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The main objective of this thesis was to develop a substantive theory that explained the phenomenon of detoxification from psychoactive drugs such as alcohol, tranquillisers, opioids, and amphetamines in a medical treatment unit for licit and illicit drug users. The other objectives were to (a) determine if the differences reported in earlier studies between licit and illicit drug users in terms of socio-demographic and drug use variables remain extant, and (b) assess the extent of minor psychiatric morbidity among the participants. Both grounded theory and quantitative methods of data collection and analysis were used in the study.The findings of the quantitative component of the study indicated that there were significant differences between licit and illicit drug users in regard to age, drug use characteristics, and completing the treatment program. That is, illicit drug users were younger than licit drug users, more likely to be poly drug users, and drop out of the program. The prevalence of minor psychiatric morbidity among the participants was 93.6%, and was largely independent of socio-demographic and drug use variables. The high prevalence of minor psychiatric morbidity suggests that the majority of participants warranted further follow-up support in the community after they left the treatment unit. The uptake of referrals for follow-up support, however, was 55.9%.The basic or core social psychological problem identified by the constant comparative method of grounded theory was found to have two parts, both of which were interpreted as forms of disequilibrium. The first part of disequilibrium, which was a precursor to treatment, was conceptualised as Hitting the Wall. The events associated with the symbolic "wall" interrupted the participants' drug focussed lifestyles and induced them to enter treatment. These events and problems were not resolved whilst in ++ / treatment, they lingered with the participants while they were in the unit, and remained to be addressed when they left. Whilst undergoing detoxification the participants encountered the second part of disequilibrium which was categorised as Incompatibility. The problem of Incompatibility was related to the heterogeneity of the participants and the structure of the treatment program that in many cases was unable to accommodate individual differences and needs.The core or basic social psychological process was conceptualised as Seeking Balance through Hanging In. The participants engaged in this process to deal with the disequilibrium of the precursor problem of Hitting the Wall and the problem of Incompatibility encountered in the unit. Seeking Balance through Hanging In was found to have four phases. The phases were Making the Break, Submitting to Cleansing, Fitting In, and Moving On. The process was linear in that the phases were sequential, and failure to complete a phase meant dropping out of the detoxification program. The experience of detoxification was modified by several contextual conditions. These were the physical enviroment, the participants' expectations of withdrawal symptoms, and the workload of the staff.The substantive theory, Seeking Balance through Hanging In, integrated all emergent categories, and explained the experience of the phenomenon of withdrawal from psychoactive drugs in a particular context. Recommendations for further research include testing the described phases and relationships of the substantive theory in similar environments, exploring the importance of the modifying conditions on client outcomes, and undertaking follow-up studies to determine the outcomes of those who completed the program as compared to the outcomes of those who dropped out. In addition, further studies are recommended to assess the transientness of the level ++ / of minor psychiatric morbidity detected among the participants in this study.The findings of this study make an important contribution to understanding the experience of detoxification from the perspective of the participants. The substantive theory has implications for clinical practice, professional education, management, and further research.

