[pt] Este estudo investiga o tema das drogadicções a partir de um referencial psicanalítico. A droga é vista como um meio de intensa satisfação pulsional, que pode levar, pela drogadicção, a um certo isolamento e alheamento das determinações subjetivas. O autor parte de algumas proposições freudianas sobre a droga e as drogadicções para investigar as operações de constituição do sujeito em Lacan. Verifica, a partir daí, a importância da relação com a alteridade no processo contínuo de sustentação da atividade representativa inconsciente. Para o tratamento, propõe que o analista forneça uma atenção especial aos atos - passagem ao ato e acting-out - que surgem desde as entrevistas preliminares. Indica a presença, nestes casos, de uma operação de exclusão da atividade representativa, que poderá ser inicialmente retomada pela via dos atos que, por sua vez, podem servir para resgatar a função do sujeito do inconsciente. Inclui um caso clínico, onde se fez uso das concepções teóricas desenvolvidas. / [en] This study investigates the theme of drug addiction from a psychoanalytic referential. The drug is seen as a way of intense drive satisfaction, which may lead, through drug addiction, to a certain alienation and isolation from subjective determinations. Starting with some Freudian principles about the drug and the drug addictions, the author sets out to investigate the operations of subject constitution in Lacan. It is therefore ascertained the importance of the relation with the Other in the continuous process of sustaining the representative activity of the unconscious. For the treatment, it is proposed that the analyst pays particular attention to the acts - passage à l acte and acting-out - which become evident from the preliminary interviews. It is indicated the existence of an operation of exclusion of the representative activity. This representative activity may be initially resumed via the acts, which, in turn, may serve to recapture the function of the unconscious subject. A clinical case is included, in which the use of theoretical concepts developed is made.

Made available in DSpace on 2016-03-22T17:26:37Z (GMT). No. of bitstreams: 1 lucimar.pdf: 769485 bytes, checksum: 1a4fa809a383d1d13bc1023dcc908204 (MD5) Previous issue date: 2011-10-14 / This work tries to contribute with necessary knowledges to the area of the Social Policies debating drugs policy and, mainly, opening space to argue the drug questions in the media, specially for the analysis of anti-drug advertising conducted by the RBS TV Campaign entitled "Crack nem pensar". The research is based on the critical cultural studies, bringing to the discussion the production of the media, searching to verify with school teenagers, as they mediate the reception of these advertisements, understanding themselves as critical subjects. To emphasize the idea of bringing the drug questions and the media is important, because it is an important vehicle for disseminating informations, which should contribute to the prevention and also to the discussion of these issue to formulate policies aimed to our reality, because the brazilian anti-drug policy is important from other countries. The research seeks to base the study object, aim of this work; the drug quests and policies toward the subject, bringing to the discussion the prevention, the form idealized by the Campaign "Crack nem pensar". In this way, the relevance of this work is in the discussion that interlace from the approach taken by the campaign, allying itself with the discussion of the brazilian anti-drug policy. Policies aimed at young people are mostly compensatory in order to mitigate an existent problem and it isn't going deep into the root of the problem. The most important authors referred in the media analysis, on the studies of production and reception and still in the understanding of it role in the modern world are Jonh Thompson (1995), Douglas Kellner (2001), Néstor Garcia Canclini (1995), Jesús Martin-Barbero (1997), Stuart Hall (2002) among others. These authors are of fundamental importance to understanding the hegemonic role of the media nowadays, but also to do a counter-hegemonic reading as far as possible in order to think the receiver not only as passive subject, but as that subject which interacts with the messages of the media and does its reading according to their own culture and experiences. Key-words: Media; Ideology; Addiction; Social Policy; Reception / Este trabalho procura contribuir com conhecimentos necessários à área das Políticas Sociais, debatendo a política de drogas e, principalmente, abrindo espaço para discutir a questão das drogas na mídia, especialmente pela análise da propaganda antidrogas feita pela RBS TV através da Campanha intitulada Crack nem pensar . A investigação toma por base os estudos culturais críticos, trazendo ao debate a produção da mídia, buscando verificar com adolescentes escolares, como eles mediam a recepção destas propagandas, entendendo-os como sujeitos críticos. Importa ressaltar a idéia de trazer para o debate a questão das drogas e a mídia, por esta ser um veículo importante de difusão de informações, o que deveria contribuir para a prevenção e também à discussão do assunto para se formularem políticas voltadas à nossa realidade, pois a política antidrogas brasileira é importada de outros países. A pesquisa busca fundamentar o objeto de estudo, alvo deste trabalho; a questão das drogas e as políticas voltadas para o assunto, trazendo ao debate a prevenção, a forma idealizada pela campanha Crack nem pensar . Desta forma, a relevância deste trabalho está no debate que se trava a partir do enfoque dado pela campanha, aliando-se a discussão da política antidrogas brasileira. As Políticas voltadas para os jovens são, na maioria, políticas compensatórias visando amenizar um problema já existente, não indo a fundo na raiz do problema. Os autores mais importantes usados para fundamentar este trabalho na análise da mídia, nos estudos de produção e recepção e ainda no entendimento do papel dela no mundo moderno são John Thompson (1995), Douglas Kellner (2001), Néstor Garcia Canclini (1995) Jesús Martin-Barbero (1997), Stuart Hall (2002), entre outros. Mencionados autores são de fundamental importância para se entender hoje o papel hegemônico dos meios de comunicação, mas também para se fazer uma leitura contra-hegemônica na medida do possível a fim de pensar o receptor não apenas como sujeito passivo, mas como aquele sujeito que interage com as mensagens da mídia e faz a sua leitura de acordo com a cultura própria e vivências

