Background. Little is known about longitudinal prescribing practices for psychoactive medications for individuals with intellectual disabilities and developmental disabilities (IDDD) who are living in community settings. Methods. Computerized pharmacy records were accessed for 2344 community-based individuals with IDDD for whom a total of 3421 prescriptions were written during a 17-month period of study. Forty-two psychoactive medications were rank ordered in terms of prescription frequency. Results. Fifty-two per cent (52%) of all prescriptions written during the study period were for psychoactive medications. Anticonvulsant, antipsychotic and antidepressant medications were the most commonly filled prescriptions among psychoactive medications. Sixty per cent (62%) of the study population was given prescriptions for more than one psychoactive medication and 36% received three or more psychoactive medications. During the study period there was a statistically significant increase in prescriptions filled for olanzapine, risperidone, valproic acid, and clonazepam whereas prescriptions filled for thioridazine, haloperidol, and benzotropine showed a significant decline (P < 0.05-0.001). Distribution of psychoactive drug class by age showed that the majority of prescriptions were filled for individuals between 20 and 50 years with the exception of prescriptions for psychostimulants which peaked for individuals prior to 20 years. Conclusions. (1) Analysis of pharmacy billing records provides a method for assessing prescribing patterns of psychoactive medications in community-based individuals with IDDD. (2) Polypharmacy for psychoactive medications is prevalent in this setting. (3) The second-generation antipsychotic medications are prominently represented by an increasing number of filled prescriptions during the study period.

Indiana University-Purdue University Indianapolis (IUPUI) / In this work we developed paper spray mass spectrometry methods to obtain lower detection limits for pharmaceuticals and drugs of abuse. The second chapter investigates blood fractionation membranes for their ability to obtain lysis free plasma from whole blood without changing the drug concentration relative to centrifugation. We presented a device capable of obtaining and analyzing plasma samples from whole blood and obtaining quantitative results similar to traditional methods. In the third chapter the properties of the paper substrate are investigated systematically for their impacts on ionization efficiency and recovery in combination with the solvent choice. The fourth and fifth chapters detail a simple method for lowering detection limits using a method called paper strip extraction. In this method biofluids are wicked through either sesame seed oil or solid phase extraction powder on a paper strip to concentrate and preserve (in the case of THC) analytes out of biofluids. The use of 3D printing for rapid prototyping and how it potentially impacts paper spray MS sensitivity is outlined in the final chapter.

Yes / Designer benzodiazepines are one of the primary new psychoactive substances (NPS) threats around the world, being found in large numbers in post-mortem, driving under the influence of drugs (DUID) and drug facilitated sexual assault (DFSA) cases. Even though when compared to many other NPS types, such as opioids and cathinones, there are relatively few designer benzodiazepines being monitored. Recently a new NPS benzodiazepine has been reported in Europe, the USA and Canada, desalkygidazepam, also known as bromonordiazepam. This substance is a metabolite of the pro-drug gidazepam, a drug licenced for use in Ukraine and Russia under the name Gidazepam IC®. In the paper we review what is currently known about the use, pharmacology and analytical detection of gidazepam, its metabolite desalkygidazepam, and their other possible metabolites.

The addiction psychoactive substances currently represents a major problem. The number of users of such substances has been increasing. The intravenous application of psychoactive substances is associated with many health risks. Transmission and spreading of infection is associated mainly with frequent sharing and use of needles, syringes and other instruments among the users. In recent years the spreading of hepatitides (particularly VHC) has been reported as one of serious consequences of addiction to psychoactive substances, particularly in case of intravenous application. Protection against the spreading of diseases consist mainly in the prevention. The objective of the thesis is to verify whether the people addicted to psychoactive substances are aware of risks of transmission and spreading of infectious diseases (particularly VHC) as a result of intravenous application. The research was conducted on a group of drug addicts intercepted in the network of contact center and on a group of drug addicts in a therapeutic program of a psychiatric facility. I have used the method of inquiry in the form of questionnaires. In the thesis I set five hypotheses. The first, the third and the fifth hypotheses have been confirmed. The second and the fourth hypotheses have not been confirmed. The results of the research may be used by facilities providing low-threshold services as a part of secondary and tertiary prevention and harm reduction. It may also serve as source of information for workers dealing with anti-drug issues.

