Bakgrund: Beroendeproblematik är utbrett i samhället, och orsakar mycket ohälsa och lidande. Synen på personer med beroendeproblematik är skiftande. Skalan går från att se beroende som en sjukdom, till att se de drabbade som moraliskt bristfälliga personer som har sig själva att skylla. Vården styrs via riktlinjer och policydokument. Vilken människosyn som uttrycks i dokument som vårdprogram inom beroendevård är sällan problematiserad. Det finns risk för att omvårdnaden kan påverkas beroende på hur synen på personer med beroendeproblematik signaleras från regional nivå. Syfte: Syftet med studien var att undersöka hur personer med beroendeproblematik framställs i regionala vårdprogram inom beroendevård. Metod: En kritisk diskursanalys utfördes på regionala vårdprogram inom beroendevård. Resultat: Flera diskurser framträdde i materialet, dessa rörde bland annat kriminalitet, utanförskap, kontroll, motivation, samt omvårdnad. Frekvent förekommande nyckelord identifierades och problematiserades. Slutsats: Regionala vårdprogram är inte undantagna tendensen att stigmatisera denna patientgrupp. Ett omvårdnadsperspektiv saknas ofta i dokumenten. Inte sällan uttrycks att personerna får rätta sig i ledet och försöka bevisa sin skötsamhet. Undantag finns, och de behöver bli fler för att detta synsätt ska kunna utmanas. / Background: Substance dependence is widespread in society and causes considerable suffering and ill health. Attitudes towards persons with substance use disorder (SUD) are diverse, and range from the concept of addiction as a disease to the view that persons with SUD are morally lacking and only have themselves to blame. Health services are governed by guidelines and policy documents. The views expressed in documents such as care programs within addiction medicine, are seldom assessed. Nursing is at risk of being affected, depending on how attitudes towards persons with SUD are communicated from a county council. Aim: The aim of this study was to examine how persons with substance use disorder are depicted in regional care programs within addiction health care. Method: A critical discourse analysis was applied to regional care programs in addiction health care. Results: Several discourses were identified, regarding criminality, marginalisation, control, motivation, and nursing. Frequently used keywords were identified and problematised. Conclusions: Regional care programs are not exempt from the tendency to stigmatise persons with SUD. A nursing perspective is often missing from these documents. Persons with SUD have to toe the line and try to prove that they are well-behaved. There are exceptions to these representations, and more exceptions are needed to challenge the prevailing perspective.

No description available.

Samsjuklighet i form utav psykisk ohälsa och substansbrukssyndrom är ett nationellt omfattandefolkhälsoproblem. Personer som lever med samsjuklighet söker sig ofta till vården vilket ställerkrav på den vård som erbjuds inom psykiatrisk vård. Patienten som lever med samsjuklighetanses ofta som komplexa och vårdkrävande i kontakt med sjukvården. Vårdpersonalensbemötande i kontakt med den patientgrupp kan uppfattas på olika sätt av patienter.Vårdpersonalens bemötande kan upplevas som värdefull respektive dålig erfarenhet beroende påhur patienter upplever det och vad det tillfört i deras lidande. Syftet: var att beskriva patientensupplevelse av psykiatrisk vård vid samsjuklighet i form av psykiatrisk ohälsa ochsubstansbrukssyndrom. Metod: Studien utfördes som en litteraturstudie med en metod förinnehållsanalys. Sexton vetenskapliga artiklar analyserades. Resultat: Analysen resulterade ifyra kategorier: Att mötas av okunskap och brist på förståelse, Att bli bemött utifrån enhelhetssyn, Att acceptera att man behöver hjälp och ha viljan att kämpa för att ett bättre liv, Attuppleva brist i uppföljnings och behandling. Resultatet visade att patienter upplevde brist avkunskap och kompetens hos vårdpersonalen som ska bidra till att minska / hindra uppkomst avfördomar, stigma i möte med vårdpersonal. Patientgruppen upplevde att en bemötande som ettpräglas av en helhetssyn från vårdpersonal är nyckeln till god vård som främjar derasåterhämtning. Patienter upplevde att egen acceptans och insikt på att de är i behov av hjälp var ien viktig del i behandlingen och brist på kontinuerlig uppföljning och deras behandling var en avde faktorer som försämrade och försvårade återhämtningsprocessen och beslut att sluta medsubstansbruk. Diskussion: Diskussion: Bemötande som speglar av helhetssyn, kontinuerliguppföljning under behandling, kunskap samt kompetensutveckling bör prioriteras inom denpsykiatrisk vården för att förbättra patientens upplevelse av vården som erbjöds.

