 44 papers, eight of which reported actual CCI. None concerned the Brazilian context. This is, to our knowledge, the first Brazilian case report of CCI.
One paper reports an increase of CCI between 1990 and 1993 in London, from 1 to 27%.2 Another study presented the results of a 1997-1999 cohort of 2,198 homeless IDUs recruited from six U.S. cities and estimated the frequency of CCI as 15% among participants.3 A later U.S. study with 989 participants reported a 9% lifetime prevalence of CCI among IDUs,4 and a Canadian study with 4,088 IDUs reported a 15.2% rate of CCI.5
CCI is accomplished by dissolving crack in vinegar or lemon juice and does not require the application of heat. The shift from cocaine use to CCI can be explained by several reasons, including changes in illicit drug markets and a desire for greater psychoactive effects. This is particularly important as some anecdotal unpublished reports state that cocaine may be present in greater amounts in crack than in its powder form.
CCI may be a marker of high-risk behaviors, and correlates with use of shooting galleries, initiation of others into drug injection, and serologic evidence of hepatitis B virus and hepatitis C virus infection.3 Furthermore, crack injectors reported higher rates of abscesses and mental illness.4 HIV infection is also a real risk for all IDUs. All of these factors can have an important impact on public health issues related to drug use, and must be considered in policy development.
Furthermore, this population may require broader treatment strategies. For instance, since severe mental illness may be more prevalent in crack cocaine injectors, hospitalization can be necessary for acute management of high-risk symptomatology (suicidality, aggressiveness, agitation). Moreover, health maintenance programs (i.e., management of infectious diseases), first-line social assistance (shelter, food, hygiene), and access to sustainable livelihood programs (housing, vocational training) can be vital for comprehensive treatment.
CCI deserves a more comprehensive investigation among the Brazilian drug user population, as it may be a marker of high-risk behaviors. Public health surveillance of this practice is of great importance to provide a better understanding of the behavior of users who self-administer crack cocaine via this route and to enable implementation of prevention and harm reduction policies.
REFERENCES
1. United Nations Office on Drugs and Crime (UNODC). World Drug Report 2013. United Nations publication, Sales N°. E.13.XI.6 [Internet]. 2013 [cited 2014 Ago 14].http://www.unodc.org/unodc/secured/wdr/wdr2013/World_Drug_Report_2013.pdf [ Links ]
2. Hunter GM, Donoghoe MC, Stimson GV. Crack use and injection on the increase among injecting drug users in London. Addiction. 1995;90:1397-400. [ Links ]
3. Santibanez SS, Garfein RS, Swartzendruber A, Kerndt PR, Morse E, Ompad D, et al. Prevalence and correlates of crack-cocaine injection among young injection drug users in the United States, 1997-1999. Drug Alcohol Depend. 20057;77:227-33. [ Links ]
4. Buchanan D, Tooze JA, Shaw S, Kinzly M, Heimer R, Singer M. Demographic, HIV risk behavior, and health status characteristics of “crack” cocaine injectors compared to other injection drug users in three New England cities. Drug Alcohol Depend. 2006;81:221-9. [ Links ]
5. Roy E, Leclerc P, Morissette C, Arruda N, Blanchette C, Blouin K, et al. Prevalence and temporal trends of crack injection among injection drug users in eastern central Canada. Drug Alcohol Depend. 2013;133:275-8. [ Links ]
Recebido: 28 de Maio de 2014; Aceito: 24 de Julho de 2014
01/06/2015
Antibiotic Cuts Alcohol Cravings, May Enhance Psychotherapy
Antibiotic Cuts Alcohol Cravings, May Enhance Psychotherapy
An antibiotic typically used to treat tuberculosis reduces alcohol cravings and may enhance cue-related extinction therapies in individuals with alcohol use disorders, new research shows.
The study, which was funded by the National Institutes of Health, showed that low doses of D-cycloserine significantly reduce alcohol cravings for up to 3 weeks, leading to significant reductions in alcohol consumption.
The researchers believe that the drug could also be used to enhance the effect of psychotherapies, such as cognitive-behavioral therapy (CBT), to provide a more durable outcome.
"We're trying to turn up the gas on this CBT intervention that focuses on helping people cope with their cravings better," lead author James MacKillop, PhD, Peter Boris Center for Addictions Research, McMaster University, Hamilton, Ontario, Canada, told Medscape Medical News.
"What we're trying to take are the most critical points in treatment and try to tune up the brain's responsiveness to those points to ultimately not just affect the person the most but lead to new learning that will be more robust over time and improve outcomes," Dr. MacKillop added.
The study was published online April 7 in Translational Psychiatry.
Unique Approach
D-cycloserine is the dextrorotary form of cycloserine and is a partial agonist of N-methyl-D-aspartate receptors, which play a central role in memory and learning.
To examine whether the drug could accelerate the extinction of cue-elicited craving for alcohol, the team studied individuals with alcohol use disorders who were seeking alcohol treatment and had evidence of reacting to alcohol cues.
Participants underwent an alcohol extinction paradigm, given as four sessions of manualized motivational enhancement therapy akin to cue exposure therapy, over 2 weeks in a naturalistic bar laboratory environment.
For sessions 1 and 3, which took place 1 week apart, the participants received D-cycloserine, 50 mg (n = 16), or placebo (n = 14) 1 hour beforehand. Follow-up cue reactivity sessions were then conducted 1 week and 3 weeks later.
At study outset, participants had significant and robust alcohol cue reactivity, with no significant differences between the two groups.
Those who received the study medication had significant reductions in alcohol craving and significant increases in extinction during the first session compared with those given placebo (P ≤ .05 for both). The significant impact of D-cycloserine on alcohol cravings was maintained at week 3 (P ≤ .05).
At the end of the study, participants who received the medication reported significantly fewer drinks per day, lower percentage of drinking days, and lower percentage of heavy drinking days (P ≤ .05, P ≤ .05, and P ≤ .01, respectively). However, these effects were no longer significant at the 3-week follow-up.
Minimal adverse effects occurred with the study drug. The only notable effect was a nonsignificant increase in drowsiness after the second administration.
See more here.
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