O presente estudo faz uma análise sobre os discursos veiculados pela mídia impressa em torno do consumo de substâncias psicoativas no âmbito das tendências culturais instituídas na modernidade e na sociedade brasileira. Reúne 110 reportagens que tratam sobre diferentes produtos e medicamentos, personalidades e questões éticas, para desenvolver uma leitura focalizada à luz das ciências da linguagem, principalmente da teoria psicanalítica. O trabalho é apresentado em três partes que organizam o corpo teórico e sustentam a hipótese da investigação. A primeira parte discorre sobre a farmacotimia social, conceito que aglutina a dissertação, verificando os lugares em que se encontra o consumo de substâncias na cultura. Introduz o discurso medicinal como parâmetro disciplinar e consensual em relação à vida saudável e às virtudes morais. Essa parte também desenvolve uma reflexão sobre o estigma da droga, onde consumo e dependência aparecem enlaçados à disposição medicatriz. Na segunda parte, a dissertação situa a questão da temporalidade no universo do consumo e das culturas do corpo e da juventude emergentes nos últimos séculos. Comenta a dimensão do tempo dentro de uma lógica que aproxima o sujeito de que se trata a uma elasticidade do presente. Com isso introduz a noção da atemporalidade no inconsciente para justificar a peculiar disposição farmacotímica e efeitos significantes. A terceira e última parte consiste na leitura sobre a sistematização dos enunciados extraídos das reportagens, que constitui o corpus da pesquisa, e sua implicação quanto aos conteúdos teóricos desenvolvidos nas primeiras partes. A análise se sustenta nas marcas significantes e seus efeitos agrupados em tópicos de investigação, e circunscreve o sujeito farmacotímico como sintoma de mecanismos sociais, hipótese do estudo. / The present study makes an analysis about the information conveyed by the press concerning to the consumption of psychoactive substances in an environment of culturally established tendencies in Brazilian society. It aggregates 110 reports that discuss about different products and medicines, individual e ethical matters, to develop a focalized reading in the light of language sciences, especially psychoanalytic theory. The piece of work is shown in three parts, which organize theoretical points and give support to the hypothesis of the investigation. The first part discusses the social pharmacothymie, concept that concerns the dissertation, exploring locations where one can find a cultural consumption of substances. This introduces medical language as consensus and disciplinary paradigm in reference to healthy life and moral virtues. This part develops a reflection on the drug stigma, where consumption and dependence are related to a disposition to take medicine. In the second part, the dissertation states the matter of temporality in the universe of consumption and of youth and body cultures emerging in the last centuries. It comments on the time dimension inside a logical frame that brings the subject concerned to a present elasticity. From this point, the timeless notion in the unconscious justifies peculiar pharmacotymic disposition and significant effects. The third and last part consists in the reading over the excerpts from the reports, systematized in the corpus of the research, and their implications regarding the theoretical contents previously developed. The analysis focuses on the significant remarks and effects united in topics of investigation, circumscribing a pharmacotymic subject as the symptom of social mechanisms, the hypothesis of the study.

This thesis, New Psychoactive Substances in British Drug Policy Discourse addresses new psychoactive substances (NPS) in drug policy discourse in Great Britain between 2000-2014. It focuses on the identification of individual frames and aims to understand the different perspectives NPS can be framed in The theoretical framework of this thesis is based on the idea of social constructivism and Frame Theory. On this basis, the thesis identifies individual sponsors, the general characteristics of the problem, the injured party, the public policy implications and the value base. It identifies four frames which are present in the discourse. The first, called Fragmented, does not perceive NPS as a comprehensive problem, but as individually occurring substances. The second frame the Prohibitionist wishes to tackle the issue of NPS using new tools of prohibition. The third one, the Regulatory frame is strongly polarized towards the previous frame and wants to solve the NPS issue by creating a legally regulated market for psychoactive substances. The last, Wicked frame, perceives NPS as an unstructured problem, therefore it cannot be solved by one measure. This frame favors an expert debate and evidence in order to find the optimal solution. The thesis puts the issue into context and focuses on NPS...