Bakgrund: Personer med substansbrukssyndrom är en stadigt ökande patientgrupp inom somatisk vård. Forskning som finns belyser främst vårdpersonals upplevelser av att vårda patienter med substansbrukssyndrom. Tidigare forskning visar att personer med substansbrukssyndrom har en rädsla för att utsättas för stigmatisering vid hälso- och sjukvårdsbesök. Att vården i hög grad är specialiserad och tydligt avgränsad medför att de riskerar att få sämre vård vid somatisk samsjuklighet. Specialistsjuksköterskor inom psykiatrisk vård möter personer med substansbruk i sitt arbete och ansvarar för att främja hälsa utifrån den enskildes behov genom ett holistiskt förhållningssätt. Syfte: Syftet med studien var att sammanställa aktuell kunskap om hur personer med substansbrukssyndrom upplever och erfar att vårdas inom somatisk vård.  Metod: En litteraturöversikt genomfördes och resultatet baserades på 16 vetenskapliga artiklar som inhämtats genom systematisk sökning i databaser. Data analyserades i enlighet med Granheim och Lundmans kvalitativa innehållsanalys (2017) på en manifest nivå med induktiv ansats. Resultat: Analysen resulterade i tre huvudkategorier med sju tillhörande subkategorier. Huvudkategorierna är: Upplevelse av stigmatisering, Upplevelse av brister i vårdpersonalens yrkesfärdigheter och Upplevelse av vårdande relation. Slutsats: Personer med substansbrukssyndrom upplever stigmatisering utifrån hur vårdpersonal bemöter och behandlar dem när de söker vård. De upplever att de inte tas på allvar, att de blir diskriminerade och upplever att de får sämre vård än andra patienter på grund av bristande kunskap hos vårdpersonal. Tidigare negativa erfarenheter bidrar till att de undviker kontakt med sjukvården. Genom ökad kunskap hos vårdpersonal, medvetenhet om egna fördomar, fortsatt implementering av personcentrerad omvårdnad och samverkan mellan somatisk respektive psykiatrisk vård är förhoppningen att detta kan förebyggas. Ytterligare forskning behövs för att klarlägga vilka omvårdnadsåtgärder specialistsjuksköterskan inom psykiatrisk vård kan tillämpa för att förbättra vårdupplevelsen för personer med substansbrukssyndrom.

The aim of this thesis is to explore how men in recovery from substance use conceptualize challenges and use their inherent strengths to navigate them. Estimates of substance use prevalence rates in Canada suggest that approximately one-in-five Canadians will meet the diagnostic criteria for substance use disorder throughout their lifetime (Pearson, Janz & Ali, 2013). These prevalence estimates represent a significant cause for concern as addiction is a significant phenomenon in contemporary Canadian society. A scoping literature review was conducted on nineteen research studies to investigate the state of current research. Although there is a wealth of studies on addiction, research frequently utilizes pathologizing approaches. These approaches are commonly focused on addiction in the context of a social or individual issue ripe with problematizing discourses. Six qualitative semi-structured interviews were conducted on men living in recovery-based supportive housing for this research to explore their experiences from the onset of substance use into substance use and recovery efforts. A strength-based perspective was adopted for analysis purposes in order to more accurately reflect on the inherent strengths of the participants. The men provided in-depth accounts of their experiences, conceptualized challenges to their recovery and contrary to many contemporary research discourses, demonstrated an affluence of strengths while articulating challenge navigation. The men were also proactive in their ability to anticipate future challenges and conceive methods of effective challenge navigation. Findings of this study are analyzed and discussed in the context of recognizing the magnitude of the challenges facing the men in recovery and the incredible strengths that they demonstrate in challenge navigation. The implications for current social work practice are outlined and several suggestions are tabled with the goal of improving current practice methods. Finally, suggestions for future strength-based addiction research are offered with the intention of seeking overall improvements to the research field and addressing existing gaps within the literature. / Thesis / Master of Social Work (MSW)