O uso indevido de drogas tem sido objeto de diversos estudos no Brasil, devido à crescente preocupação com os hábitos de consumo de drogas lícitas e ilícitas e seus impactos sociais, econômicos e, sobretudo, suas implicações na saúde da população. O objetivo desta pesquisa é estimar a prevalência do tabagismo e o uso de outras drogas e descrever o perfil epidemiológico, dos pacientes que frequentam o Centro de Fisioterapia Oscar Pires de Andrade do SUS de Itapira-SP. Trata-se de um estudo epidemiológico, descritivo, modelo inquérito, com uma abordagem metodológica quantitativa. Dos 399 pacientes agendados, foram entrevistados 217 (54,38%) pacientes, nos meses de julho e agosto de 2010. Os pacientes foram entrevistados pelo pesquisador deste trabalho conforme o Questionário Sócio Demográfico e sobre Prevalência do Tabagismo no Centro de Fisioterapia de Itapira - SP (SUS) e Teste de Fagerstrom para a Dependência a Nicotina (FTND) e Questionário ASSIST V. 3.0. A média de idade, dos pacientes entrevistados foi 50 anos, maioria é do sexo feminino (63, 13%), a moda de anos de escolaridade foi 11 anos e a mediana foi cinco. Lombalgia, cervicalgia e tendinite representaram juntos 50% dos encaminhamentos para fisioterapia com diagnóstico médico por explicitos. Mais da metade dos pacientes relataram ter outras doenças além daquela que foi motivo do encaminhamento para a fisioterapia, as doenças mais citadas pelos pacientes foi hipetensão e diabetes. Mais da metade dos pacientes relataram apenas uma queixa principal sendo a dor a queixa mais frequente. A prevalência de fumantes foi 17%, a média de idade dos pacientes fumantes foi 48 anos e 51% eram do sexo feminino, a maioria (89%) relatou fumar apenas cigarros comercializados, a mediana do número de cigarros fumados por dia foi 10 e a mediana de tempo que o indivíduo usou o tabaco foi 30 anos. A metade dos tabagistas foram classificados, de acordo com o FTND, como muito baixa e baixa dependência à nicotina, a média do escore de Fagerström foi de 4,1. Sobre o uso de substâncias psicoativas na vida, 70% dos pacientes relataram ter usado tabaco na vida; 91% bebidas alcoólicas; 14% maconha; 6% cocaína, crack; 11% inalantes; 10% hipnóticos, sedativos; somente um indivíduo relatou ter usado em sua vida inalante, e nenhum experimentou alucinógenos, opióides e outras drogas a especificar. Em relação à classificação do Questionário ASSIST, o tabaco (31%) e o álcool (31%) foram as drogas mais citadas para receber intervenção breve, seguido da maconha (3%), cocaína, crack (1%), anfetaminas (1%). As drogas legais como o álcool e o tabaco são os problemas de saúde pública mais proeminente no Brasil. Essa é uma situação preocupante e aponta a importância de trabalhar a prevenção de drogas psicoativas, nos serviços de atenção primária. / The misuse of drugs has been the subject of several studies in Brazil, due to growing concern about the consumption patterns of licit and illicit drugs and their negative social, economic, and especially its implications for population health. The objective of this research is to estimate the prevalence of smoking and the use of other drugs and describe the epidemiological profile of the patients attending the Physiotherapy Centre Oscar Pires de Andrade Itapira SUS-SP. This is an epidemiological study, descriptive model survey is a quantitative approach. Of the 399 patients scheduled were interviewed, 217 (54.38%) patients in the months of July and August 2010. Patients were interviewed by the researcher in this study as the Socio - Demographic Questionnaire on Smoking Prevalence and Fitness Center in Itapira - SP (SUS) and the Fagerstrom Test for Nicotine Dependence (FTND) questionnaire and ASSIST V. 3.0. The mean age of patients interviewed was 50 years, most are female (63, 13%), the fashion of years of education was 11 years and the median was five. Low back pain, neck pain and tendinitis together accounted for 50% of referrals for physical therapy with medical diagnostic explicit. More than half of patients reported having other diseases beyond what was reason for referral for physical therapy, the disease most often cited by patients was hipetensão and diabetes. More than half of patients reported only one major complaint is the pain the most frequent complaint. The prevalence of smokers was 17%, the average age of smokers was 48 years and 51% were female, most (89%) reported smoking only cigarettes sold, the median of cigarettes smoked per day was 10 and median time that the person has used tobacco was 30 years. Half the smokers were classified according to the FTND, as very low and low nicotine dependence, the average Fagerström score was 4.1. On the use of psychoactive substances in life, 70% of patients reported having used tobacco in their lives, 91% alcohol, 14% marijuana, 6% cocaine, crack, inhalants 11%, 10% hypnotics, sedatives, only one person reported having used inhalants in their lifetime, and none experienced hallucinogens, opioids and other drugs to specify. Regarding the classification of the Questionnaire Assist, tobacco (31%) and alcohol (31%) were the most commonly cited to receive brief intervention, followed by marijuana (3%), cocaine, crack cocaine (1%), amphetamines (1% ). Legal drugs like alcohol and tobacco are the health problems more prominent in Brazil. This situation is worrisome and highlights the importance of working prevention of psychoactive drugs in primary care services.

