Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2016-0002
Trends in Psychiatry and Psychotherapy
Original Article

Main mental disorders in crack-cocaine users treated at Psychosocial Care Centers for Alcohol and Drugs in the city of Recife, Brazil

Principais transtornos mentais em usuários de crack em tratamento nos Centros de Atenção Psicossocial Álcool e Drogas na cidade do Recife, Brasil

Antonio Gomes de Castro Neto; Diego César Nunes da Silva; Magda da Silva Figueiroa

Downloads: 0
Views: 560

Abstract

Abstract Introduction: Brazil's Northeast region has the highest crack-cocaine consumption in the country. Crack-cocaine has more intense effects than cocaine powder and can cause greater chemical dependence. Psychosocial Care Centers for Alcohol and Drugs (CAPSad) are public health services that provide treatment for drug dependence. It is common for drug users, and particularly crack-cocaine users, to develop mental disorders. Objective: To evaluate the most common mental disorders in crack-cocaine dependents in treatment at CAPSad in the city of Recife, Brazil. Methods: The research database "Between rocks and shots: user profiles, consumption strategies, and social impact of crack cocaine" (CEP/CCS/UFPE no. 206/11) was consulted to establish the areas of crack cocaine consumption in the city of Recife. Results: There were 885 patients in treatment for crack-cocaine use, with a mean age of 29.8±9.4 years. The mean duration of drug use was 6.1±4.6 years. Most of the patients were males (80.3%), had left school at some point between the 1st and 9th grades (45.6%), were unemployed and/or seeking employment (52%) and used drugs daily (56.4%). Cocaine chemical dependence was more significant when correlated with use of crack-cocaine and other drugs such as medications and hallucinogens (p = 0.01). Conclusions: Data from this study showed strong associations between crack-cocaine uses and development of mental disorders, particularly when abuse of multiple substances occurs. Based on these data, there is a clear need for coordination of related public policies for support and social reintegration to provide these people with comprehensive care.

Keywords

Crack-cocaine, mental disorders, drug combinations

Resumo

Resumo Introdução: A região Nordeste do Brasil possui o maior consumo de crack no país. O crack proporciona efeitos mais intensos comparados aos da cocaína em pó, podendo causar dependência química maior. Os Centros de Atenção Psicossocial Álcool e Drogas (CAPSad) são serviços públicos de saúde que promovem o tratamento para dependência de drogas. Normalmente, o uso de drogas pode desenvolver transtornos mentais, principalmente em usuários de crack. Objetivo: Avaliar os principais transtornos mentais em dependentes de crack em tratamento nos CAPSad da cidade do Recife. Métodos: O banco de dados da pesquisa "Entre pedras e tiros: perfil dos usuários, estratégias de consumo e impacto social do crack" (CEP/CCS/UFPE nº 206/11) foi consultado para estabelecer as áreas de consumo de crack na cidade do Recife. Resultados: Havia 885 pacientes em tratamento devido ao uso de crack, com média de idade de 29,8±9,4 anos. A duração média do uso de drogas foi de 6,1±4,6 anos. A maioria dos pacientes era do sexo masculino (80,3%), com primeiro ao nono ano incompleto (45,6%), desempregados e/ou procurando emprego (52%) e uso diário de drogas (56,4%). A dependência química da cocaína foi mais significativa quando correlacionada ao uso associado de crack e outras drogas como medicamentos e alucinógenos (p = 0,01) . Conclusão: Os dados deste estudo mostraram fortes associações entre uso de crack e desenvolvimento de transtornos mentais, particularmente quando ocorre multiuso. Mostra-se a necessidade de coordenação de outras políticas públicas de apoio e reintegração social para atendimento integral a essas pessoas.

Palavras-chave

Crack, transtornos mentais, combinações de drogas

References

Louzã MRN, Hélio E. Psiquiatria básica. 2007.

II Levantamento Nacional de Álcool e Drogas (LENAD). O uso de cocaína e crack no Brasil. 2013.

Pesquina Nacional sobre o uso de Crack. 2014.

World Drug Report. 2014.

Edwards G, Marshall J, Cook C. O tratamento do alcoolismo. 1999.

Cunha PJ, Novaes MA. Avaliação neurocognitiva no abuso e dependência do álcool: implicações para o tratamento. Rev Bras Psiquiatr. 2004;26:23-7.

Silveira DX, Jorge MR. Co-morbidade psiquiátrica em dependentes de substâncias psicoativas: resultados preliminares. Rev Bras Psiquiatr. 1999;21:145-51.

Alves H, Kessler F, Ratto LRC. Comorbidade: usos de álcool e outros transtornos psiquiátricos. Rev Bras Psiquiatr. 2004;26:51-3.

Ratto L, Cordeiro DC, Figlie NB, Laranjeira R, Bordin S. Principais comorbidades psiquiátricas na dependência química. 2004:167-86.

Zaleski M, Laranjeira RR, Marques ACPR, Ratto L, Romano M, Alves HNP. Diretrizes da associação brasileira de estudos do álcool e outras drogas (ABEAD) para o diagnóstico e tratamento de comorbidades psiquiátricas dependência de álcool e outras substâncias. Rev Bras Psiquiatr. 2006;28:142-8.

A política do Ministério da Saúde para a atenção integral a usuários de álcool e outras drogas. 2003.

Parry CD, Plüddemann A, Myers BJ. Cocaine treatment admissions at three sentinel sites in South Africa (1997-2006): findings and implications for policy, practice and research. Subst Abuse Treat Prev Policy. 2007;2:37.