Self-concept is the individual's subjective view of themselves. It impacts interaction with others and, in turn, further the development of the self. Cultural aspects, gender differences, and psychiatric and substance use disorders further impact the subjective view of the self. Structural Analysis of Social Behavior (SASB) is a model rooted in interpersonal theory and the interpersonal circle that divides the self-concept into eight behavioral clusters over love-hate and autonomy-control. The individual's measured self-beliefs can be used in motivational work and treatment. The forensic psychiatric population is complex, with high levels of comorbidity, but little is known about how they view themselves. This study aims to capture their self-concept and examine if different psychiatric diagnostic groups have distinct self-concept profiles. One hundred and six patients who had previously completed the SASB introject questionnaire were included. Demographic data and other variables were also coded from their electronic journal. The participant's descriptives showed differences from the normative group and slight differences between the psychiatric groups. Inferential statistical analysis showed a significant difference regarding the negative clusters between the Neurodevelopmental and Psychosis groups and a trend of differing scores between the Neurodevelopmental and Personality Disorders groups. Study limitations make it hard to point to distinct self-concept profiles, but SASB-results indicate that the patients generally feel positive about themselves. Further research is needed to increase the findings' generalizability and better capture self-concept in comorbid inpatients. / FOR-SATA

Au Canada, chaque nuit, en moyenne 6000 jeunes sont sans-abri. Ceux souffrant de psychose et de toxicomanie sont particulièrement à risque d’itinérance. La littérature suggère qu’il y a nécessité de soins adaptés pour cette population. Une équipe d’intervention intensive de proximité ÉQIIP SOL (ES) fut créée au CHUM en 2012 afin de mieux offrir une approche adaptée la clientèle des jeunes itinérants souffrants d’un premier épisode psychotique et de toxicomanie (JIPEPT). Objectif : Étudier l’impact de l’ajout de l’ES aux services de la Clinique spécialisée d’intervention précoce pour la psychose (CIP) sur l’évolution symptomatique et fonctionnelle et l’utilisation de services des JIPEPT. Méthode : Étude de suivi longitudinale comparant l’évolution des JIPEPT suivis par l’ES en ajout à une CIP depuis 2012 à ceux suivis dans une CIP (2005-2011). La stabilité à l’hébergement (issue primaire), l’autonomie en hébergement, l’évolution fonctionnelle (SOFAS) et clinique globale (GAF, CGI), la sévérité de la toxicomanie (AUS, DUS), et l’utilisation de services (consultations à l’urgence et hospitalisations) ont été collectées de manière prospective durant 24 mois. Résultats : Le suivi de l’ES+CIP est associé à un taux plus élevé de JIPEPT en hébergement stable que le traitement régulier CIP seul (RR=2,38, p=0,017). L’évolution fonctionnelle, clinique et de la toxicomanie des 2 groupes sont similaires. Conclusion : L’ajout de l’ES à une CIP semble permettre d'augmenter le taux de stabilité en hébergement chez les JIPEPT. Toutefois, les facteurs de mauvais pronostic prémorbides et l’intensité déjà élevée du traitement comparateur (CIP) expliquent possiblement que l’ES n’ait pas d’impact supplémentaire sur l’évolution du fonctionnement et de la toxicomanie à court terme. / In Canada, every night, about 6000 youths are homeless. Those suffering from psychosis and substance use disorder (SUD) are at higher risk for homelessness. Today’s literature suggests the need for dedicated interventions for this population. In 2012, an intensive outreach team (ÉQIIP SOL (ES)) was created at the CHUM, to help homeless youth suffering from psychosis and SUD (HYPS). Objective: Explore the impact of ES added to an early intervention for psychosis clinic (EIC) on service use and the symptomatic and functional outcome for the HYPS. Method: Longitudinal study comparing the outcome of HYPS who received care from ES in addition to an early intervention for psychosis clinic (EIPC) (2012-2015) to an HYPS historical cohort who received care from EIPC only (2005-2011). Housing stability (main outcome), living arrangement autonomy, global assessment of functioning scale (SOFAS), clinical global assessment scales (GAF, CGI), SUD severity (AUS, DUS) and services use (Emergency consultations and hospitalizations) have been collected prospectively for 24 months. Results: With ES + EPIC, there is a higher rate of HYPS in stable housing than with EIPC only (RR=2,38, p=0,017). Symptomatic and functional outcomes as well as drug and alcohol misuse are somewhat similar for the 2 groups. Conclusion: The addition of ES to an EIPC seems to benefit HYPS in increasing housing stability. However, poor prognostic factors of HYPS and the high intensity of the comparator treatment (EPIC) may explain why ES does not seem to have an additional impact on shortterm symptomatic, functional and SUD outcome.