DUBOVÁ, T. Rehabilitation of family drug addicted parents. Key words: Abstinence - oriented treatment, Dependance syndrome, Dysfunctional family, Rehabilitation of family, Resocialization, Withdrawal syndrome This thesis addresses the issue of drug addiction and parenting. It focuses on society's view on drug addicted parents and briefly defines the concept of addiction. The core work is the rehabilitation of these families and its various forms. It describes the role of professional institutions that deal with protecting the interests of the child and work with drug addicted parents and contributes to the rehabilitation of the family. The work also includes specific aspects of women's drug addiction and the consequences of substance use during pregnancy on the child. At the end of the theoretical chapter is devoted to professional institutions and their programs to work with the family. The practical part of this thesis includes three case studies that describe families of drug addicted parents and the way their efforts to restore or maintain the family.

THE ABSTRACT It has been shown recently that workload, stress, and burnout syndrome among the staff of the medical rescue service may be major risk factors in terms of triggering the use of psychoactive substances. Representing what is understandably a delicate issue, substance use among emergency medical staff has not been thoroughly studied in our country. Emergency medical workers' difficult working conditions and the chronic stress they are exposed to, in combination with a lack of support and care on the part of their employers, result in exhaustion and general distress, accompanied by the development of symptoms associated with both physical and mental disorders. This condition may lead to the use of psychoactive substances as a negative coping strategy. Consisting of both theoretical background and case studies, the paper points out the relationship between the chronic effect of stressors pertaining to the job of emergency medical workers and the use of psychoactive substances as a way of coping with and compensating for the implications of work-related stress and fatigue. Thorough case studies are presented to demonstrate the onset and development of addictive behaviour within a wider context, with special emphasis being placed on its association with coping with both acute and chronic occupational...

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En raison de leur diffusion sauvage sur le e-commerce, leur soi-disant sécurité d’usage et l’alternative légale aux stupéfiants habituels qu’ils constituent, les nouvelles substances psychoactives (NPS) sont un phénomène mondial émergeant. Au-delà de différents défis dans nos sociétés (législation, prévention,... ), la capacité d'identifier les NPS dans des échantillons biologiques présente de nombreux challenges analytiques : ces nouvelles substances ne sont pas référencées dans les bibliothèques habituelles de spectrométrie de masse commerciales, leur métabolisme est inconnu (avec parfois des métabolites actifs), les doses actives sont parfois très faibles et par conséquent, les concentrations dans le sang ou l'urine sont également faibles. Dans ce contexte, notre laboratoire effectue régulièrement des analyses toxicologiques dans un contexte clinique, et pour les forces de l’ordre, dans des échantillons biologiques à l'aide de deux principaux types d’analyseurs : la chromatographie liquide couplée à la spectrométrie de masse tandem (CL-SM/SM) pour le criblage ciblé et la chromatographie liquide couplée à la spectrométrie de masse haute résolution (CL-SMHR) pour le criblage non ciblé. Cette dernière technique est basée sur la masse exacte (mais également, le profil isotopique et le temps de rétention) des composés de l’échantillon à partir de laquelle la formule chimique est déterminée et recherchée dans une base de données spectrales en utilisant un logiciel dédié. L’objectif de ma thèse est de caractériser des NPS et leurs métabolites (afin d’alimenter cette base de données) en utilisant une stratégie combinant des approches in vitro, in silico et in vivo. Il s’agit, en particulier, d’augmenter la sensibilité de détection de la prise de NPS en se focalisant sur les métabolites qui sont le plus souvent les produits majeurs d’élimination des NPS.A cet effet, une méthode in vitro destinée à produire les métabolites des NPS et utilisant des microsomes