O consumo de drogas e álcool constitui cada vez mais um problema social e de saúde pública, pelas consequências negativas que provocam no desenvolvimento emocional e físico dos indivíduos. Existem poucas referências na literatura avaliando o uso destas substâncias por portadores de doença falciforme (DF). Estes pacientes apresentam crises álgicas severas, recorrentes, frequentemente controladas por opióides. O comprometimento da qualidade de vida predispõe a ocorrência de transtornos psiquiátricos não-psicóticos, como depressão por exemplo, tornando o grupo vulnerável ao uso abusivo de substâncias. Objetivos: avaliar o consumo de álcool e drogas em pacientes portadores de DF acompanhados pelo Centro de Referência de Doença Falciforme (CRAF) do Hospital de Clínicas de Porto Alegre (HCPA), estimar o percentual de pacientes em tratamento da doença falciforme que fazem uso abusivo de álcool e drogas, e colaborar com o estudo que avaliará a efetividade de um centro de referência multidisciplinar para esta população. Métodos: estudo transversal, de uma amostra de conveniência, com 139 pacientes portadores de DF acompanhados no CRAF do HCPA. Resultados: a prevalência do uso abusivo foi de 1,5% para o álcool e 3,0% para o tabaco, e não se identificou o uso abusivo de outras substâncias, inclusive opióides. O padrão para o uso de substâncias não foi influenciado pela exposição ou por transtornos psiquiátricos não-psicóticos. Conclusão: São necessários mais estudos para reforçar estes achados, mas demonstra-se a segurança do uso de analgésicos opióides para o manejo das crises dolorosas apresentadas pelos portadores de DF. / Drug abuse is increasingly becoming a social and public health problem, because of the negative consequences that such abuse causes on the emotional and physical development of individuals. There are few references in the literature evaluating the use of these substances by individuals with sickle cell disease (SCD). These patients have severe and recurrent pain crises, frequently needing opioids drugs to control it. The compromised quality of life can predispose this population to the occurrence of non-psychotic psychiatric disorders such as depression, making them vulnerable to substance abuse. Objectives: To evaluate the level of consumption of alcohol and drugs in patients with SCD followed by Sickle Cell Disease Reference Center (CRAF) at Hospital de Clínicas de Porto Alegre; to estimate the percentage of patients in treatment of SCD who abuse alcohol and drugs, and to collaborate with the study evaluating the effectiveness of the CRAF. Methods: cross-sectional study of a convenience sample of 139 patients with SCD treated at CRAF. Results: the prevalence of abusive use of the studied population was 1.5% for alcohol and 3.0% for tobacco, and no abusive use of any other substance, including opioids, was identified. It was verified that the pattern for substance use was not influenced by exposure to substances or the presence of non-psychotic psychiatric disorders. Conclusion: More studies are needed to reinforce these findings, but they suggested that the use of opioid analgesics for the management of SCD painful crises is safe and do not induces substance abuse.