Treningsterapi som en del av tverrfaglig spesialisert rusbehandling. Formålet med studiet er å undersøke hvordan en gruppe pasienter med rusmiddelavhengighet og psykiske lidelser opplever og beskriver sine erfaringer med treningsterapi som en del av behandlingen ved Stiftelsen Bergensklinikkene. Dette sett i lys av Self-Determination Theory (SDT) - selvbestemmelsesteorien.    Studiet har en kvalitativ tilnærming hvor det empiriske materialet er basert på forskningsintervju. Det er blitt gjennomført intervjuer av syv pasienter med rusmiddelavhengighet alle med erfaring med bruk av treningsterapi ved Bergensklinikkene. Treningsterapi vil si planlagte og strukturerte fysiske aktiviteter. Empirien i dette studiet er analysert ved bruk av tradisjonell kvalitativ tilnærming og meningskonsentrering. Hovedfunnene viser at et autonomistøttende miljø er en forutsetning for å bli motivert for behandling. Brukermedvirkning og selvbestemmelse er faktorer som styrker motivasjonen for endring.   Økt kompetanse blant pasientene gjennom nye erfaringer og økt innsikt i treningsterapi, ga grunnlag for en autonomistyrt behandling.  Relasjon til treningsterapeutene var viktig for at pasientene opplevde terapeutens informasjon og veiledning som nyttig. Opplevelsen av et inkluderende felleskap med behandlere og medpasienter var av stor betydning for informantene. I studien kom det frem at behovet for tettere oppfølging i overgangen fra institusjon til hjem var nødvendig.     Opplevelse av bedre rusmestring, bedre søvn, mindre angst og depresjon og mindre ADHD-symptomer var viktige motivasjonsfaktorer. Dessuten ga fysiske effekter både indre og ytre motivasjon til bruk av treningsterapi. Gjennom studien kan en ut fra resultatene konkludere med at informantene blant annet vektlegger en autonomistøttende struktur, økt kompetanse, opplevelse av fellesskap og motivasjon som viktig og nødvendig i treningsterapi. / Excercise as therapy  Exercise as therapy as part of multidisciplinary specialized treatment. The purpose of the study is to understand how a group of patients with substance use disorders and mental illness experience and describe their experiences with exercise therapy as part of treatment at the Bergen Clinics Foundation. The thesis uses a framework of self-determination theory (SDT).   The study has a qualitative approach where the empirical material is based on research interviews. Seven patients were strategically selected to undertake semi-structured interviews regarding their experience with exercise as therapy as part of multidisciplinary specialized treatment in The Bergen Clinics Foundation. Exercise as therapy is physical activity that is planned and structured. The empirical data in this study is analyzed using the traditional qualitative approach.    The results show that an autonomy supportive environment is a prerequisite for being motivated for treatment. User involvement and self-determination are factors that strengthen the motivation for change.   Increased competence among patients through new experiences and greater insight into exercise as therapy, provided the basis for an autonomy-guided therapy. The patients´ relationship with the therapists was important: in case this relationship was deficient, they wouldn´t experience the information and guidance as helpful.   The experience of an inclusive community of practitioners and fellow patients was of great significance for patients. The study revealed that the need for closer monitoring of the transition from institutional to home was necessary.    Experience of better control of drug dependence, better sleep, less anxiety and depression and less ADHD symptoms were important motivators. Besides giving physical effects both intrinsic and extrinsic motivation for use of exercise as therapy.   One can conclude from the study that in the patients´ view an autonomy supportive structure, increased expertise, experience of community and motivation represented the most important and indispensable factors in exercise therapy.