O uso indevido de drogas tem sido objeto de diversos estudos no Brasil, devido à crescente preocupação com os hábitos de consumo de drogas lícitas e ilícitas e seus impactos sociais, econômicos e, sobretudo, suas implicações na saúde da população. O objetivo desta pesquisa é estimar a prevalência do tabagismo e o uso de outras drogas e descrever o perfil epidemiológico, dos pacientes que frequentam o Centro de Fisioterapia Oscar Pires de Andrade do SUS de Itapira-SP. Trata-se de um estudo epidemiológico, descritivo, modelo inquérito, com uma abordagem metodológica quantitativa. Dos 399 pacientes agendados, foram entrevistados 217 (54,38%) pacientes, nos meses de julho e agosto de 2010. Os pacientes foram entrevistados pelo pesquisador deste trabalho conforme o Questionário Sócio Demográfico e sobre Prevalência do Tabagismo no Centro de Fisioterapia de Itapira - SP (SUS) e Teste de Fagerstrom para a Dependência a Nicotina (FTND) e Questionário ASSIST V. 3.0. A média de idade, dos pacientes entrevistados foi 50 anos, maioria é do sexo feminino (63, 13%), a moda de anos de escolaridade foi 11 anos e a mediana foi cinco. Lombalgia, cervicalgia e tendinite representaram juntos 50% dos encaminhamentos para fisioterapia com diagnóstico médico por explicitos. Mais da metade dos pacientes relataram ter outras doenças além daquela que foi motivo do encaminhamento para a fisioterapia, as doenças mais citadas pelos pacientes foi hipetensão e diabetes. Mais da metade dos pacientes relataram apenas uma queixa principal sendo a dor a queixa mais frequente. A prevalência de fumantes foi 17%, a média de idade dos pacientes fumantes foi 48 anos e 51% eram do sexo feminino, a maioria (89%) relatou fumar apenas cigarros comercializados, a mediana do número de cigarros fumados por dia foi 10 e a mediana de tempo que o indivíduo usou o tabaco foi 30 anos. A metade dos tabagistas foram classificados, de acordo com o FTND, como muito baixa e baixa dependência à nicotina, a média do escore de Fagerström foi de 4,1. Sobre o uso de substâncias psicoativas na vida, 70% dos pacientes relataram ter usado tabaco na vida; 91% bebidas alcoólicas; 14% maconha; 6% cocaína, crack; 11% inalantes; 10% hipnóticos, sedativos; somente um indivíduo relatou ter usado em sua vida inalante, e nenhum experimentou alucinógenos, opióides e outras drogas a especificar. Em relação à classificação do Questionário ASSIST, o tabaco (31%) e o álcool (31%) foram as drogas mais citadas para receber intervenção breve, seguido da maconha (3%), cocaína, crack (1%), anfetaminas (1%). As drogas legais como o álcool e o tabaco são os problemas de saúde pública mais proeminente no Brasil. Essa é uma situação preocupante e aponta a importância de trabalhar a prevenção de drogas psicoativas, nos serviços de atenção primária. / The misuse of drugs has been the subject of several studies in Brazil, due to growing concern about the consumption patterns of licit and illicit drugs and their negative social, economic, and especially its implications for population health. The objective of this research is to estimate the prevalence of smoking and the use of other drugs and describe the epidemiological profile of the patients attending the Physiotherapy Centre Oscar Pires de Andrade Itapira SUS-SP. This is an epidemiological study, descriptive model survey is a quantitative approach. Of the 399 patients scheduled were interviewed, 217 (54.38%) patients in the months of July and August 2010. Patients were interviewed by the researcher in this study as the Socio - Demographic Questionnaire on Smoking Prevalence and Fitness Center in Itapira - SP (SUS) and the Fagerstrom Test for Nicotine Dependence (FTND) questionnaire and ASSIST V. 3.0. The mean age of patients interviewed was 50 years, most are female (63, 13%), the fashion of years of education was 11 years and the median was five. Low back pain, neck pain and tendinitis together accounted for 50% of referrals for physical therapy with medical diagnostic explicit. More than half of patients reported having other diseases beyond what was reason for referral for physical therapy, the disease most often cited by patients was hipetensão and diabetes. More than half of patients reported only one major complaint is the pain the most frequent complaint. The prevalence of smokers was 17%, the average age of smokers was 48 years and 51% were female, most (89%) reported smoking only cigarettes sold, the median of cigarettes smoked per day was 10 and median time that the person has used tobacco was 30 years. Half the smokers were classified according to the FTND, as very low and low nicotine dependence, the average Fagerström score was 4.1. On the use of psychoactive substances in life, 70% of patients reported having used tobacco in their lives, 91% alcohol, 14% marijuana, 6% cocaine, crack, inhalants 11%, 10% hypnotics, sedatives, only one person reported having used inhalants in their lifetime, and none experienced hallucinogens, opioids and other drugs to specify. Regarding the classification of the Questionnaire Assist, tobacco (31%) and alcohol (31%) were the most commonly cited to receive brief intervention, followed by marijuana (3%), cocaine, crack cocaine (1%), amphetamines (1% ). Legal drugs like alcohol and tobacco are the health problems more prominent in Brazil. This situation is worrisome and highlights the importance of working prevention of psychoactive drugs in primary care services.