Background: Opioid dependence is a chronic disease. Substitution treatment for opioid addiction involves a lot of rules and control that can lead to stigmatization. Purpose: To describe the experience of control and stigma in people with substitution treatment during opioid dependence. Method: A literature review with qualitative content analysis inspired by Graneheim & Lundman (2004). The study is based on 14 scientific articles that were applied mainly through the databases Cinahl and Pubmed. Result: Two main themes with eight sub-themes emerged. The most prominent in the result was that people with substitution treatment feel stamped as a drug addict. They can also feel suspicious and less credible. Having substitution treatment is associated with shame. One does not always dare to tell the surroundings that one has treatment. Within the framework of treatment, they feel controlled and supervised. Conclusion: People with substitution treatment experience stigma in terms of discrimination, preconceived opinions and reduced credibility. Stigma arises in several different contexts, such as work, friends and family, but also in health care and even in substitution treatment. This is because this form of treatment includes a number of rules and controls that make you feel controlled and supervised. This risks contributing to further stigmatization.

Syftet med denna studie var att undersöka hur man inom socialtjänst och psykiatri i en kommun i mellansverige arbetar med samsjuklighet avseende missbruk och psykisk ohälsa, samt vilka utmaningar de yrkesverksamma möter i arbetet. För att uppnå syftet har en kvalitativ metod använts där datainsamling utgjorts av semistrukturerade intervjuer med tre yrkesverksamma personer från respektive verksamhet. Kvalitativ innehållsanalys har därefter använts för att kunna strukturera och tolka det insamlade materialet. Resultatet visade att det finns en tydlig uppdelning mellan de båda verksamheterna avseende arbetsuppgifter och ansvar. Psykiatrin arbetar med psykologisk behandling medan socialtjänstens arbete är inriktad på missbruksproblematik. Således kräver arbetet med samsjuklighet att de båda verksamheterna samverkar med varandra. Resultatet visade också att samverkan inte fungerar bra. Den största utmaningen är, enligt intervjupersonerna, att socialtjänsten får bära det största ansvaret för att kunna skapa en välfungerande samverkan. För att ytterligare förstå resultatet har systemteori tillämpats i analysavsnittet. Det systemteoretiska greppet om studien visar att socialtjänsten och psykiatrin kan förstås som delsystem av det mer övergripande välfärdssystemet. Den icke-fungerande samverkan gör att syftet med välfärdssystemet inte uppnås, eftersom de hjälpsökande människorna inte får tillgång till relevanta insatser. / The aim of this study was to survey the work with comorbidity (mental illness and drug addiction), and to reach the purpose of this study a qualitative method was used. Semi-structured interviews were conducted with professionals from the social service and the psychiatric care, six in total, three from each organization. These interviews formed the basis of this study. A content analysis was applied to analyse the gathered empirical data. The result showed that there is a distinct division between the two organizations regarding duties and responsibility concerning people with comorbidity. The psychiatric care works with psychological treatment for their patients while the social service’s mission is to treat their clients’ drug addiction. According to these facts the result indicated that these two parties have to collaborate to be able to work with comorbidity. It also showed that collaboration between these two is not well-functioning. According to the study’s informants, the largest responsibility in order to accomplish a well-functioning collaboration concerning people with comorbidity lies with the social service. The result has been analysed with systems theory in order to obtain a more profound understanding. This analysis implied that the social service and the psychiatric care are two subsystems in a lager context, the welfare system. When the collaboration is not well-functioning the mission of the welfare system does not get fulfilled, because the people with comorbidity do not receive appropriate interventions.