Il est possible qu’une personne qui consulte pour un problème d’utilisation de substances souffre également d’un problème associé à un état de stress post-traumatique ( ESPT ). Plusieurs auteurs croient qu’il existe un lien expliquant cette co-morbidité. Voilà pourquoi plusieurs hypothèses ont été formulées pour expliquer le lien entre un trouble tel que celui lié à l’utilisation de substance (TUS) pouvant exister avant l’ESPT, la vulnérabilité suite au TUS, ainsi que l’automédication. Plusieurs recherches proposent deux types d’interventions afin d’aider les personnes aux prises avec cette double problématique. La première consiste à traiter les deux problèmes séparément alors que la seconde, préconise une approche intégrée et simultanée. Puisque les écrits conseillent davantage un traitement intégré, il y aura une présentation d’une de ces formes de traitement nommé « À la recherche de la sécurité ». Le volet académique visait à comprendre le lien existant entre le TUS, les traumas psychologiques et l’ESPT ainsi que les différentes formes d’interventions pour aider les personnes ayant cette co-morbidité. Nous avons utilisé un module du programme « À la recherche de la sécurité » récemment traduit en français afin de vérifier sa mise en application et l’appréciation qu’en ont fait cinq usagers du Centre Dollar-Cormier-Institut universitaire sur les dépendances (CDC-IUD) ayant vécu un traumatisme au cours de leur vie. En conclusion, il sera démontré dans nos résultats que les hypothèses quant au lien de comorbidité sont effectivement présentes dans la réalité des personnes ayant un ESPT et un TUS, et qu’une intervention intégrée offre des points positifs autant pour l’usager que pour l’intervenant. / It is possible that the substance abuse disorder for which a person consults is associated with Posttraumatic Stress Disorder (PTSD). Several authors believe that there is a link explaining this co-morbidity. For this reason, several hypotheses have been formulated to explain this link as the substance abuse disorder (SUD) prior to PTSD, vulnerability following the SUD and selfmedication. Moreover, research shows the various interventions to help people struggling with these twin problems. The first is to separate the two issues while the second includes PTSD and the SUD. Research advice a more integrated treatment, there will be a presentation of one of these forms of treatment called "Seeking Safety". The academic component of our apprenticeship was to understand the link between the SUD, psychological trauma and PTSD and the various forms of interventions to help people with this co-morbidity. We used a module of "Seeking Safety" recently translated in French to ensure its implementation and its assessment from five users of the Centre Dollar-Cormier-Institut universitaire sur les dépendances who experienced trauma in their lives. In conclusion of the study, it is clearly shown that different assumptions are present in the reality of people with PTSD and SUD and an integrated response has positives for both the user and for the speaker.

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.