Criminological aspects of drug criminality Drug criminality is a big problem of current time and it concerns all of us regardless of sex, age or social status. The topic of drug criminality is very wide though. This diploma thesis focuses in more detail on the current and very dangerous phenomenon of drugs in transport. The main target of the thesis is to provide a comprehensive summary about the psychoactive drugs which are used by the drivers most frequently, to analyse in detail their properties and effects and to describe, which influence the particular types of psychoactive drugs have on the physical and mental state of driver and which changes in his behaviour these drugs cause. The thesis is divided into introduction, four main chapters and conclusion. The first chapter is focused on the explanation of some basic terms which are used in the thesis. The second chapter summarizes the historical development in using of psychoactive drugs in the world and in the area of our country. The Czech state experienced in the past a few fundamental turns, after that the situation in the society changed. With regard to these periods the passage about the history of using of psychoactive drugs in the area of our country is divided into three parts. In the third chapter are analysed in detail the particular...

O olhar para uma população específica, crianças/adolescentes, em uso/abuso de álcool e outras substâncias psicoativas foi o enredo desse trabalho. Partiu-se a priori da investigação de 38 casos de adolescentes que deram entrada no Pronto Atendimento Municipal (PAM) e foi-se construindo o caminho percorrido pela amostra dentro das possibilidades de atendimento em Taquaritinga-SP, este município do interior paulista pertencente à regional de Araraquara que tem como estrutura uma rede de serviços de saúde mental especializados: um ambulatório infantil (ASMi) e um centro de atenção psicossocial infantil (CAPSi). Identificou-se que não se tratava de uma questão simples, mas complexa com muitas facetas, vindo em direção às perspectivas de Morin que confrontam teorias e idéias sem preconceitos. Esse trabalho usa o estudo exploratório descritivo de abordagem quantitativa e qualitativa e teve por objetivo identificar o percurso de crianças/adolescentes usuários de álcool e outras substâncias psicoativas, além de verificar se o Centro de Atenção Psicossocial infantil (CAPSi) do município se faria presente como estratégia de tratamento prevista no Plano Emergencial de Ampliação do Acesso ao Tratamento e Prevenção de Álcool e outras Drogas (PEAD 2009-2011). A análise resultante desse estudo revelou que os serviços prestam acolhimento a população adscrita por várias portas de entrada, mesmo não tendo um programa para tratamento. Mostra também que o trabalho tem a necessidade de ser realizado em conjunto, ser articulado em rede e que sua concretização é um desafio. Com a inexistência de respostas prontas, alerta-se para a necessidade da busca de novas reflexões e construções a respeito do tratamento de crianças/adolescentes usuários de substâncias psicoativas. / The look for a specific population, children/adolescents, in the use/abuse of alcohol and other psychoactive substances was the scenario of this work. The starting point was the investigation of 38 cases of adolescents who were admitted to the Municipal Emergency Care (PAM) and has been built the road traveled by the sample within the possibilities of service in Taquaritinga-SP, this city in the interior belonging to regional Araraquara which has as structure network of specialist mental health services: a childhood ambulatory (ASMi) and a psychosocial care center for children (CAPSi). It was found that this was not a simple matter, but with many complex facets, coming towards the Morin´s prospects which confront theories and ideas without prejudice. This work uses the descriptive exploratory study of quantitative and qualitative approach and aimed to identify the route of children/adolescents who use alcohol and other psychoactive substances, besides to checking if the Psychosocial Care Center child (CAPSi) of the city would be present as treatment strategy referred on the Emergency Plan for Expansion of Access to Treatment and Prevention of Alcohol and other Drugs (PEAD 2009-2011). The resulting analysis of this study revealed that the hosting services are provided to enrolled population by various ports of entry, while not having a program for treatment. It also shows that the work has needed to be done together, to be articulated in the network and that its implementation is a challenge. With the lack of ready answers, it is cautioned to the need to search for new ideas and constructions concerning the treatment of children/ adolescents users of psychoactive substances.