hépatiques humains a été mise en oeuvre. Les métabolites obtenus, comparés aux prédictions in silico, ont été enregistrés dans la base de données. Cette approche a été confrontée à l’analyses de comprimés et d’autres produits non biologiques contenant des NPS, mais également, à des données in vivo d’exposition aux NPS : cas d’intoxications, études expérimentales et études épidémiologiques prospectives et rétrospectives dans des populations ciblées, ou non…Au total, ce travail basé sur cette stratégie in vitro, in silico, in vivo m’a permis d’enrichir notre base de données de spectres de masse haute résolution (SMHR) pour le criblage non ciblé et également notre base de données de criblage ciblé (SM/SM). Notre méthode en haute résolution, qui s’est enrichie au cours de ces 3 années de thèse de 83 nouveaux NPS et 281 métabolites, constitue aujourd’hui un outil analytique efficient pour la détection d’une exposition aux NPS. / Owing to wild e-commerce diffusion, alleging safety and legal alternative to usual drugs of abuse arguments, the new psychoactive substances (NPS) are emerging phenomenon in the world. In our societies, through various consecutive challenges (legislation, prevention, …), the ability to identify NPS in biological samples exhibits numerous analytical pitfalls: new substances which are not referenced in the usual commercial mass spectrometric libraries, unknown metabolism (with sometimes active metabolites), sometimes very low active dosages and consecutively low concentrations in blood or urine. In this context, clinical and forensic toxicological analyses in biological samples are routinely performed in our laboratory using two main analytical devices: liquid chromatography-tandem mass spectrometry (LC-MS/MS) for targeted screening and liquid chromatography-high resolution mass spectrometry (LC-HRMS) for non-targeted screening. This last technique is based on the accurate mass (together with isotopic pattern and retention time) of sample components, from which the chemical formula is calculated and searched against a database of mass spectra using dedicated software. The aim of my thesis is to characterize NPS and metabolites (in order to increase the spectral database) using a strategy combining in vitro, in silico, and in vivo approaches. Therefore, the main goal is to increase the detection sensitivity of the NPS use by focusing on the metabolites that are most often the major products of NPS elimination. For this purpose, an in vitro method designed to produce NPS metabolites using human liver microsomes incubations was applied. Obtained metabolites, after confrontation with metabolites in silico predicted, were saved in database. This approach was subsequently confronted with analysis of tablets or other non-biological product containing NPS, but also, with in vivo observed data from NPS exposure: intoxication cases, experimental studies and prospective and retrospective epidemiological studies in targeted population or not … All in all, this work based on this in vitro, in silico and in vivo strategy allowed me to enhance our high resolution spectra database (HRMS) for non-targeted screening and also our spectra database for targeted screening (MS/MS). Today, our HRMS device, with a database that was increased with 83 new NPS and 281 metabolites for the duration of my thesis, is an efficient analytical tool for NPS use detection.

Made available in DSpace on 2016-01-26T12:51:40Z (GMT). No. of bitstreams: 1 janelisebpazianicosta_dissert.pdf: 2457459 bytes, checksum: 519e9ac156cca4f5016a58719a8b2cb1 (MD5) Previous issue date: 2012-06-15 / Introduction: The use/consumption of psychoactive substances is considered a complex phenomenon, which has biological, psychological and social origins and consequences. Objectives: Describing, analyzing and comparing socio-demographic, psychological and clinical characteristics presented by a population having a Substance Use Disorder. Casuistic and Method: A convenience sample comprising 50 adult male patients who took part in the present study were seen in a Psychosocial Attention Center Alcohol and Drugs (CAPSad) based in a medium-sized city located in São Paulo State countryside. An Identification Form containing personal and socio-demographic features, as well as a Semi-directed Interview Script, were used for people with alcohol and/or drug-related problems. Data were analyzed by means of non-parametric statistic evidences and qualitative analysis of frequency and percentage of answer category having the same semantic meaning. Results: The study group mostly comprised an adult (28-37 and 48-58 years old), negroid (62%), not engaged (72%), evangelic (44%), unemployed (59,18%) population born in areas around the target city (44,68%), with 5 to 8 years of study (42%) and a monthly family income of 3-5 minimum salaries (47,73%). 