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Olivari CF, Gaete J, Rodriguez N, Pizarro E, Del Villar P, Calvo E, Castillo-Carniglia A. Polydrug Use and Co-occurring Substance Use Disorders in a Respondent Driven Sampling of Cocaine Base Paste Users in Santiago, Chile. J Psychoactive Drugs 2021; 54:348-357. [PMID: 34724873 DOI: 10.1080/02791072.2021.1976886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We characterized substance use patterns and co-occurring substance use disorders among active cocaine base paste (CBP) users in Santiago, Chile using data from respondent-driven sampling (RDS) in three areas of Metropolitan Santiago. Recruitment began with nine seeds, reaching 398 active CBP users (18% women; mean age 37.7 years), defined as persons consuming CBP at least twice per week in the last three months. Population proportions and uncertainty were estimated accounting for individuals' social network and homophily. The median CBP age of initiation was 21 years, and the median number of years using CBP was 7 for women and 15 for men. The median days of use in the past month was 25 days, with a median of 56 doses per week. The proportion of monthly income spent on CBP was 65%. The prevalence of substance use disorders (SUDs) were: 98% for CBP, 67% for alcohol, 60% for marijuana, and 41% for cocaine hydrochloride. Heavy polydrug use patterns and co-occurring SUDs are frequent among active CBP users in the metropolitan area of Santiago. Traditional surveillance strategies may have underestimated polysubstance use and co-occurring SUDs in active CBP users. RDS proved to be a feasible methodology that could be effectively used for substance use surveillance among hard-to-reach populations.
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Affiliation(s)
- Carla F Olivari
- Society and Health Research Center, Universidad Mayor, Santiago, Chile
| | - Jorge Gaete
- Faculty of Education, Universidad de los Andes, Santiago, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, MI, USA
| | - Nicolás Rodriguez
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Esteban Pizarro
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Paloma Del Villar
- Centro de estudios Justicia y Sociedad, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Esteban Calvo
- Society and Health Research Center, Universidad Mayor, Santiago, Chile.,School of Public Health, Universidad Mayor, Santiago, Chile.,Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.,Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Santiago, Chile.,School of Public Health, Universidad Mayor, Santiago, Chile.,Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Dokkedal-Silva V, Fernandes GL, Morelhão PK, Pires GN, Rowlett JK, Galduróz JCF, Berro LF, Tufik S, Andersen ML. Sleep, psychiatric and socioeconomic factors associated with substance use in a large population sample: A cross-sectional study. Pharmacol Biochem Behav 2021; 210:173274. [PMID: 34547353 DOI: 10.1016/j.pbb.2021.173274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022]
Abstract
Multiple elements modulate drug use, including sleep, which is increasingly being considered as an important contributor to substance use and abuse. The present study aimed to evaluate the association between sleep, psychiatric and socioeconomic/demographic factors and substance use in a large-scale representative sample from the city of São Paulo, Brazil. Data from the 2007 São Paulo Epidemiological Sleep Study (EPISONO) database were used. In the EPISONO study, volunteers underwent a polysomnographic exam and completed a series of questionnaires to assess objective and subjective sleep quality and associated comorbidities. Drug use was assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Linear (univariate and multivariate) and logistic regressions were performed to identify factors associated with the use of the 4 most commonly used substances in the sample (tobacco, alcohol, cannabis and cocaine/crack). Structural equation models were used to establish theoretical networks to explain the relationship between sleep, psychiatric and socioeconomic factors and use of these substances. The logistic regression results showed that psychiatric symptoms, lower income, and poorer subjective sleep were the main factors associated with tobacco consumption; gender and occupational status with alcohol intake; age and occupation with cannabis use; and education with cocaine/crack use. The structural equation models partially supported these findings and identified significant effects of psychiatric symptoms on tobacco consumption, both directly and mediated by sleep. Our results reinforce previous findings concerning factors associated with generally misused substances and suggest that sleep should be considered as an important element in future substance use disorder studies.
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Affiliation(s)
- Vinícius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Guilherme L Fernandes
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Priscila K Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Gabriel N Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - James K Rowlett
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N State St, Jackson, 39216 Jackson, United States
| | - José Carlos F Galduróz
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Laís F Berro
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N State St, Jackson, 39216 Jackson, United States.