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / Esta pesquisa objetiva investigar as prÃticas educativas e culturais dos usuÃrios de crack, por meio da biografia de um dependente dessa droga, enfocando os contextos e trajetÃrias que envolveram esse uso, relacionando fatos e determinantes socioculturais que colaboram na memÃria e histÃria de vida do sujeito biografado. Tem como aporte teÃrico abordagens teÃricas e diversos campos do conhecimento, como SaÃde, Sociologia e EducaÃÃo. Pelo fato de o sujeito biografado ser um morador de rua, o estudo foi realizado em vÃrios lugares, desde bares, churrascarias, residÃncia da famÃlia e atà mesmo nas proximidades das chamadas âbocas de fumoâ. Por se tratar de uma pesquisa qualitativa, a abordagem metodolÃgica à a histÃria de vida e a coleta dos dados à procedida com base na histÃria oral biogrÃfica, realizada por meio de entrevistas abertas e diÃrio de campo. Desta forma, a anÃlise dos dados està pautada nos conceitos e categorias centrais relacionados aos discursos do dependente de crack biografado. Na anÃlise da trajetÃria do uso de drogas nas falas de Bim Guerra, foi importante conhecermos aspectos que nos ajudaram a entender o porquà de as pessoas continuarem usando drogas, a despeito de toda sua negatividade e dos esforÃos empenhados em combater esse uso. Devem-se levar em consideraÃÃo os âdiferentes sujeitosâ e a subjetividade que os envolve quando fazem uso dessas substÃncias, assim como os diversos contextos culturais, educativo, fase de vulnerabilidade que cerca os adolescentes e permeiam essa realidade com base nos tÃpicos de estudo. Concluindo a anÃlise, foi percebido que embora nÃo afirmemos que o uso do crack seja uma prÃtica decorrente de outros tipos de drogas, nÃo podemos negar que a oportunidade de experiÃncia com outro tipo droga permita favorecer esta prÃtica. à essencial considerar nas falas de Bim Guerra a importÃncia do papel da famÃlia nas relaÃÃes de desenvolvimento comportamental/educacional no que diz respeito envolvimento com o uso de drogas. / Esta pesquisa objetiva investigar as prÃticas educativas e culturais dos usuÃrios de crack, por meio da biografia de um dependente dessa droga, enfocando os contextos e trajetÃrias que envolveram esse uso, relacionando fatos e determinantes socioculturais que colaboram na memÃria e histÃria de vida do sujeito biografado. Tem como aporte teÃrico abordagens teÃricas e diversos campos do conhecimento, como SaÃde, Sociologia e EducaÃÃo. Pelo fato de o sujeito biografado ser um morador de rua, o estudo foi realizado em vÃrios lugares, desde bares, churrascarias, residÃncia da famÃlia e atà mesmo nas proximidades das chamadas âbocas de fumoâ. Por se tratar de uma pesquisa qualitativa, a abordagem metodolÃgica à a histÃria de vida e a coleta dos dados à procedida com base na histÃria oral biogrÃfica, realizada por meio de entrevistas abertas e diÃrio de campo. Desta forma, a anÃlise dos dados està pautada nos conceitos e categorias centrais relacionados aos discursos do dependente de crack biografado. Na anÃlise da trajetÃria do uso de drogas nas falas de Bim Guerra, foi importante conhecermos aspectos que nos ajudaram a entender o porquà de as pessoas continuarem usando drogas, a despeito de toda sua negatividade e dos esforÃos empenhados em combater esse uso. Devem-se levar em consideraÃÃo os âdiferentes sujeitosâ e a subjetividade que os envolve quando fazem uso dessas substÃncias, assim como os diversos contextos culturais, educativo, fase de vulnerabilidade que cerca os adolescentes e permeiam essa realidade com base nos tÃpicos de estudo. Concluindo a anÃlise, foi percebido que embora nÃo afirmemos que o uso do crack seja uma prÃtica decorrente de outros tipos de drogas, nÃo podemos negar que a oportunidade de experiÃncia com outro tipo droga permita favorecer esta prÃtica. à essencial considerar nas falas de Bim Guerra a importÃncia do papel da famÃlia nas relaÃÃes de desenvolvimento comportamental/educacional no que diz respeito envolvimento com o uso de drogas. / This research aims investigating the educational and cultural practices from crack users, by the biography of a addict, focusing the contexts and paths that evolved this use, relating sociocultural facts and determinants which collaborate in the memory and life history of the biography subject. It has as theoretical contribution approaches from several authors and several fields of knowledge, as Healthy, Sociology and Education. By the fact the biography subject is a homeless, the study was accomplished in many places, from bars, steakhouses, the family residence, and even near the called âbocas de fumoâ. By treating this as a qualitative research, the methodological approach is the life history and the data collection is proceeded on the basis of the biographical oral history, accomplished by the open interview and field journal. In this way, the data analysis is guided in concepts and central categories related to the biography crack addictâs speech. In the pathâs analysis of drug using in the speech of Bin Guerra, it was important for us to know some aspects that helped to understand the reason why people still use drugs, despite all its negativity and the committed efforts to fight against this using. It must be considered the âdifferent subjectsâ and the subjectivity involved when they make use of these substances, as the diverse cultural, educative contexts, vulnerability phase that surrounds teenagers and permeates that reality based on the study topics. Concluding the analysis, it was noticed that even we cannot affirm that the crack use can become a practice resulted of other kinds of drugs, we cannot deny the experience opportunity with other kind of drug allows to favor this practice. It is essential to consider, in the speech of Bim Guerra, the importance of family role in the relation of behavior/educational development, concerning the involvement with the use of drugs. / This research aims investigating the educational and cultural practices from crack users, by the biography of a addict, focusing the contexts and paths that evolved this use, relating sociocultural facts and determinants which collaborate in the memory and life history of the biography subject. It has as theoretical contribution approaches from several authors and several fields of knowledge, as Healthy, Sociology and Education. By the fact the biography subject is a homeless, the study was accomplished in many places, from bars, steakhouses, the family residence, and even near the called âbocas de fumoâ. By treating this as a qualitative research, the methodological approach is the life history and the data collection is proceeded on the basis of the biographical oral history, accomplished by the open interview and field journal. In this way, the data analysis is guided in concepts and central categories related to the biography crack addictâs speech. In the pathâs analysis of drug using in the speech of Bin Guerra, it was important for us to know some aspects that helped to understand the reason why people still use drugs, despite all its negativity and the committed efforts to fight against this using. It must be considered the âdifferent subjectsâ and the subjectivity involved when they make use of these substances, as the diverse cultural, educative contexts, vulnerability phase that surrounds teenagers and permeates that reality based on the study topics. Concluding the analysis, it was noticed that even we cannot affirm that the crack use can become a practice resulted of other kinds of drugs, we cannot deny the experience opportunity with other kind of drug allows to favor this practice. It is essential to consider, in the speech of Bim Guerra, the importance of family role in the relation of behavior/educational development, concerning the involvement with the use of drugs.