68% of these patients had been under treatment for at most a month, especially the youngest interviewed ones (18-37 years old). There has been balance between the participants directed to CAPSad and the ones who have searched for help on their own. Some of the main reasons for this search were: willingness to quit consuming, psychological and emotional problems, as well as chemical addiction. 43,18% of the patient sample were abused (esp. physically) in childhood and/or adolescence, and 74% reported having family problems involving alcohol and/or others drugs. Psychoactive substances use was a contributing factor to damages in the quality of relationship with family of origin, spouse and children. Participants reported significant changes and social repertoire and part of leisure activities was associated to the very use of substances or related activities. 76,60% declared having friends who made use of alcohol and/or other drugs. Alcohol (98%), nicotine (84%), cocaine (72%) and cannabis (72%) derivates, inhalants (48%), hallucinogens (22%) and psychotropic medicine (12%) were the most commonly consumed drugs in a lifetime found among patients. Marijuana, cocaine and crack were statistically associated to research youngest population. 64% started using substances in adolescence, mainly due to friendship, party attendance and curiosity and 38% of these youngsters already made continuous use of them in this very life stage. 66% indicated ‗group, friendship circle, friends as usage partners, 72,92% declared uninterrupted use of drugs for some days and 86% of them reported having had periods without any drug contact. The main factors encountered to relapse were loneliness, family distance, belief of being able to drink with no negative consequences, as well as of feeling fine, use willingness and pleasure and individual psychological characteristics. The most common treatments for problems with alcohol and/or other drugs were CAPSad, Hospitalization, Emergency Room, ―Alcoólicos Anônimos‖, ―Narcóticos Anônimos‖, ―Amor Exigente‖ and religion. Participants reported psychological (96%), physical (90%) and cognitive (71,92%) damages related to substance use. Conclusions: It has been observed that a great percentage of the total number of adult participants in the present study presented significant damages related to alcohol and other drugs abuse/dependence, compromising all individual s functioning areas. Although the results are not conclusive to predicting factors in childhood to drug use, considering sample characteristics varied from worse to better socioeconomics and life conditions. In adolescence, individuals with significant damages, changes and sufferings, in touch with user friends and presenting common features for abuse maintenance were predominant. We may conclude that efficient health promoting and prevention programs and more effective treatments and rehabilitation programs must take into consideration users population heterogeneity. / Introdução: Considera-se o uso de substâncias psicoativas um fenômeno complexo, com origens e consequências biológicas, psicológicas e sociais. Objetivos: Descrever, analisar e comparar características sociodemográficas, psicossociais e clínicas apresentadas por uma população com Transtornos por Uso de Substâncias. Casuística e Método: Participou da pesquisa uma amostra de conveniência com 50 pacientes adultos, sexo masculino, atendida no Centro de Atenção Psicossocial Álcool e Drogas (CAPSad) de uma cidade de médio porte do interior do Estado de São Paulo. Foram utilizados: Ficha de Identificação, contendo características pessoais e sociodemográficas e Roteiro de Entrevista Semidirigida para pessoas com problemas relacionados ao álcool e/ou outras drogas. Os dados foram analisados por meio de provas da estatística não paramétrica e por análise qualitativa a partir de frequências e porcentagens de categorias de respostas com mesma semântica de enunciados. Resultados: Pode-se destacar uma população adulta (28-37 e 48-58 anos), negróide (62%), sem companheiro(a) (72%), com 5 a 8 anos de estudos (42%), evangélica (44%), natural da região administrativa da cidade alvo do estudo (44,68%), com renda mensal familiar de 3 a 5 salários mínimos (47,73%) e desempregada (59,18%). 