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
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Perrenoud LO, Oikawa KF, Williams AV, Laranjeira R, Fischer B, Strang J, Ribeiro M. Factors associated with crack-cocaine early initiation: a Brazilian multicenter study. BMC Public Health 2021; 21:781. [PMID: 33892673 PMCID: PMC8063477 DOI: 10.1186/s12889-021-10769-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 04/05/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Crack-cocaine dependence is a serious public health issue, related to several psychiatric and psychosocial problems. Crack-cocaine users are usually embedded in a context of great social vulnerability, often associated with violence, poverty, family conflict and easy and early access to alcohol, tobacco and other drugs. METHODS This cross-sectional study enrolled a consecutive sample of 577 patients admitted to 20 therapeutic communities located in Southern Brazil, between September 2012 and September 2013. A structured interview assessed life-time exposure to risk and protective factors for drug use, such as parental monitoring in childhood, deviant behaviors and peer pressure. RESULTS Presence of family conflict (p = 0.002), maltreatment (p = 0.016), and deviant behavior prior to age 15 in a bivariate analysis predicted an earlier age of crack-cocaine initiation, whereas adolescents experiencing parental monitoring during adolescence started use later (p < 0.001). In the multivariate model, perceptions related to ease of access of illicit drugs (marijuana: p = 0.028, 95% CI = - 3.81, - 0.22; crack-cocaine: p < 0.001, 95% CI = - 7.40, - 4.90), and deviant behavior (threatening someone with a gun: p = 0.028, 95% CI = - 2.57, - 0.14) remained independent predictors of early age of crack-cocaine initiation. CONCLUSIONS Early onset of crack-cocaine use seems to be associated with exposure to family conflict, easy access to drugs and deviant behavior. Treatment and preventive programs should take these factors into account when designing and implementing community interventions.
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Affiliation(s)
- Luciane Ogata Perrenoud
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), São Paulo State Secretary of Health, Rua Prates, 165, 01121000 São Paulo, Brazil
| | - Koki Fernando Oikawa
- Department of Statistics, Brazil University, São Paulo, Brazil, Rua Ibipetuba, 130, SP 03127-180 São Paulo, Brazil
| | - Anna Virginia Williams
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK, 4, Windsor Walk Denmark Hill, SE5 8AF London, UK
| | - Ronaldo Laranjeira
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
| | - Benedikt Fischer
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Applied Research in Mental Health and Addiction, Simon Fraser University (SFU Faculty of Health Sciences, 515 W. Hastings Street, Vancouver, BC V6B 5K3), Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON. M5T 1R8 Canada
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK, 4, Windsor Walk Denmark Hill, SE5 8AF London, UK
| | - Marcelo Ribeiro
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), São Paulo State Secretary of Health, Rua Prates, 165, 01121000 São Paulo, Brazil
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Czermainski FR, Lopes FM, Ornell F, Pinto Guimarães LS, Von Diemen L, Kessler F, Martins de Almeida RM. Concurrent Use of Alcohol and Crack Cocaine is Associated with High Levels of Anger and Liability to Aggression. Subst Use Misuse 2020; 55:1660-1666. [PMID: 32519554 DOI: 10.1080/10826084.2020.1756850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: To evaluate aggressiveness in individuals receiving treatment for alcohol and crack cocaine use, both alone and in combination with one another, in order to compare them to control subjects with no history of drug problems, using the State-Trait Anger Expression Inventory. Method: The sample consisted of 67 men aged 18-65 years, divided into four groups: alcohol (n = 13); crack cocaine (n = 25); crack cocaine + alcohol (n = 16) and controls (n = 13). Participants completed the following instruments: socioeconomic questionnaire, the Wechsler Abbreviated Scale of Intelligence and the State-Trait Anger Expression Inventory. Results: Individuals with alcohol dependence alone, or comorbid with crack cocaine dependence, showed elevated levels of aggression and anger, though these varied according to the drug of abuse. Concurrent users of alcohol and crack cocaine had the highest levels of aggression, followed by isolated alcohol users, suggesting an association between alcohol consumption and aggression. Conclusion: The present findings suggest that alcohol and aggression levels may be associated with violent behavior. Concurrent use of alcohol and crack cocaine was related to higher levels of aggression, which may be associated with more severe alterations in behavior and impulse control.