The idea that humans and laboratory animals can become physically dependent on marijuana or its primary psychoactive constituent, delta-9-tetrahydrocannabinol (THC), is gaining acceptance. However, there are no currently approved pharmacotherapies to treat cannabinoid withdrawal. The objective of this thesis was to evaluate whether elevating endogenous anandamide levels using mice lacking fatty acid amide hydrolase (FAAH), the enzyme responsible for anandamide metabolism, would ameliorate THC dependence. Mice were treated subchronically with a low or high THC dosing regimen and challenged with the CB1 receptor antagonist, rimonabant, to precipitate withdrawal. Following subchronic THC treatment, rimonabant precipitated a significant increase in paw flutters that was dependent on THC dose. However, FAAH-/- mice displayed a similar magnitude of withdrawal responses as wild type control mice, regardless of subchronic dosing regimen. Finally, rimonabant was equipotent in precipitating withdrawal responses in both genotypes. Collectively, these results demonstrate that FAAH-/- and +/+ mice show identical THC dependence, thus arguing against the notion that elevating anandamide levels through FAAH suppression will reduce cannabinoid withdrawal.

O presente trabalho propõe uma análise do uso religioso da ayahuasca como um problema público. Partindo de uma interlocução com um conjunto de discussões teóricas e metodológicas presentes no debate sobre secularismo e no pragmatismo francês, a pesquisa volta-se para as análises dos processos de regulamentação da ayahuasca para o uso religioso e do reconhecimento dos grupos ayahuasqueiros enquanto religiões em dois contextos distintos: o Brasil e o caso dos estados do Oregon e Novo México nos Estados Unidos. Mais especificamente o foco reside na investigação dos modos pelos quais uma série de atores disputam e se articularam em torno da definição de categorias e argumentos, bem como do estabelecimento de normatividades concernentes às práticas associadas ao uso da bebida no Brasil e nos Estados Unidos, procurando apreender a emergência do uso religioso da ayahuasca enquanto um problema público nos países em questão. / This work proposes an analysis of the religious use of ayahuasca as a public problem. Based on a dialogue with a set of theoretical and methodological issues concerning the debates on secularism and the approach presented by French pragmatism, the research turns to the analysis of the regulation processes of ayahuasca for religious use and the recognition of ayahuasca groups as religions in two distinct settings: Brazil and the cases of the states of Oregon and New Mexico in the United States. More specifically, the focus is to investigate the ways in which a series of actors contend and articulate around the definition of categories and arguments, as well as the establishment of norms concerning the practices associated to the use of the drink in Brazil and in the United States. The goal is to ascertain the emergence of the religious use of ayahuasca as a public problem in the countries in question.