Schifano F, Corkery J. Cocaine/crack cocaine consumption, treatment demand, seizures, related offences, prices, average purity levels and deaths in the UK (1990 - 2004). J Psychopharmacol. 2008;22:71-9.

Borini P, Guimarães RC, Borini SB. Usuários de drogas ilícitas internados em hospital psiquiátrico: padrões de uso e aspectos demográficos e epidemiológicos. J Bras Psiquiatr. 2003;52:171-97.

Duailibi LB, Ribeiro M, Laranjeira R. Profile of cocaine and crack users in Brazil. Cad Saude Publica. 2008;24:s545-57.

Horta RL, Horta BL, Rosset AP, Horta CL. Crack cocaine users who attend outpatient services. Cad Saude Publica. 2011;27:2263-70.

Uchôa RS. Entre pedras e tiros: perfil dos usuários, estratégias de consumo e impacto social do crack. 2012.

Chaney RA, Rojas-Guyler L. Spatial patterns of adolescent drug use. Appl Geogr. 2015;56:71-82.

Brière FN, Fallu JS, Morizot J, Janosz M. Adolescent illicit drug use and subsequent academic and psychosocial adjustment: an examination of socially-mediated pathways. Drug Alcohol Depend. 2014:13545-51.

Barber JG, Bolitho F, Bertrand L. Intrapersonal versus peer group predictors of adolescent drug use. Child Youth Serv Rev. 1999;21:565-79.

Nodora J, Hartman SJ, Strong DR, Messer K, Vera LE, White MM. Curiosity predicts smoking experimentation independent of susceptibility in a US national sample. Addict Behav. 2014;39:1695-700.

Arria AM, Garnier-Dykstra LM, Cook ET, Caldeira KM, Vincent KB, Baron RA. Drug use patterns in young adulthood and post-college employment. Drug Alcohol Depend. 2013;127:23-30.

Salas-Wright CP, Vaughn MG, Hodge DR, Perron BE. Religiosity profiles of American youth in relation to substance use, violence, and delinquency. J Youth Adolesc. 2012;41:1560-75.

Kuhns JB, Clodfelter TA. Illicit drug-related psychopharmacological violence: the current understanding within a causal context. Aggress Violent Behav. 2009;14:69-78.

Reed E, Raj A, Falbo G, Caminha F, Decker MR, Kaliel DC. The prevalence of violence and relation to depression and illicit drug use among incarcerated women in Recife, Brazil. Int J Law Psychiatry. 2009;32:323-8.

Aston EV. Are risk factors for drug use and offending similar during the teenage years?. Int J Drug Policy. 2015;26:396-403.

Palmer RH, Knopik VS, Rhee SH, Hopfer CJ, Corley RC, Young SE. Prospective effects of adolescent indicators of behavioral disinhibition on DSM-IV alcohol, tobacco, and illicit drug dependence in young adulthood. Addict Behav. 2013;38:2415-21.

Gilchrist G, Gruer L, Atkinson J. Predictors of neurotic symptom severity among female drug users in Glasgow, Scotland. Drugs (Abingdon Engl). 2007;14(4):347-65.

Weafer J, de Wit H. Sex differences in impulsive action and impulsive choice. Addict Behav. 2014;39:1573-9.

Sansone RA, Sansone LA. Gender patterns in borderline personality disorder. Innov Clin Neurosci. 2011;8:16-20.

Grella CE, Joshi V, Hser YI. llowup of cocaine-dependent men and women with antisocial personality disorder. J Subst Abuse Treat. 2003;25:155-64.

Bardeen JR, Dixon-Gordon KL, Tullb MT, Lyonsc JA, Gratz KL. An investigation of the relationship between borderline personality disorder and cocaine-related attentional bias following trauma cue exposure: the moderating role of gender. Compr Psychiatry. 2014;55:113-22.

Chaves TV, Sanchez ZM, Ribeiro LA, Nappo SA. Crack cocaine craving: behaviors and coping strategies among current and former users. Rev Saude Publica. 2011;45:1168-75.

Harris DS, Everhart ET, Mendelson J, Jones RT. The pharmacology of cocaethylene in humans following cocaine and ethanol administration. Drug Alcohol Depend. 2003;72:169-82.

Fox HC, Talih M, Malison R, Andersom GM, Kreek MJ, Sinha R. Frequency of recent cocaine and alcohol use affects drug craving and associated responses to stress and drug-related cues. Psychoneuroendocrinology. 2005;30:880-91.

McCance-Katz EF. Drug interactions associated with methadone, buprenorphine, cocaine, and HIV medications: implications for pregnant women. Life Sci. 2011;88:953-8.

Moreno RA, Moreno DH, Ratzke R. Diagnóstico, tratamento e prevenção da mania e da hipomania no transtorno bipolar. Rev Psiquiatr Clin. 2005;32:39-48.

El Mansari M, Guiard BP, Chernoloz O, Ghanbari R, Katz N, Blier P. Relevance of norepinephrine-dopamine interactions in the treatment of major depressive disorder. CNS Neurosci Ther. 2010;16:e1-17.

Ferchiou A, Szöke A, Laguerre A, Méary A, Leboyer M, Schürhoff F. Exploring the relationships between tobacco smoking and schizophrenia in first-degree relatives. Psychiatry Res. 2012;200:674-8.

6169ec37a953955fa9230b54 trends Articles
Links & Downloads

Trends Psychiatry Psychother

Share this page
Page Sections