<p>The endogenous opioid enkephalin neuropeptides are mediators of pain perception and have been implicated in human addictions. The preproenkephalin gene and its mRNA have also provided many examples of tissue- and species-specific variations in mRNA structure produced through a variety of transcriptional and post-transcriptional mechanisms. Resultant differences in mRNA structure, in several cases, have impact on translation of enkephalin prepropeptide. The reports and discussion presented herein describe studies of the preproenkephalin gene and mRNA structure in the guinea pig, an animal that may have specific advantages for modeling the human endogenous opioid system. A guinea pig brain cDNA library was constructed and screened for clones of preproenkephalin and preprodynorphin, which were then sequenced. These studies confirmed the predicted mRNA structure that had been previously proposed based on homology with gene sequences and other methods. Multiple transcription initiation sites for each of these prepropeptide genes were also identified. Studies were conducted in the guinea pig to evaluate the effects of the administration of cocaine in a “binge” paradigm for two and seven days on preproenkephalin mRNA levels in several brain regions. “Binge” cocaine administration for seven (but not two) days resulted in differential changes in mRNA levels in different brain regions. Decreases were observed in the nucleus accumbens and hypothalamus, and increases in the frontal cortex, amygdala and hippocampus. These findings differ from those of previous rodent studies and suggest that this species may provide a useful alternative model for the study of the effects of cocaine on preproenkephalin gene expression in the human brain. Human genetic studies were also conducted in opioid-dependent (formerly heroin-addicted) and control subjects to test the hypothesis that the preproenkephalin gene is associated with heroin addiction. In two separate studies, we obtained evidence that this gene may be associated with the development of human heroin addiction.</p>

The endogenous opioid enkephalin neuropeptides are mediators of pain perception and have been implicated in human addictions. The preproenkephalin gene and its mRNA have also provided many examples of tissue- and species-specific variations in mRNA structure produced through a variety of transcriptional and post-transcriptional mechanisms. Resultant differences in mRNA structure, in several cases, have impact on translation of enkephalin prepropeptide. The reports and discussion presented herein describe studies of the preproenkephalin gene and mRNA structure in the guinea pig, an animal that may have specific advantages for modeling the human endogenous opioid system. A guinea pig brain cDNA library was constructed and screened for clones of preproenkephalin and preprodynorphin, which were then sequenced. These studies confirmed the predicted mRNA structure that had been previously proposed based on homology with gene sequences and other methods. Multiple transcription initiation sites for each of these prepropeptide genes were also identified. Studies were conducted in the guinea pig to evaluate the effects of the administration of cocaine in a “binge” paradigm for two and seven days on preproenkephalin mRNA levels in several brain regions. “Binge” cocaine administration for seven (but not two) days resulted in differential changes in mRNA levels in different brain regions. Decreases were observed in the nucleus accumbens and hypothalamus, and increases in the frontal cortex, amygdala and hippocampus. These findings differ from those of previous rodent studies and suggest that this species may provide a useful alternative model for the study of the effects of cocaine on preproenkephalin gene expression in the human brain. Human genetic studies were also conducted in opioid-dependent (formerly heroin-addicted) and control subjects to test the hypothesis that the preproenkephalin gene is associated with heroin addiction. In two separate studies, we obtained evidence that this gene may be associated with the development of human heroin addiction.

About 35 years ago the WHO advocated that countries with injecting drug users should introduce the so-called needle exchange programs (NEP) to curb the spread of infection by blood-borne diseases. In Sweden the first NEP started 1985 in Lund, but the program was extremely controversial in a country with such a restrictive drug policy like Sweden. The study you are about to read shall process this controversy, when a NEP opened in Stockholm, by analyzing the articles published in the newspapers Dagens Nyheter and Svenska Dagbladet. By using discourse analysis as a processing tool we’ll try to see the difference between the two chosen newspapers. We will identify and analyze the different participant’s, such as doctors, politicians, user associations and media, arguments in the needle exchange issue.   Our results show that the liberal DN articles were supportive of the NEP and that they considered it to be an infectious disease control issue. The liberal conservative newspaper SvD had a different view of the issue and considered NEP to be a question about drug policy. Even after the decision was made the city had problems to find suitable premises for the NEP to operate from.

No description available.

Thesis (MA(Clinical Psychology))--University of Pretoria, 2004. / Includes bibliographical references.