Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Este trabalho problematiza um tipo específico de racionalidade que emergiu nos fins do século XIX e avançou no século XX, implicando na constituição de uma política mundial destinada à regulamentação de determinadas substâncias psicoativas. Tais práticas foram possíveis em virtude de uma produção discursiva cujos enunciados médico-sanitários reivindicavam a intervenção dos Estados Nacionais em assegurar a saúde coletiva. No caso do uso de psicoativos, tais discursos fizeram emergir uma série de tratados internacionais, leis nacionais, normas e regulações que modificaram o comércio e os hábitos de consumo de tais substâncias, criminalizando qualquer uso que não estivesse de acordo com a legislação vigente. O recorte que esta dissertação procura fazer tem por foco analisar como esse processo se deu no Brasil, mais especificamente a partir da criação da Comissão Nacional de Fiscalização de Entorpecentes CNFE, organização esta de caráter governamental, que após sua criação passou a centralizar as políticas sociais sobre drogas no país. A CNFE foi constituída por meio do Decreto-Lei n 780em 28 de abril de 1936, vinculada ao Ministério das Relações Exteriores em conjunto com o Departamento Nacional de Saúde, através do Serviço de Fiscalização do Exercício Profissional. Neste caso, utilizando a documentação encontrada no Arquivo Histórico do Itamaraty, na Biblioteca de Saúde Pública da Fundação Oswaldo Cruz, Centro de Pesquisa e Documentação da Fundação Getúlio Vargas, dentre outras. Procurei delimitar esta pesquisa nos primeiros dez anos de atuação da Comissão, isto é, entre 1936 e 1946, para tanto, utilizo como instrumento de análise teórico-metodológico duas noções que serviram às reflexões do pensador francês Michel Foucault; biopolítica e governamentalidade. Desta forma, procuro acionar tais noções para localizar as estratégias de poder que culminaram na governamentalização do Estado voltadas para a gestão da vida das populações, tendo como pano de fundo os interditos das políticas sociais sobre drogas. / This research aims to put in doubt a specific sort of rationality that began and made progress between the end of the nineteenth century and the early twentieth century, implying a world-wide policy for some psychoactive substances regulation. That was possible due to discursive production composed by medical and sanitary statements that claimed the action of National States in order to ensure collective health. In terms of psychoactive drugs, that discourse has resulted in a series of international treaties, national laws, rules and regulations that changed the sale and use of those substances and criminalized any use that was not according to the current legislation. At this point, the dissertation focus on the study of this process in Brazil, more specifically from the creation of ComissãoNacional de Fiscalização de Entorpecentes CNFE (National Narcotic Control Commission), a governmental organization that concentrates social policies about drugs in the country. CNFE was set up by decree law 780 on April 28, 1936, linked to the Ministry of Foreign Affairs together with National Department of Health, through Professional Exercise Supervision Service. In this case, using documents found in Itamaraty Historical Archives, in Public Health Library of Oswaldo Cruz Foundation and in Center for Research and Documentation of Getulio Vargas Foundation , among others, I have attempted to focus this research in the first ten years following the Commission creation, between 1936 and 1946. Therefore, I have used, as theoretical and methodological analysis tool, two concepts that helped French philosopher Michel Foulcault thoughts; biopolitics and governmentality. Thus, I try to use those concepts in order to find the power strategies that have led up to the Governmentalization of the State and have been directed to the management of peoples life, all this against the background of interdiction from social policies about drugs.