68% estavam em tratamento no período de ‗até um mês , principalmente os entrevistados mais jovens da pesquisa (18-37 anos). Houve equilíbrio entre participantes que foram encaminhados ao CAPSad e os que buscaram ajuda por conta própria, sendo os principais motivos: cessar o consumo, problemas psicológicos, emocionais e dependência química. 43,18% sofreram abusos (principalmente físicos) na infância e/ou na adolescência e 74% relataram possuir familiares com problemas de álcool e/ou outras drogas. Uso de substâncias psicoativas foi um fator contribuinte para prejuízos na qualidade dos relacionamentos com família de origem, cônjuge e filhos. Os participantes referiram significativa mudança e redução do repertório social e parte das fontes de lazer esteve relacionada ao próprio uso de substâncias ou atividades afins. 76,60% relataram possuir amigos que faziam uso de álcool e/ou outras drogas. Álcool (98%), nicotina (84%), derivados de coca (72%) e de canabinóides (72%), inalantes (48%), alucinógenos (22%), medicamentos psicotrópicos (12%) foram os tipos de drogas mais consumidas durante a vida. Maconha, cocaína e crack foram associadas estatisticamente à população mais jovem da pesquisa. 64% iniciaram o uso de substâncias na adolescência, sendo os principais motivos amizades, frequência em festas e curiosidade e 38% já faziam uso contínuo nessa mesma fase da vida. 66% relataram ‗turma, amigos, colegas como companheiros de uso, 72,92% uso ininterrupto de drogas por alguns dias e 86%, períodos sem o consumo. Principais fatores relacionados à recaída foram solidão, distância dos familiares, impressão de poder beber sem consequências negativas ou de estar bem, vontade e prazer no uso e características psicológicas próprias dos entrevistados. Tratamentos mais utilizados para problemas com álcool e/ou outras drogas foram CAPSad, Internação, Pronto Socorro, Alcoólicos Anônimos, Narcóticos Anônimos, Amor exigente e Religioso. 96% dos participantes relataram prejuízos psicológicos, 90% físicos, e 71,92% cognitivos, relacionados ao consumo de substâncias. Conclusões: Na vida adulta foram evidenciados, para quase a totalidade dos participantes do presente estudo, significativos prejuízos relacionados ao abuso/dependência de álcool e/ou outras drogas, em todas as áreas de funcionamento dos indivíduos. Embora os resultados não permitem evidenciar fatores considerados como preditores na infância para o início do uso de substâncias, uma vez que características da amostra foram variadas entre piores e melhores condições socioeconômicas e de vida, para a adolescência, houve predomínio de sujeitos com prejuízos relevantes, mudanças e sofrimentos, em contato com amigos usuários, demonstrando características comuns para a manutenção do abuso. Há a necessidade de programas eficazes de promoção e prevenção de saúde, tratamentos e reabilitações mais efetivos que levem em consideração a heterogeneidade da população usuária.

This paper main objectives are to evaluate the characteristics of tobacco and alcoholic beverage consumption as well as associated psychosocial factors in 466 adolescent freshmen in a private university in Lima.We found life prevalence and current consumption rates are higher for alcohol among male students, being beer the most consumed alcohol beverage than other spirits. The pattern of consumption of these substances is social and recreational. With regard to psychosocial aspects, similarities were found between alcoholic beverages and tobacco consumers and nonconsumers or totally abstemious ones (neither alcohol nor tobacco).Only nine adolescents, out of 466, reported that they had never consumed alcoholic beverages nor tobacco (non-consumers) and eight percent of the sample reported illegal psychoactive substance live prevalence. / Esta investigación tiene como objetivos principales evaluar las características del uso de bebidas alcohólicas y de tabaco, y los factores psicosociales asociados, en adolescentes que cursan el primer año de estudios en una universidad privada en Lima. Los resultados muestran que, entre los varones, la tasa de prevalencia de vida y de uso actual es mayor para el alcohol, siendo la cerveza la más utilizada. El patrón de consumo de las sustancias evaluadas de tipo social y recreativo. En relación a los aspectos psicosociales se encontraron tabaco, y los abstinentes totales o no usuarios de ambas sustancias. De los 466 adolescentes encuestados, sólo nueve reportaron que nunca habían usado bebidas alcohólicas ni tabaco (abstinentes totales o no usuarios) y sólo un ocho por ciento de los encuestados reportó prevalencia de vida de sustancias psicoactivas ilícitas.