O presente estudo teve como objetivo principal compreender como o consumo de psicofármacos se legitimou como uma tecnologia de si no interior do dispositivo de medicalização. Concluímos que esta é uma tecnologia que incide sobre os corpos por estar acoplada aos modos de subjetivação contemporâneos. A análise aqui apresentada trata do contexto social de Boa Vista das Missões, um pequeno município do Rio Grande do Sul. Realizamos uma pesquisa de campo com seis meses de duração e entrevistamos uma amostra representativa de 400 pessoas. A análise dos relatos e das informações construídas buscou dar visibilidade aos enunciados presentes nas formações discursivas que definem e explicam o consumo de psicofármacos por 53% dos 400 pesquisados. Utilizamos a perspectiva genealógica de Michel Foucault para refletir sobre este campo de pesquisa e problematizar a produção de modos de vida marcados por formas de controle individualizantes e totalizantes ao mesmo tempo. Neste sentido, partimos do histórico da inserção dos psicofármacos em nossa cultura para entender as dimensões que ocupam neste contexto. A análise pode identificar as redes enunciativas no interior do dispositivo de medicalização que fundamentam uma apresentação do biopoder que se sustenta no tripé “dependência, assistencialismo, individualismo” / The main goal of this research was to comprehend how the consuming of psychoactive prescribed drugs was legitimated as a technology of the self inside the medicalization device (dispositf). We concluded that this technology has its incidence on the body because it is attached to contemporary modes of subjectification. The analysis presented here refers to Boa Vista das Missões, a small town in the countryside of Rio Grande do Sul state. We conducted a six months field research and interviewed a sample of 400 inhabitants. The accomplished speech and data analysis intended to give visibly to the discursive formations’ statements that explain and sustain the consuming of prescribed psychoactive drugs by 53% of 400 researched We used Michel Foucault’s genealogical perspective to guide our understanding of the research field and to problematize the production of lifestyles characterized by individualized and totalized forms of control. As a stating point we described the history of the introduction of psychoactive drugs in our culture in order to understand the dimension of the consuming in this specific context. The analysis identified statements arragements in the interior of the medicalization device (dispositif) that found a form of biopower sustained in the tripe “dependence – assistancialism – individualism”.

