Objectives: demonstrate and discuss how the black population’s access to health services occurs Methods: integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles. Results: studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities. Final Considerations: several limiting factors compromise the black population’s access to health services, including institutional and structural factors

Objective: To analyze and characterize the use of night beds in a Psychosocial Attention Care Center for Alcohol and Drugs (Centro de Atenção Psicossocial Álcool e Drogas – CAPS ad). Method: It is a quantitative, documental, descriptive and retrospective study. Data were gathered from 565 medical records. An analysis of continuous variables was performed. Results: When admitted to the beds, most users (87.6%) consumed multiple substances daily and were vulnerable, specially in street situation (68.3%). These users were admitted on an average of two times, undergoing a previous evaluation by the nurse (85.8%), usually for detoxication or due to the vulnerable condition. They stayed in the center for an average of seven days and 31.1% did not finish what was proposed. For a few cases, hospital support was needed. Overall, discharges were planned, but the return happened without booking. Conclusion: Social issues cut through the use of night beds, however, it is a therapeutic resource that meets significant demands and is present in the daily lives of vulnerable users as a comprehensive care.

RESUMOObjetivo: avaliar se os usuários dos Centros de Atenção Psicossocial em Álcool e Outras Drogas percebem mudanças com o tratamento recebido e quais as variáveis associadas a tais mudanças. Método: estudo quantitativo, avaliativo, transversal, descritivo e exploratório com amostra de 263 usuários. Como instrumento de coleta de dados, utilizou-se um instrumento adaptado construído com base na Portaria n.° 336/2002 do Ministério da Saúde. As respostas foram registradas no software Microsoft Excel® 2010 e processadas com o programa SPSS, versão 20,0. Para verificar a associação entre as variáveis, elaboraram-se modelos de regressão linear univariada e múltipla pelo método de mínimos quadrados ordinários (OLS). Resultados: os usuários referiram boas mudanças em relação à confiança em si próprios, humor, problemas pessoais, interesse pela vida, capacidade de suportar situações difíceis e qualidade do sono. Pequenas mudanças foram percebidas na convivência com amigos, estabilidade emocional, convivência com a família e com outras pessoas. Conclusão: os usuários, no geral, perceberam mudanças com a assistência recebida nos Centros de Atenção Psicossocial em Álcool e Outras Drogas e os resultados permitem direcionar investimentos no projeto terapêutico das pessoas em tratamento. Descritores: Avaliação de Serviços de Saúde; Transtornos Relacionados ao Uso de Substâncias; Serviços de Saúde Mental; Resultados do Tratamento. ABSTRACT Objective: to evaluate if users of Psychosocial Care Centers in Alcohol and Other Drugs perceive changes with treatment received and what variables are associated with such changes. Method: quantitative, evaluative, transversal, descriptive and exploratory study, with a sample of 263 users. As an instrument of data collection, an adapted instrument was built based on Administrative Rule no. 336/2002 from the Ministry of Health. Responses were recorded in Microsoft Excel® 2010 software and processed with SPSS software, version 20.0. To verify the association between the variables, univariate and multiple linear regression models were elaborated using the least squares method (OLS). Results: users reported good changes in relation to self-confidence, humor, personal problems, interest in life, ability to endure difficult situations and quality of sleep. Little changes were noticed in the coexistence with friends, emotional stability, coexistence with the family and with other people. Conclusion: the users, in general, perceived changes with the assistance received in the Centers of Psychosocial Care in Alcohol and Other Drugs and the results allow directing investments in the therapeutic project of the people under treatment. Descriptors: Evaluation of Health Care; Disorders Related to Substance Abuse; Mental Health Services; Treatment Results.RESUMEN Objetivo: evaluar si los usuarios de los Centros de Atención Psicosocial en Alcohol y Otras Drogas perciben cambios con el tratamiento recibido y cuáles son las variables asociadas a tales cambios. Método: estudio cuantitativo, evaluativo, transversal, descriptivo y exploratorio, con muestra de 263 usuarios. Como instrumento de recolección de datos, se utilizó un instrumento adaptado construido basado en la Portaría n °. 336/2002 del Ministerio de Salud. Las respuestas se registraron en el software Microsoft Excel® 2010 y se procesaron con el programa SPSS, versión 20,0. Para verificar la asociación entre las variables, se elaboraron modelos de regresión lineal univariada y múltiple por el método de mínimos cuadrados ordinarios (OLS). Resultados: los usuarios mencionaron buenos cambios en relación a la confianza en sí mismo, humor, problemas personales, interés por la vida, capacidad para soportar situaciones difíciles y calidad del sueño. Pequeños cambios fueron percibidos en la convivencia con amigos, estabilidad emocional, convivencia con la familia y con otras personas. Conclusión: los usuarios, en general, percibieron cambios con la asistencia recibida en los Centros de Atención Psicosocial en Alcohol y Otras Drogas y los resultados permiten dirigir inversiones en el proyecto terapéutico de las personas en tratamiento. Descriptores: Evaluación de Servicios de Salud; Trastornos Relacionados con Sustancias; Servicios de Salud Mental; Resultados del Tratamiento.