Orientador: Francisco José Teixeira Neto / Banca: Antonio José de Araújo Aguiar / Banca: Denise Tabacchi Fantoni / Resumo: Poucos estudos vem sendo reportados com uso da metadona em pequenos animais. Neste estudo os efeitos sedativos, cardiorrespiratórios e comportamentais da metadona e da morfina foram comparados em seis cães conscientes sem raça definida. No dia do estudo, os cães (16,4 ± 2,8 kg) foram instrumentados para monitorização hemodinâmica com isoflurano, e após 60 minutos do término da anestesia inalatória foi iniciada a coleta de dados. Morfina, (1 mg/kg) ou duas doses de metadona (0,5 mg/kg [MET0,5] ou 1,0 mg/kg [MET1]) foram administradas pela via intravenosa durante um minuto em um delineamento aleatório cruzado, aguardando-se um intervalo mínimo de 1 semana entre cada tratamento. As variáveis foram registradas antes (basal) e por 120 minutos após a administração dos fármacos, adotando como nível de significância p< 0,05. Devido a um marcado aumento (356%) do índice de resistência vascular sistêmica (dinas•seg/cm5/m2) após cinco minutos da administração de morfina, um animal apresentou resultado positivo para o teste de detecção de outlier (teste de Grubb) não sendo incluso na análise estatística das variáveis hemodinâmicas. Não houve diferença entre os tratamentos nos parâmetros basais. A morfina reduziu a FC (bpm), comparado aos valores basais, dos 30-120 minutos (valores mínimos: 86±11 aos 120 minutos), contudo o IC (L/min/m2) reduziu-se aos 120 minutos (4,40±1,07). Comparado com a com a morfina, MET 1 causou maior e mais prolongada redução destes parâmetros (valores mínimos: 63±16 e 2,95±1,06 para FC e IC respectivamente); reducões intermediárias foram observadas com MET 0,5 (valores mínimos: 78±9 e 3,72±0,81 para FC e IC respectivamente). O IRVS aumentou apenas após a administração de metadona, sendo a MET 1 produziu maior aumento que MET 0,5 (valores máximos: 3192±882 e 2178±588 para MET 1 e MET 0,5 respectivamente) A morfina aumento a POAP (mmHg) após cinco minutos (12±4) enquanto ... / Abstract: Few controlled studies have been reported on the use methadone in small animals. In this study, the cardio-respiratory effects of methadone and morphine were compared in six conscious mongrel dogs. On the study day, the dogs (16.4±2.8 kg) were instrumented for hemodynamic monitoring under isoflurane anesthesia, allowing at least 60 min from termination of inhalant anesthesia before commencing data collection. Morphine (1 mg/kg) or two different doses of methadone (0.5 mg/kg [MET0.5] or 1.0 mg/kg [MET1]) were administered intravenously over 1 min in a randomized crossover design (minimum washout period: 1-week). Variables were recorded before (baseline), and for 120 min after drug administration. A split plot design model compared cardiopulmonary data (mean±SD) (p<0.05). Because of marked increases in SVRI (dynes•seg/cm5/m2) after morphine (353% increase from baseline at 5 min, one animal tested positive for an outlier detection test (Grubbs' test) and was not included in the statistical analysis for hemodynamic data. Baseline variables did not differ among treatments. Morphine reduced HR (beats/min) compared to baseline from 30-120 min (lowest value: 8611 at 120 min), while CI (L/min/m2) was reduced from baseline at 120 min (4.40±1.07). Compared to morphine, MET1 caused greater and more prolonged reductions in these parameters (lowest values: 63±16 and 2.95±1.06 for HR and CI, respectively), while intermediate reductions in HR and CI were observed after MET0.5 (lowest values: 78±9 and 3.72±0.81 for HR and CI, respectively). The SVRI was increased after methadone only, with MET1 producing a higher SVRI than MET0.5 (highest values: 3192±882 and 2178±588 for MET1 and MET0.5, respectively). Morphine increased PAOP (mm Hg) from baseline at 5 min (12±4), while this parameter remained increased from baseline for 90 and 120 min after MET0.5 (maximum increase: 163) and MET1.0 (maximum increase: 173), respectively. / Mestre

I denna studie undersöker vi vilka samband som finns mellan lagidrott och temana, narkotika, välbefinnande, alkohol samt motivation. Data har samlats in från 78 respondenter i urvalsgruppen, pojkar i åldrarna 15–18 år aktiva inom lagidrott, samt jämförts med kontrollgruppen i samma ålder och könskategori från Centralförbundet för alkohol- och narkotikaupplysning CAN (Gripe &amp; Thor, 2017) gällande temana alkohol och narkotika. Relevant tidigare forskning och teorin socialisation har nyttjats vid analys och diskussion kring resultatet i vår studie. Resultatet tyder på att det finns en mängd positiva effekter förknippade med lagidrott och att de motivationsfaktorer och orsaker respondenterna valt är kopplade till deras välbefinnande. Dessa positiva effekter och det ökade välbefinnande kan antas leda till ett lägre bruk av alkohol och narkotika då våra respondenter utmärker sig i att de ligger under genomsnittet i kontrollgruppen.

Sveriges narkotikapolitik har en tydlig noll vision; Sverige skall bli ett drogfritt samhälle. För att uppnå det målet följer Sverige en så kallad nolltoleransmodell, vilket innebär en strikt policy som säger att all hantering och bruk oavsett volym och syfte är olagligt. Jag argumenterar att det är en skadlig och ineffektiv policy att applicera på drogproblematiken i Sverige och argumenterar därför istället för att införa en så kallad skadereducerande policy. Detta är istället en policy som accepterar att droger är en del av samhället. En sådan policy jobbar främst med förebyggande och behandlande åtgärder, jag argumenterar för en avkriminalisering av personligt bruk av drog. Jag kommer använda mig av empirisk källor och moralfilosofiska argument för att påvisa att en skadereducerade policy gynnar samhället både ur ett socialt och ekonomiskt perspektiv.