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The goal of this Dissertation is to analyze the influence of legal instruments concerning drugs on the way that the drug users perceive themselves and are socially perceived. Thus, an empiric research was developed at Psychosocial Care Centers for alcohol and other drugs (CAPS ad), together with the users and the professionals from this service. The ethnographic fieldwork (GEERTZ, 1973) lasted six months, including the direct observation and semi-structured interviews, that were analyzed in reference to the theoretical methodical approach of “discursive practices” (SPINK, 2004). One focus point was on how the interlocutors are influenced by the legal discourses, for example about prohibitionism, harm reduction, the current law on drugs (N°11.343 / 2006) and the public policy on drugs, investigating in which way these are producing meanings. Further investigating the elements involved in the construction of the user category and in the way what the health professionals think about the matter/issue of drugs, how they perceive the users and conduct their works practices. Finally, how these conceptions are affected by the legal instrument and manifested by the professionals and therefore affect how the users perceive themselves, conceptualize the substances, conceive the drugs law and influence the relationship that users established with the healthy services. In the period of the research, I notice that the criminalization of drug use intervened negatively in the way that the users are socially perceived, which is in fact affecting their health care. A possible change can be seen in the harm reduction programs, however, the elaboration of progress strategies become limited by the prevalence of the prohibitionist based and still drug criminalizing Brazilian legislation. Thus, the discussion about drug's decriminalization or drug's regulation is a present and ongoing topic. Thereby, in the first chapter, I describe the negotiation process, the integration, adaptation and the process itself of the research accomplished at CAPS ad. In the second chapter, I contextualize the user term, seeking to comprehend it from the legal instrument about drugs and the space where this norms have regulatory function, like in this case, the CAPS ad. In the third chapter, I discuss how the legal framework is transmitted through the daily practice, in the contact and dialog between the interlocutors, with the intention to understand how the subject is constituted in this discursive web and how it refuses or identifies itself with the dominant discourses. / Esta Dissertação tem por finalidade analisar a influência dos instrumentos legais sobre drogas no modo como os usuários de substâncias psicoativas (SPA) se percebem e são percebidos socialmente. Para tanto, uma pesquisa empírica foi desenvolvida em um Centro de Atenção Psicossocial Álcool e outras Drogas (CAPS ad), junto aos usuários e aos profissionais do serviço. O trabalho de campo, de base etnográfica (GEERTZ, 1973), teve a duração de seis meses e contemplou a observação direta e a realização de entrevistas semiestruturadas, as quais foram analisadas à luz do referencial teórico-metodológico das “práticas discursivas” (SPINK, 2004). Com um olhar direcionado ao modo como os interlocutores são acionados pelos discursos regulamentadores, a exemplo do proibicionismo, da redução de danos, da atual lei nacional sobre drogas (Lei n°11.343/2006) e de políticas públicas sobre drogas, busquei compreender a produção de sentidos e os elementos em disputa envolvidos na construção da categoria usuário. Ademais, investiguei como os profissionais de saúde pensam a questão das drogas, percebem os usuários e conduzem as suas práticas cotidianas de trabalho; e como essas concepções, disseminadas pelos instrumentos legais e manifestadas pelos profissionais, afetam a maneira como os usuários se