Polysubstance use in a Brazilian national sample: Correlates of co-use of alcohol and prescription drugs

Alcohol use disorder in people with infectious and chronic diseases and mental disorders: Brazil, 2015

The study aimed to estimate the prevalence of alcohol use disorder (AUD) and associated factors in Brazilian adults that reported chronic noncommunicable diseases (NCDs), mental disorders (MDs), and infectious diseases (IDs). This was a secondary analysis of the 3rd National Survey on Drug Use by the Brazilian Population in which the principal outcome was presence of AUD. Prevalence of AUD was estimated for three subgroups: individuals that reported NCDs, MDs, and IDs. Factors associated with AUD in each group were analyzed using logistic regression models. Of the 15,645 adults interviewed, 30.5% (95%CI: 29.4-31.5) reported NCDs, 17.6% (95%CI: 16.5-18.7) MDs, and 1.6% (95%CI: 1.2-1.9) IDs. Considering comorbidities, the analytical sample was 6,612. No statistically significant difference was found in the prevalence of AUD between individuals with NCDs (7.5% [95%CI: 6.1- 8.7]), MDs (8.4% [95%CI: 6.7-10.2]), and IDs (12.4% [95%CI: 7.0-17.8]). The main factors associated with AUD in all the groups were male sex and young adult age. Considering the high prevalence of AUD in all the groups, systematic screening of AUD is necessary in health services that treat NCDs, MDs, and IDs.

Shift in hospital opioid use during the COVID-19 pandemic in Brazil: a time-series analysis of one million prescriptions

The pronounced change in the profile of hospitalized patients during COVID-19 and the severe respiratory component of this disease, with a great need for mechanical ventilation, led to changes in the consumption pattern of some medicines and supplies. This time-series study analyzed the in-hospital consumption of opioids during the COVID-19 pandemic in 24 Brazilian hospitals compared to the pre-pandemic period. Data included 711,883 adult patients who had opioids prescribed. In 2020, the mean consumption was significantly higher compared to 2019 for parenteral fentanyl, enteral methadone, and parenteral methadone. It was significantly lower for parenteral morphine parenteral sufentanil, and parenteral tramadol. For remifentanil, it did not differ. The number of patients in 2020 was lower but the mean consumption was higher for fentanyl, parenteral methadone, and remifentanil. It was lower for enteral methadone and parenteral sufentanil. The consumption of parenteral morphine and parenteral tramadol was stable. There was a relevant increase in hospital consumption of some potent opioids during the COVID-19 pandemic in Brazil. These results reinforce the concern about epidemiological surveillance of opioid use after periods of increased hospital use since in-hospital consumption can be the gateway to the misuse or other than the prescribed use of opioids after discharge.

Understanding alcohol-related indicators from population surveys: answering the "Five W's of Epidemiology"

The harmful use of alcohol is a major risk factor for the global burden of disease, and public policies are the most effective strategies to prevent it. Population-based surveys are milestones for planning, implementing, and monitoring those policies. However, there are numerous ways to measure alcohol consumption which may result in different indicators. Researchers and stakeholders should find common ground in the understanding of these measures to avoid misinterpretation and confusion in the field. Answering to the "Five W's Epidemiology", when interpreting alcohol-related information, may improve the communication, as well as reproducibility and comparability of research findings. This paper aims to exemplify this approach by describing some indicators from the World Health Organization's Global Information System on Alcohol and Health (GISAH) and the corresponding data available from the latest Brazilian household surveys. Notably, none of the Brazilian surveys reports on all the nine selected GISAH indicators, and only two provided the necessary methodological details to be fully reproducible. A stronger agenda is of the utmost importancefor advancing in the monitoring and prevention of alcohol-related harms in Brazil.

Would the Brazilian population support the alcohol policies recommended by the World Health Organization?

OBJECTIVE

To evaluate the support of the Brazilian population to the alcohol-policies proposed by the World Health Organization to decrease alcohol harm (specifically: to decrease alcohol availability and advertising, and to increase pricing). In addition, we evaluated the factors associated with being against those policies.

METHODS

Data from 16,273 Brazilians, aged 12-65 years, interviewed in the 3rd Brazilian Household Survey on Substance Use (BHSU-3) were analyzed. The BHSU-3 is a nationwide, probability survey conducted in 2015. Individuals were asked if they would be against, neutral, or in favor of seven alcohol policies grouped as: 1) Strengthen restrictions on alcohol availability; 2) Enforce bans or restrictions on alcohol advertising, sponsorship, and promotion; and 3) Raise prices on alcohol through excise taxes and pricing. Generalized linear models were fitted to evaluate factors associated with being against each one of those policies and against all of policies.

RESULTS

Overall, 28% of the Brazilians supported all the above mentioned policies, whereas 16% were against them. The highest rate of approval refers to restricting advertising (53%), the lowest refers to increasing prices (40%). Factors associated with being against all policies were: being male (AOR = 1.1; 95%CI: 1.0-1.3), not having a religion (AOR = 1.4; 95%CI: 1.1-1.8), being catholic (AOR = 1.3; 95%CI: 1.1-1.5), and alcohol dependence (AOR = 1.6; 95%CI: 1.1-2.4).

CONCLUSIONS

The Brazilian government could count on the support of most of the population to restrict alcohol advertising. This information is essential to tackle the lobby of the alcohol industry and its clever marketing strategy.