Substance use disorders (SUDs) affect a significant portion of the population and are noteworthy public health concerns. Mutual help organizations (MHOs) such as Alcoholics Anonymous and Narcotics Anonymous are considered evidence-based practices for SUDs. Despite a growing body of research examining mechanisms of change in MHOs, relatively few investigations of 12-step organizations have been theory-driven. Theory-based models of recovery provide a more comprehensive view of the range of individual factors affecting individuals in recovery and how and why they might engage in recovery-related behaviors. Stress and coping theory fills a gap in explaining how improvements occur as a result of MHO recovery engagement from a bio-psycho-social perspective. Although some recovery program-related mechanisms of change in MHOs have proven to be important factors in promoting long-term recovery from SUDs, fewer studies have examined what factors may influence participation in recovery practices. Using a sample of community-based Narcotics Anonymous members from 26 U.S. states, the relationships between stress and engagement in various recovery practices are examined from the perspective of a psychobiological, SUD-specific stress and coping framework. It is hypothesized that the relationship between stress and recovery practice engagement is moderated by abstinence duration, such that individuals at lower levels of abstinence duration would have fewer coping resources to mitigate stress and therefore would evidence a greater association between stress and engagement in higher levels of recovery practices. Results indicated the stress-recovery practice involvement relationship was not moderated by abstinence duration, and stress was not significantly associated with any recovery practices. However, helpfulness of social support received from individuals in recovery, abstinence duration, neuroticism, and substance use severity all significantly predicted recovery practice involvement. Gaining additional understanding of mechanisms that influence recovery involvement will allow clinicians and researchers to enhance interventions and facilitate involvement in beneficial aspects of recovery programs.

Approximately 10% of adults living in the United States meet criteria for a Substance Use Disorder. Although 12-step groups are considered evidence-based practices for substance use problems, an understanding of the underlying mechanisms by which they facilitate recovery practices remains in its infancy. The purpose of the current study was to explore whether attachment could be considered a possible mediator of the effects of recovery practices on positive psychosocial outcomes. Participants (N = 112) were self-identified NA members from 26 U.S. states who completed an online survey assessing attachment style, psychosocial sense of community, psychological well-being, and various other recovery and psychosocial constructs. Results indicated a number of recovery-related practices emerged as significant predictors of secure attachment, over and above covariates. For example, higher levels of home group comfort were associated with increased probability of secure attachment classification (by self-report). In general, psychological sense of community did not significantly predict secure attachment, over and above covariates. Although attachment predicted psychological well-being in univariate models, it generally failed to predict psychological well-being in models that included covariates and recovery-related predictors. Theoretically, these data suggest that functional social support variables are primary recovery-related predictors implicated in NA-involvement, above and beyond other structural social support variables. This further suggests that attachment-related dimensions of 12-step interventions may be integral to recovery outcomes.

In drug analysis, different kinds of immunoassays are often used as an initial screening for urine samples. The positive screening results are then followed by a confirmatory test, which consists of mass spectrometry methods to detect the drugs. The confirmatory tests are considered to be more resistant to manipulation than the screening tests. If the tested person wants to obtain a false negative result in the drug analysis, there are a lot of different manipulation strategies available today. Manipulation of urine with oxidants before the drug analysis, oxidizes the drugs, and obtains negative results. The aim of this study was to investigate how the results of the drug analysis with the screening test; cloned enzyme donor immunoassay (CEDIA) and the confirmatory test; liquid chromatography- high resolution mass spectrometry (LC-HRMS), were affected when the urine was manipulated with oxidants before the analysis.  Four different oxidants (pyridinium chlorochromate, hypochlorite, sodium nitrite and povidone iodine) in three different concentrations, were investigated and evaluated on 37 different drugs with LC-HRMS. The most effective oxidant and the most adulterated drugs were then further investigated with LC-HRMS, CEDIA and with urine adulteration test strips. The results of the drug analysis were affected by the oxidants with both the CEDIA, and LC-HRMS analysis. All samples containing pyridinium chlorochromate and hypochlorite obtained negative results with CEDIA. With LC-HRMS, the tested samples containing 1 % hypochlorite effectively lowered the drug concentrations under the cut-off. Adulteration tests can be used to identify urine samples, manipulated with oxidants.