percebem, conceituam as substâncias, concebem as leis que as regulamentam e se vinculam aos serviços de saúde. No transcorrer da pesquisa, pude notar como a criminalização do uso de drogas interfere negativamente no modo como o usuário é percebido socialmente, afetando, por sua vez, o cuidado em saúde. Uma mudança se releva por intermédio das políticas de redução de danos, contudo, a elaboração de estratégias mais progressistas é limitada pela lei brasileira, que é de base proibicionista, e ainda, altamente criminalizadora sobre o uso; aspectos que fazem das discussões sobre a descriminalização ou a regulamentação das drogas, temáticas atuais. Assim, no primeiro capítulo descrevo o processo de negociação, inserção, ambientação e o decurso da pesquisa realizada no CAPS ad. No segundo capítulo contextualizo o termo usuário, buscando compreendêlo a partir dos instrumentos legais sobre drogas e do espaço onde tais normas têm função regulamentadora, neste caso, o CAPS ad. E no terceiro capítulo discuto como o aporte legal é de alguma forma traduzido numa prática cotidiana e na interface, no encontro e no diálogo entre os interlocutores, com o intuito de compreender como o sujeito é constituído em meio a essa teia discursiva e de que modo ele recusa ou se identifica com os discursos dominantes.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2017-07-07T17:29:02Z No. of bitstreams: 2 Dissertação - Sandra Hernandez Morais de Araújo - 2017.pdf: 3596744 bytes, checksum: 396468c02a05d61bf35172317ac7f3d7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-07-10T14:45:10Z (GMT) No. of bitstreams: 2 Dissertação - Sandra Hernandez Morais de Araújo - 2017.pdf: 3596744 bytes, checksum: 396468c02a05d61bf35172317ac7f3d7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-07-10T14:45:10Z (GMT). No. of bitstreams: 2 Dissertação - Sandra Hernandez Morais de Araújo - 2017.pdf: 3596744 bytes, checksum: 396468c02a05d61bf35172317ac7f3d7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-05-30 / Introduction: The use of Psychoactive Substances (PS) brings problems in several areas of the subject's life such as: health, psychological and social. Epidemiological studies show that it is in the passage from childhood to adolescence that the use begins. In Brazil, the treatment is preferentially done in the Centers of Psychosocial Care and in them are offered psychosocial and pharmacological interventions and the combination of them. Pharmacological interventions can be used to stabilize, detoxify, ameliorate withdrawal symptoms and prevent relapse. The pharmacist plays an important role in the safe and effective use of medicines in children and adolescents, since it can prevent identifying, evaluating and intervening in problems related to pharmacotherapy. Objective: to analyze the use of drugs by users of the Psychosocial Care Center Alcohol and Drugs Infanto Juvenil 24 hours (CPCAD adi III). Methodology: an analytical and quantitative cross-sectional study, carried out by reviewing medical records. The medical records of users who were younger than 18 years of age and with prescription of medicines were included and the medical records that were not filled out were excluded. Potential drug interactions (PDI) were analyzed using the Micromedex® and Medscape® database. Descriptive and bi-and multivariate logistic regression analyzes were performed considering a statistically significant relationship p≤0.5. Results: Of the 159 records used in the study, 71.7% were male subjects with mean age of 16 ± 1.9 years, incomplete elementary schooling (88%) and the search for treatment occurred in 55, 3% by judicial measure. Among the diagnostic hypotheses, the most frequent were mental and behavioral disorders due to the use of multiple drugs and the use of other psychoactive substances (F19) 34.9% and mental and behavioral disorders associated with the use of cannabinoids (F12) With 17.2%. The age of first use of SP was on average 12.4 ± 1.90 years. The most used PS was Cannabis (37.2%). The most prescribed drugs were the N03A (antiepileptic) 39.94% and N05A (antipsychotic) 34.83%% groups. A total of 815 PDI were found per type of interaction, 352 drugcannabis, 139 drug-ethanol, 125 drug-foods, 99 drug-tobacco, 83 drug-drug, and 17 drug-cocaine. Regarding the severity of the PDI found, 59.4% were moderate, 23.8% were secondary, 15.7% were serious and 1.1% were contraindicated. The drugs that presented