O olhar para uma população específica, crianças/adolescentes, em uso/abuso de álcool e outras substâncias psicoativas foi o enredo desse trabalho. Partiu-se a priori da investigação de 38 casos de adolescentes que deram entrada no Pronto Atendimento Municipal (PAM) e foi-se construindo o caminho percorrido pela amostra dentro das possibilidades de atendimento em Taquaritinga-SP, este município do interior paulista pertencente à regional de Araraquara que tem como estrutura uma rede de serviços de saúde mental especializados: um ambulatório infantil (ASMi) e um centro de atenção psicossocial infantil (CAPSi). Identificou-se que não se tratava de uma questão simples, mas complexa com muitas facetas, vindo em direção às perspectivas de Morin que confrontam teorias e idéias sem preconceitos. Esse trabalho usa o estudo exploratório descritivo de abordagem quantitativa e qualitativa e teve por objetivo identificar o percurso de crianças/adolescentes usuários de álcool e outras substâncias psicoativas, além de verificar se o Centro de Atenção Psicossocial infantil (CAPSi) do município se faria presente como estratégia de tratamento prevista no Plano Emergencial de Ampliação do Acesso ao Tratamento e Prevenção de Álcool e outras Drogas (PEAD 2009-2011). A análise resultante desse estudo revelou que os serviços prestam acolhimento a população adscrita por várias portas de entrada, mesmo não tendo um programa para tratamento. Mostra também que o trabalho tem a necessidade de ser realizado em conjunto, ser articulado em rede e que sua concretização é um desafio. Com a inexistência de respostas prontas, alerta-se para a necessidade da busca de novas reflexões e construções a respeito do tratamento de crianças/adolescentes usuários de substâncias psicoativas. / The look for a specific population, children/adolescents, in the use/abuse of alcohol and other psychoactive substances was the scenario of this work. The starting point was the investigation of 38 cases of adolescents who were admitted to the Municipal Emergency Care (PAM) and has been built the road traveled by the sample within the possibilities of service in Taquaritinga-SP, this city in the interior belonging to regional Araraquara which has as structure network of specialist mental health services: a childhood ambulatory (ASMi) and a psychosocial care center for children (CAPSi). It was found that this was not a simple matter, but with many complex facets, coming towards the Morin´s prospects which confront theories and ideas without prejudice. This work uses the descriptive exploratory study of quantitative and qualitative approach and aimed to identify the route of children/adolescents who use alcohol and other psychoactive substances, besides to checking if the Psychosocial Care Center child (CAPSi) of the city would be present as treatment strategy referred on the Emergency Plan for Expansion of Access to Treatment and Prevention of Alcohol and other Drugs (PEAD 2009-2011). The resulting analysis of this study revealed that the hosting services are provided to enrolled population by various ports of entry, while not having a program for treatment. It also shows that the work has needed to be done together, to be articulated in the network and that its implementation is a challenge. With the lack of ready answers, it is cautioned to the need to search for new ideas and constructions concerning the treatment of children/ adolescents users of psychoactive substances.

O presente estudo teve como objetivo principal compreender como o consumo de psicofármacos se legitimou como uma tecnologia de si no interior do dispositivo de medicalização. Concluímos que esta é uma tecnologia que incide sobre os corpos por estar acoplada aos modos de subjetivação contemporâneos. A análise aqui apresentada trata do contexto social de Boa Vista das Missões, um pequeno município do Rio Grande do Sul. Realizamos uma pesquisa de campo com seis meses de duração e entrevistamos uma amostra representativa de 400 pessoas. A análise dos relatos e das informações construídas buscou dar visibilidade aos enunciados presentes nas formações discursivas que definem e explicam o consumo de psicofármacos por 53% dos 400 pesquisados. Utilizamos a perspectiva genealógica de Michel Foucault para refletir sobre este campo de pesquisa e problematizar a produção de modos de vida marcados por formas de controle individualizantes e totalizantes ao mesmo tempo. Neste sentido, partimos do histórico da inserção dos psicofármacos em nossa cultura para entender as dimensões que ocupam neste contexto. A análise pode identificar as redes enunciativas no interior do dispositivo de medicalização que fundamentam uma apresentação do biopoder que se sustenta no tripé “dependência, assistencialismo, individualismo” / The main goal of this research was to comprehend how the consuming of psychoactive prescribed drugs was legitimated as a technology of the self inside the medicalization device (dispositf). We concluded that this technology has its incidence on the body because it is attached to contemporary modes of subjectification. The analysis presented here refers to Boa Vista das Missões, a small town in the countryside of Rio Grande do Sul state. We conducted a six months field research and interviewed a sample of 400 inhabitants. The accomplished speech and data analysis intended to give visibly to the discursive formations’ statements that explain and sustain the consuming of prescribed psychoactive drugs by 53% of 400 researched We used Michel Foucault’s genealogical perspective to guide our understanding of the research field and to problematize the production of lifestyles characterized by individualized and totalized forms of control. As a stating point we described the history of the introduction of psychoactive drugs in our culture in order to understand the dimension of the consuming in this specific context. The analysis identified statements arragements in the interior of the medicalization device (dispositif) that found a form of biopower sustained in the tripe “dependence – assistancialism – individualism”.