Substance use disorder is one of the most stigmatized health conditions. Stigma internalization is one of the main consequences of the stigmatization process, and it is associated with lower self-esteem and self-efficacy and worse recovery prospects. It may also bring guilt, hopelessness, anxiety, self-devaluation, and depression. This study investigated self-stigma among substance dependents who sought treatment, testing the construction of a psychosocial model for understanding this phenomenon. Individual interviews were conducted at the Psychosocial Care Center for Alcohol and Drugs at Juiz de Fora, Brazil. Data were subjected to exploratory statistical analysis, using descriptive and standard deviation. Three explanatory models of self-stigma were tested: the sociodemographic model, including variables such as gender, religious practice, education, marital status, employment status, and involvement in illicit activities; the psychological model, with variables related to symptoms of depression, self-esteem, and hope; and the psychosocial model, which included all sociodemographic and psychological variables. The sample was composed by 461 individuals. The results supported the hypothesis that the psychosocial model would have greater explanatory power of self-stigma among substance dependents. An association between self-stigma and the sociodemographic variables and the type of substance used was confirmed. Depressive symptoms contributed to higher scores on self-stigma. Stigma may be a barrier to access to health care, treatment, social research, social inclusion, and recovery opportunities. Interventions and treatment models that are able to reduce self-stigma would have the potential to contribute toward a reduction in the negative impacts associated with substance use disorder.
O estudo visa analisar os conteúdos divulgados pelas principais revistas de circulação na mídia digital brasileira acerca do consumo de crack. Pesquisa documental, exploratório-descritiva, com abordagem qualitativa das três revistas semanais com maior circulação no país. O acesso foi através dos sites das revistas, as palavras-chave: "crack", "óxi" e "merla" foram utilizadas e apenas a categoria de notícias foi incluída. As 661 notícias encontradas foram analisadas em relação a duplicação, quando "crack" não foi utilizado como droga e quando não era o tema central na notícia. Restando assim, 559 notícias. A análise de conteúdo temática identificou os principais temas presentes. A maior parte das notícias é permeada pela criminalização e moralização dos usuários de crack, relacionando-se principalmente ao tratamento, bem como o tráfico, com reportagens de ações policiais e ao enfrentamento do fenômeno, através de iniciativas de combate. Compreende-se a mídia enquanto formadora de opinião, mas também como produto sócio-histórico que reflete posições e visões de mundo. Observa-se a necessidade de modificação da abordagem ao fenômeno do crack pelos meios de comunicação analisados, na tentativa de estimular um debate ampliado e realista sobre a temática, em detrimento dos correntes discursos maniqueístas, estigmatizantes e de sobreposição de racionalidades.
This article aimed to understand, from the framework of community psychology, the care network for drug users from professionals’ experiences, and implications of a community level work. Six semi-structured focus groups were conducted with 42 professionals from care networks of four Brazilian cities in the state of Minas Gerais. Data was analyzed through thematic content analysis. Results indicate the need of enhancing network’s operational structure and, mainly, consolidating a comprehensive and continuous care model. Professionals’ critical views of the care network lift a series of contributions to improve it, with the necessity of embracing a community level work and a resources-focus approach to drug abuse. Related to this, there is the necessity to focus care on community and its needs, by understanding it as the main element of care networks for drug users.
Viabilidade da terapia de aceitação e compromisso para dependentes de drogas Feasibility of acceptance and commitment therapy for drug addicts
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