No abstract

Objetivo. Describir el perfil de usuarios, pacientes atendidos y tratamientos brindados en el Centro Takiwasi por medio del sistema de información PPLUS, entre los años 2013-2018. Materiales y métodos. Estudio descriptivo. De acuerdo con los objetivos bajo los cuales el sistema PPLUS ha sido concebido, se recolectó información sobre la cantidad de registros, número de usuarios del sistema, áreas involucradas, modalidad de egreso de la comunidad terapéutica, prácticas de medicina tradicional amazónica, uso de los módulos del sistema, y perfiles de usuarios por fines de investigación. Resultados. Se encontró una tendencia irregular de registros de información, siendo registrado el pico máximo en el año 2016. Ciento ochenta y ocho pacientes egresaron de la comunidad terapéutica, de los cuales el 45,2% (85) recibió alta médica. Entre el 54,8% de los pacientes de Takiwasi que no terminaron el tratamiento, un 33,5% no lo hicieron por solicitar retiro voluntario, en su mayoría durante el primer mes de tratamiento. Se registraron 19 620 prácticas de medicina tradicional amazónica, de las cuales las sesiones de ayahuasca representaron el 36,1% y las sesiones de purga, el 39,1%. Se observó que el 46,5% de perfiles de investigación correspondieron a practicantes de psicología, mientras que el 29,8% (34) fueron investigadores externos. Conclusiones. La implementación y uso del sistema PPLUS en el Centro Takiwasi, durante los años 2013 a 2018, ha sido gradual, pero no lineal; sin embargo, la información obtenida y la capacitación del personal en su uso hacen que se convierta en una herramienta tecnológica con potencial para la investigación y desarrollo a corto plazo.

Purpose Substance abuse is a major public health concern, with over millions of people suffering from it worldwide. Although there is an abundance of treatment options, many of these rehabilitative trajectories are subject to “drop-out”. In addition, “drop-out” is a significant risk factor for relapse. There is an urgent demand for effective treatment, which would enable patients to reduce abuse and prevent relapse. Takiwasi is an addiction treatment centre that combines traditional Amazonian plant medicine with conventional western medicine and psychotherapy. The purpose of this paper is to explore whether socio-demographics factors, such as education level and occupation, psychiatric comorbidities and primary drug use, are associated with treatment non-completion of Ayahuasca (AYA)-assisted addiction therapy. Design/methodology/approach Data on the first treatment episode of 121 patients were collected from the patient database from the years 2012 to 2017. To determine whether there is an association between the variables of interest and treatment non-completion, a χ2 analysis and a logistic regression analysis were performed. Findings Of the 121 patients analysed, 48.2 per cent completed their treatment, whilst 51.8 per cent did not. Students compared to those who are employed showed significantly higher odds for treatment non-completion (p=0.006; OR=3.7; 95% CI=1.5–9.6). Other variables in the multivariable analysis showed no significant relationship with treatment non-completion. While several limitations restricted the study, the findings suggest that the AYA-assisted treatment in Takiwasi may benefit from additional support for patients who are students. Moreover, it is advised to conduct more long-term follow-up of patients in order to gain better insight into the outcome of treatment at an AYA-assisted treatment centre. Originality/value It appears that AYA-assisted therapy in a therapeutic community is a feasible type of treatment for addiction, for which further studies should elucidate the role of motivation in relation to socio-demographic factors and type of addiction in the risk of treatment non-completion.

<i>Aristolochia didyma</i> (Yawar Panga) and other <i>Aristolochia</i> species are used as traditional herbal remedies with potent emetic properties. Scientific data for such Yawar Panga species, however, are scarce in the literature. The aim of this study was to describe the use of Yawar Panga within the context of the therapeutic community Takiwasi, in which the plant is used as part of the protocol for the rehabilitation of individuals with drug addiction. Fieldwork with experts in the administration of Yawar Panga at Takiwasi Center, as well as a retrospective qualitative analysis of experiences with this plant remedy in a residential inpatient population were performed. <i>In-silico</i> analysis of the main constituents of <i>A. didyma</i> as represented in the literature was completed in order to identify its putative pharmacological targets. The therapists interviewed consider Yawar Panga to be the most potent purga at Takiwasi and consider it especially useful in attenuating addiction withdrawal syndrome. From the patient’s perspective, this plant induces strong physical effects, and commonly precipitates effects in the oneiric and emotional dimensions. GABA B seems to be the receptor involved in the emesis induced by the phytochemicals contained in this plant species. Despite some relevant concerns related to the safety of the genus <i>Aristolochia</i> in modern western pharmacopoeias, some species, including <i>A. didyma</i>, are routinely used in the context of traditional herbal medicine in the Peruvian Amazon. Further phyto-pharmacological investigations would be helpful to elaborate this species’ medical utility, especially within the context of addiction treatment.