Introduction: Approximately 5% of the global population used an illicit drug in 2013. Regarding licit drugs, alcohol is responsible for the occurrence of approximately 200 diseases, among them depression. In addition to health impairments, alcohol is also implicated in many acts of violence. This study aimed to measure the properties of the Rasch model of the Portuguese version of the Global Appraisal of Individual Needs-Short Screener based on evidence obtained during care for users of alcohol and other drugs. Method: To collect the data, 128 interviews were held at the Psychosocial Care Center for Alcohol and Other Drugs in the state capital, during which the scale was applied.Results: The Rasch model revealed that the subscales of the instrument were appropriate, with all items having mean infit and outfit values from 0.5 to 1.5, considered optimal for measurement. There was no evidence of differential performance for gender. Substance use and crime and violence items presented redundancy for severity measures. Conclusion: Given the need for validated instruments for use in Brazil, it is encouraging that the Portuguese version of the scale was valid for the Rasch model. The results are consistent with studies using the other American, Brazilian, and Canadian versions of the instrument.

Structured intervention programs are an important resource for supporting people with substance addiction. Although evidence suggests that they improve health outcomes, such as specific symptoms, less is known about their impact on patients’ ability to self-manage the consequences of substance addiction. The aim of this review is to scope outpatient intervention programs focused on the self-management of substance addiction consequences. Approach. This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. MEDLINE and CINAHL (through Ebsco), Psychology & Behavioral Sciences Collection (including PsycINFO) and Web of Science were screened to identify articles published in the last 10 years. Only primary research was included. Out of 891 records, 19 were eligible for this review—12 randomized controlled trials (RCT), 6 quasi-experimental study and 1 observational study. Those studies reported group interventions (10), individual interventions (8) and 1 mixed approach. The most common interventions were based on motivational strategies, relapse prevention and definition of active plans for risky situations. 10 studies reported positive effects. The identification of structured programs may support the development of new approaches focused on empowerment and quality of life of people with substance addiction. Programs to empower patients for self-management of substance addiction consequences are often complex and rely on health professionals’ commitment. Nevertheless, they are a feasible approach that seems to benefit patients managing chronic conditions associated with substance addiction.

RESUMO Objetivo Descrever a percepção de pessoas em situação de rua que permanecem na Avenida Paulista da cidade de São Paulo em relação ao acesso aos dispositivos de saúde da região. Método Pesquisa de abordagem qualitativa, realizada com 10 pessoas que se encontravam em situação de rua na Avenida Paulista em janeiro de 2019. Os dados foram coletados por meio de entrevista semiestruturada, e a análise dos achados se deu pela hermenêutica–dialética. Criaram-se duas categorias de resultados: Serviços de saúde acessados na região pela população em situação de rua; Barreiras de acesso à saúde pela PSR da Avenida Paulista de São Paulo. Este estudo obteve aprovação ética. Resultados A procura por serviços de emergência se dá como a principal porta de entrada para as pessoas em situação de rua da região, e entre as barreiras enfrentadas, o preconceito é colocado como o principal fenômeno. Conclusão É preciso considerar as especificidades dessa população, compreender suas concepções do processo de saúde-doença e suas trajetórias, para que, dessa forma, possa-se aprimorar os serviços e garantir o acesso à saúde deste grupo vulnerável e em crescimento.

Objective: To compare the consequences of psychoactive substance use among users of mental health services in Brazil and Portugal. Method: Cross-sectional, comparative, quantitative study, carried out with 362 users of two specialized treatment services in the cities of São Paulo (n = 200) and Lisbon (n = 162). Data collected in 2019 through the application of the Substance Addiction Consequences scale. A descriptive analysis and ordinary least squares and logistic regressions were performed. Results: All dimensions assessed by the scale were more severe for Brazilian users, with a difference for the physical domain and cognitive skills (p < 0.01). Brazilian participants were more likely to consume cocaine (p < 0.01) and have psychosis (p = 0.02) and Portuguese participants to have hepatitis (p < 0.01), personality disorders (p < 0.01), use benzodiazepines (p < 0.01) and tobacco (p < 0.01), and receive pharmacological support (p < 0.01). Conclusion: It was found that Brazilian users have more serious consequences related to substance use, and Portuguese users have more comorbidities and exposure to risky consumption. It emerges that Portuguese responses minimize the consequences severity.

Objetivos: avaliar a associação entre o uso de álcool e outras drogas, variáveis sóciodemográficas e aspectos psicossociais, com o comportamento sexual de risco dos usuários. Métodos: pesquisa quantitativa transversal, entrevistados 110 usuários de um Centro de Atenção Psicossocial em Álcool e outras Drogas (CAPSad) com o instrumento Avaliação Global das Necessidades Individuais. Utilizou-se a Escala de Risco Sexual, características sociodemográficas, dias de uso de drogas e demais subescalas do instrumento. Resultados: o comportamento sexual de risco foi significativo em usuários que estavam a mais dias em uso de crack, em situação de rua e mais graves em aspectos psicossociais. Conclusão: fatores do cotidiano dos usuários tem influências importantes sobre o comportamento sexual de risco e doenças sexualmente transmissíveis.