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Affiliation(s)
| | | | - Felipe Ornell
- Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Lisia Von Diemen
- Center for Drug and Alcohol Research, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Felix Kessler
- Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Gavioli A, Pazin PTN, Marangoni SR, Hungaro AA, Santana CJ, Oliveira MLFD. Drug use by men admitted to a psychiatric hospital*. Rev Lat Am Enfermagem 2020; 28:e3296. [PMID: 32578752 PMCID: PMC7304981 DOI: 10.1590/1518-8345.3370.3296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/15/2020] [Indexed: 12/21/2022] Open
Abstract
Objective: to assess risk related to drug use in men admitted to a psychiatric hospital
and to identify associations with sociodemographic, socioeconomic variables,
and risk conditions. Method: a cross-sectional study with the application of a screening test in 209
participants hospitalized for mental and behavioral disorders due to the use
of psychoactive substances. Statistical analysis was performed using
descriptive statistics and adjustment of a binary logistic regression model
for moderate or high risk of drug use. The odds ratio measured the strength
of association. Results: high use in life was observed, with alcohol and tobacco experimentation in
adolescence. A high prevalence of related risk was observed for alcohol,
tobacco, smoked and inhaled cocaine, and marijuana. Moderate and elevated
risks were found for tobacco (22.5% and 62.5%, respectively), alcohol (13.5%
and 73%), marijuana (16% and 32.5%), smoked cocaine (3% and 41%) and inhaled
cocaine (9% and 19.5%). Conclusion: the results showed high use in life, with an age of early experimentation.
Tobacco and alcohol are the main drugs used by hospitalized men.
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Czermainski FR, Willhelm AR, Santos ÁZ, Pachado MP, de Almeida RMM. Assessment of inhibitory control in crack and/or cocaine users: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 39:216-225. [PMID: 28813109 DOI: 10.1590/2237-6089-2016-0043] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 02/16/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Impairments involving inhibitory control have been considered central deficits in drug users, but it appears that dysfunctions may be specific to users' drug of choice. This article aims to review recent findings on inhibitory control impairment in samples of crack and/or cocaine users. METHODS Searches were conducted on the PubMed, PsycINFO, and Web of Knowledge databases in two stages according to eligibility criteria. Initially, databases were searched and the titles and abstracts of results were analyzed and then selected articles were read in full. Inclusion criteria were: empirical articles written in English, Portuguese, or Spanish, published in the last ten years and involving the assessment of inhibitory control in crack and/or cocaine users. RESULTS The database searches returned a total of 3,796 titles, 56 of them were selected initially and then a further 20 were excluded. Thirty-six articles were included in this review. In 90% of the studies reviewed the presence of inhibitory control deficits was reported, verified by impaired cognitive processing and response monitoring, as well as high levels of impulsiveness, regardless of the pattern of crack and/or cocaine consumption (recreational or chronic). Former users showed high levels of impulsiveness even after long periods of abstinence. CONCLUSIONS Crack and/or cocaine users may have inhibitory control deficits, irrespective of different consumption patterns. High levels of impulsiveness can represent a factor of vulnerability to drug use and relapse.
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Conceição MIG, Cardona HH, Assis JT, Mohr RR, Sudbrack MFO, Strike C. Usuários de Crack que Buscam Tratamento em Brasília. PSICOLOGIA: TEORIA E PESQUISA 2016. [DOI: 10.1590/0102-3772e32ne216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivando identificar o perfil de pacientes ambulatoriais que procuram tratamento para problemas relacionados com crack em Brasília, 132 usuários que recebem serviços psicológicos preencheram o Questionário sobre o Perfil de Consumo de Crack e o Cocaine Craving Questionnaire-Brief. Os participantes eram homens (83,6%), solteiros (38,8%) e possuíam residência (100%). O primeiro uso foi motivado pela curiosidade (65,9%), influência dos pares (58,3%) e fácil acesso (50,8%). A maioria (65,2%) relatou poliuso. O mais longo período de abstinência foi de quatro anos (1,5%) e a maioria (46%) relatou menos de 30 dias. O poder letal, dependência e contextos de vulnerabilidade social associados ao crack foram questionados neste estudo. São necessários esforços para melhor atender aos que não acessam o sistema de tratamento.
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