the most PDI were chlorpromazine (32.3%) and diazepam (19.6%). Conclusion: the adolescents were the majority of males, the diagnostic hypothesis that had the highest frequency was that of mental and behavioral disorder due to the use of SPA (F-19). The use of PS was on average at 12 years of age and the most consumed PS was marijuana. The most commonly prescribed drugs were valproic acid (30.63%) and chlorpromazine (20.72%). It was found of 815 PDI with 59.4% classified as moderate. The factor involved in polypharmacy was total PDI and among the factors involved in the occurrence of total PDI were: being studying and the amount of diagnostic hypothesis. In view of the high PDI index, the relationship with polypharmacy and a high number of diagnostic hypotheses, it is necessary to increase the attention of health professionals regarding the topic and the development of protocols to support decision making. / Introdução: o uso de Substâncias Psicoativas (SPA) acarretam problemas em diversas áreas da vida do sujeito tais como: na saúde, psicológicos e sociais. Estudos epidemiológicos mostram que é na passagem da infância para a adolescência que se inicia o uso. No Brasil, o tratamento é feito preferencialmente nos Centros de Atenção Psicossocial e neles são ofertadas intervenções psicossociais e farmacológicas e a combinação delas. As intervenções farmacológicas podem ser utilizadas para estabilizar, desintoxicar, melhora dos sintomas de abstinência e evitar recaídas. O farmacêutico exerce papel importante na utilização segura e eficaz de medicamentos em crianças e adolescentes, pois o mesmo pode prevenir identificar, avaliar e intervir nos problemas relacionados à farmacoterapia. Objetivo: analisar a utilização de medicamentos por usuários do Centro de Atenção Psicossocial Álcool e Drogas Infanto Juvenil 24 horas (CAPS adi III). Metodologia: estudo transversal analítico e quantitativo, realizado por meio da revisão de prontuários. Foram incluídos os prontuários dos usuários que eram menores de 18 anos de idades e com prescrição de medicamentos e foram excluídos os prontuários que não estavam devidamente preenchidos. As potenciais interações medicamentosas (PIM) foram analisadas por meio do banco de dados Micromedex® e Medscape®. Foram realizadas análises descritivas e de regressão logística bi e multivariada considerando relação estatística significante p≤0,5. Resultados: dos 159 prontuários utilizados no estudo, 71,7% eram sujeitos do sexo masculino com a média de idade de 16 ± 1,9 anos, escolaridade ensino fundamental incompleto (88%) e a busca pelo tratamento deu-se em 55,3% por medida judicial. Dentre as hipóteses diagnósticas, as que apresentaram maior proporção foram os transtornos mentais e comportamentais decorrentes do uso de múltiplas drogas e do uso de outras substâncias psicoativas (F19) 34,9% e transtornos mentais e comportamentais associados com o uso de canabinóides (F12) com 17,2%. A idade do primeiro uso de SPA foi em média de 12,4 ±1,90 anos. A SPA mais utilizada foi a Cannabis (37,2%). Os medicamentos mais prescritos foram os grupos N03A (antiepilépticos) 39,94% e N05A (antipsicóticos) 34,83%%. Foram encontradas 815 PIM e por tipo de interação, foram encontradas 352 medicamento-cannabis, 139 medicamento-etanol, 125 medicamentoalimento, 99 medicamento-tabaco, 83 medicamento-medicamento e 17 medicamento-cocaína. Em relação a gravidade das PIM encontradas foram 59,4% moderadas, 23,8% secundárias, 15,7% graves e 1,1% contraindicado. Os medicamentos que mais apresentaram as PIM foram a clorpromazina (32,3%) e o diazepam (19,6 %). Conclusão: os adolescentes eram a maioria do sexo masculino, a hipótese diagnóstica que teve a maior frequência foi a de transtorno mental e comportamental devido ao uso de SPA (F-19). O uso de SPA foi em média aos 12 anos de idade e a SPA mais consumida foi a maconha. Os medicamentos mais prescritos foram: ácido valpróico (30,63%) e clorpromazina (20,72%). Encontrou-se de 815 PIM com 59,4% classificadas como moderada. O fator envolvido na polifarmácia foi o total de PIM e dentre os fatores envolvidos na ocorrência do total PIM, foram: estar estudando e a quantidade de hipóteses diagnóstica. Diante do alto índice de PIM, a relação com polifarmácia e alto número de hipóteses diagnósticas, faz-se necessário maior atenção dos profissionais de saúde quanto ao tema e desenvolvimento de protocolos para suporte na tomada de decisão.