Vulnerabilidades clínicas e sociais em usuários de crack de acordo com a situação de moradia: um estudo multicêntrico em seis capitais brasileiras Clinical and social vulnerabilities in crack users according to housing status: a multicenter study in six Brazilian state capitals Vulnerabilidades clínicas y sociales en consumidores de crack, de acuerdo con el acceso a la vivienda: un estudio multicéntrico en seis capitales brasileñas Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado.
This study aimed to investigate the association between exposure to different types of child maltreatment (CM) and the development of substance use disorders (SUDs) later in life. A systematic review was conducted: the PubMed, EMBASE and PsycINFO databases were searched for relevant papers and ten studies were identified for further analysis. Random effects meta‐analyses were performed for each type of maltreatment in order to estimate the odds ratio (OR) for SUD incidence, and meta‐regressions were performed to explore potential moderators. Individuals with a history of physical abuse during childhood had a 74 per cent increased risk for drug abuse later in life (OR = 1.74, 95% confidence interval (CI) = 1.362.18). The risk for drug abuse was also 73 per cent higher in individuals with a history of sexual abuse during childhood (OR = 1.73, 95% CI = 1.242.41). A meta‐regression found that gender has a moderating effect, with women at a greater risk of SUD incidence compared to men. Exposure to CM, such as physical and sexual abuse in childhood, increases the risk of further substance abuse. Understanding the interplay between the different factors associated with violence and abuse of psychoactive substances is of fundamental importance in designing prevention approaches and interventions for drug users. Key Practitioner Messages Child exposure to violence was associated with the development of substance use disorder. Exposure to violence affects men and women in a gender‐dependent manner, with females being at a higher risk. Understanding the interplay between the different factors associated with violence and drug abuse is of fundamental importance to design prevention approaches and interventions. Drug users have higher rates of child maltreatment and psychological suffering compared to the general population.
RESUMOAs ações intersetoriais visam romper com a fragmentação das políticas públicas, mas identifica-se que alguns equipamentos do SUS e SUAS situados no mesmo espaço geográfico podem ser ofertados isoladamente, dificultando a integralidade do atendimento. No caso do uso abusivo de substâncias psicoativas, a complexidade inerente ao tema prejudica o indivíduo em diversas áreas da vida, requerendo respostas integradas e abrangentes do poder público. Visando contribuir para minimizar entraves na execução da prática intersetorial entre a saúde e a assistência social, o objetivo deste estudo foi identificar representações sociais de gestores e profissionais sobre a intersetorialidade na área de drogas no município de Resende -RJ. Por meio de uma metodologia qualitativa, foram realizadas oito entrevistas com gestores e dois grupos focais com quatorze representantes das equipes técnicas do município. Como metodologia de análise, foram construídas categorias com auxílio do software NVIVO para posterior análise temática. Os resultados indicaram dificuldades no estabelecimento de protocolos e que muitos profissionais da rede desconhecem a função de cada política setorial. A intersetorialidade é vista como viabilizadora de direitos, mas os profissionais da Secretaria de Assistência Social sentem-se pouco valorizados pelo setor saúde, que desconhece a atuação da política assistencial. Destaca-se a importância de romper a fragmentação para ações conjuntas de cuidado aos usuários, já que os mesmos sujeitos transitam entre as áreas e qualquer entrave de acesso pode refletir negativamente no tratamento. Espera-se contribuir para melhorar os fluxos da rede de acolhimento em nível local, fortalecendo a reinserção social de usuários de álcool e outras drogas. PALAVRAS-CHAVE:Intersetorialidade. Drogas. Políticas públicas. Seguridade Social.
Objective: This study reviewed and analyzed the prevalence of suicidal behaviors among cocaine users who sought health services. Methods: This is a systematic review and meta-analysis of studies published until January 2021. PubMed/MEDLINE, Scopus, Embase, PsycINFO, and LILACS were searched. The inclusion criteria were observational (retrospective or prospective), case-control, and/or cross-sectional reports that contained samples of cocaine users aged over 14 years who were assessed in health facilities or were in treatment. The random-effects model was used to calculate the overall prevalence of suicidal behavior with a 95% confidence interval. Subgroup analysis was conducted to investigate sources of heterogeneity. Results: Twenty articles were included, yielding a total of 2,252 cocaine users. The estimated prevalence was 43.59% (95%CI 31.10-57.38) for suicidal ideation and 27.71% (95%CI 21.63-34.73) for suicide attempts. High heterogeneity was found between studies for both outcomes (I 2 ≥ 93%), although subgroup analysis considering the quality of the studies showed a significant difference in suicide attempts (p = 0.03). Conclusion: Cocaine use can be considered a risk factor for suicidal behavior, and prevention and early screening measures should be implemented to facilitate adequate treatment.
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