Bakgrund: Substansbrukssyndrom är en sjukdom som påverkar flera miljoner individer i världen idag, varav sjuksköterskor är en särskilt utsatt grupp. Detta bland annat på grund av tillgängligheten till narkotika på arbetsplatserna. Trots detta råder det stor kunskapsbrist kring ämnet. Det medför att omvårdnadsarbetet kan påverkas negativt, och patienter, kollegor och den missbrukande sjuksköterskan själv kan utsättas för risker. Syfte: Att beskriva sjuksköterskans upplevelse av personligt substansmissbruk och missbruksrehabilitering. Metod: Litteraturstudien baserades på åtta kvalitativa studier inhämtade genom databassökningar i CINAHL och PubMed. Analyserades med Fribergs femstegsmodell.Resultat: Fyra huvudkategorier framkom ur analysen: ”Orsaker till missbruket”, “missbrukets konsekvenser”, “Att konfrontera missbruket” samt “rehabilitering”. Huvudkategorierna delades upp i 8 underkategorier. Konklusion: Missbruk leder till sociala och ekonomiska konsekvenser för sjuksköterskan samt kan negativt påverka kvaliteten på patientens vård. Det finns effektiva interventioner men upplevelsen av dessa varierar och är beroende av flera faktorer. Det finns ett kunskapsgap och det behövs mer forskning kring frågan. / Background: Substance use disorder is a disease that afflicts millions of individuals worldwide today, of which nurses are vulnerable as a group because of the easy access to narcotics amongst other reasons. Despite this, there is a great lack of knowledge about the subject. This affects the nursing care negatively, and patients, colleagues and the substance abusing nurse themselves can be put at risk. Aim: To describe the nurses’ experience of personal substance abuse and rehabilitation. Methods: This literature study is based on eight qualitative studies acquired through database-searches in CINAHL and PubMed, the analysis was conducted using Friberg`s five step model. Results: Four main categories were found through the analysis: “Causes for substance abuse”, “consequences of substance abuse”, “Confronting the substance abuse” and “rehabilitation”. The main categories were divided into 8 subcategories. Conclusion: Substance abuse leads to social and economic consequences for the nurse and can negatively affect the quality of the patient's care. There are effective interventions but the experiences of these vary and are dependent on multiple variables. There is a lack of research on the subject, and more is needed.

Syftet med denna studie var att titta på kriminalitet, brottsutsatthet och narkotika ien ungdomsgrupp. Även samband mellan dessa tre variabler studerades. Dettagjordes genom en enkätstudie som besvarades av gymnasieungdomar i åldrarna16-21 år. Tidigare forskning på området visar att den mest förekommandenarkotikasorten som ungdomar provar är marijuana. Lindrigare stöldbrott, somsnatteri, är enligt tidigare studier det vanligaste brottet. 12,7 % av deltagarna idenna studie har någon gång provat narkotika och det vanligaste brottet somungdomar har begått är lindrigare stöldbrott. I studien kommer vi fram till att detfinns ett samband, både mellan kriminalitet och narkotikaanvändning, ochbrottsutsatthet och narkotikaanvändning. Sambandet med att ha provat narkotikavar starkare för den egna kriminaliteten jämfört med brottsutsattheten. Socialtumgänge hade en korrelation med narkotikaanvändning där de som umgicks mermed sina vänner och ”driver runt” oftare hade provat narkotika. / The purpose with this study was to look at crime, victimization and narcotics in ayouth group. The correlation between these three variables was studied as well.This was done by doing a survey that was answered by high school students in theage between 16-21 years old. Previous research in this area has come to theconclusion that the most frequent kind of narcotics being used by youths ismarijuana. Kinds of larceny, like shoplifting, is according to previous research themost common crime performed by youths. 12, 7 % of the participants have usedsome type of narcotics and the most common crime in this youth group waslarceny. In the study we find a correlation, both between crime and use ofnarcotics, as well as between victimization and having tried narcotics. Thecorrelation between narcotic use and victimizations was stronger then the onebetween narcotics and crime. Social company had a correlation with usingnarcotics where the ones that spent more time with their friends “doing nothing”more often had used narcotics.

The purpose of this study has been to gain an understanding of how drug addicts get out of an addiction from the perspective of people who have previously been addicted to narcotics. To achieve the purpose of this study we interviewed former addicts and social workers whose work is to help drug addicts. The interviews with the informants have been semi structured where as we had prepared some open questions but also as the interviews went on we thought of follow up questions to ask. The analysis was conducted with three theories: the turning point, natural recovery and social bond. The results show that there are different ways to reach a turning point when you decide to quit the habit and then there are various factors that facilitate a person of getting out of an addiction that also prevent relapse. Furthermore, the results show that their own perspective on what mattered the most during their way out of an addiction was the support of people who had gone through the same process of changing their lifestyle. They found that fellowship is essential to recovery and relapse prevention.