Existem evidências da relação entre espiritualidade e saúde, e também de que o exercício da dimensão espiritual tem potencial para estimular mudanças positivas entre usuários de álcool ou de outras drogas em processo de reabilitação. Este estudo teve como objetivo avaliar a relação entre espiritualidade e os níveis motivacionais (Modelo Transteórico) entre indivíduos que fazem uso nocivo ou são dependentes de substâncias psicoativas, em tratamento ou membros do grupo de mútua-ajuda e avaliar o desempenho da versão traduzida e adaptada da Spirituality Self Rating Scale (SSRS). O desenho metodológico do estudo é do tipo transversal. Um questionário foi elaborado contendo informações sociodemográficas e escalas de motivação e espiritualidade - URICA e SSRS, respectivamente. A amostra foi constituída de 138 (69%) indivíduos do sexo masculino. Participaram usuários vinculados a um grupo de AA, um serviço de CAPS-ad e três Comunidades Terapêuticas (evangélica, católica e sem vinculação religiosa). Dentre os resultados, foi encontrado que os entrevistados apresentaram idade média de 39 anos, católicos 71(51,4%), praticantes 83(60,1%). A maioria respondeu que a substância psicoativa consumida pela última vez foi o álcool 65(47,1%) e que 49(35,5%) usam ou usaram substâncias psicoativas por mais de 10 anos, todos ou quase todos os dias 90(60,2%). A escala SSRS apresentou bom índice de confiabilidade, com alfa de chronbach global de 0,8333, variando de 0,7028 a 0,8878. Não houve relação estatística significante entre espiritualidade e aspectos da vida religiosa dos indivíduos. A maioria 84(60,8%) considera espiritualidade diferente de religiosidade. Os estágios motivacionais que apresentaram relação com espiritualidade foram a pré-contemplação, a ação e a manutenção, mediante a análise de regressão linear múltipla. Os resultados nos fazem refletir que o exercício da dimensão espiritual em cada um dos estágios pode ser pensada no sentido de estimular o indivíduo a obter sucesso no processo de mudança de comportamento em relação ao uso de substância e na reabilitação em diversos contextos. A escala SSRS pode ser recomendada para uso, apesar de suas limitações. Concluímos que existe a necessidade de sucessivas avaliações dos processos que envolvem os aspectos da espiritualidade no contexto do tratamento e motivação na mudança de comportamentos em relação ao abuso e dependência de substâncias psicoativas. / There are evidences of the relationship between spirituality and health and also that the exercise of spiritual dimension has potential to stimulate positive changes among users of alcohol or other drugs, in the rehabilitation process. This study aimed to evaluate the relationship between spirituality and motivational levels (Transtheorical Model) among individuals who make harmful use or are dependent on psychoactive substances, in treatment or members of a group of mutual-help, and evaluate the performance of translated and adapted version of Spirituality Self Rating Scale (SSRS). The methodological design of the study is made on transversal type. A questionnaire was drawn up, containing sociodemographic information and motivation and spirituality scales - URICA and SSRS, respectively. The sample consisted of 138 (69%) males. Participating users were linked to a group of AA, a service of CAPS-ad and three Therapeutic Communities (evangelical, catholic and without religious ties). Amidst the results, it was found that the respondents had an average age of 39 years, catholics 71 (51.4%) and practitioners 83 (60.1%). The majority answered that the consumed psycoative substance for the last time was alcohol 65 (47.1%) and 49 (35.5%) use or used psychoactive substances for over 10 years, all or almost all day 90 (60,2%). The SSRS scale showed good index of reliability, with overall alpha of chronbach 0.8333, ranging from 0.7028 to 0.8878. There was no statistically significant relationship between spirituality and religious aspects. Most 84 (60.8%) considers spirituality different from religiosity. The motivational stages that showed association with spirituality were pre-contemplation, action and maintenance, through linear multiple regression analysis. The results make us reflect that the exercise of spiritual dimension in each stage can be considered to stimulate the individual to succeed in the process of behavior changing, in relation to the use of substance and rehabilitation in various contexts. The scale SSRS can be recommended for use, despite its limitations. We conclude that there is a need of successive assessments of the processes involving the aspects of spirituality, in context of treatment and motivation in the behavior changing, in relation to abuse and dependence of psychoactive substances

Novel Psychoactive Substances (NPS) also known as "legal highs" replicate the effects of illegal substances such as ecstasy and cocaine. The most common NPS reported are stimulants and synthetic cannabinoids. Despite the Psychoactive Ban (2016) recent reports identified the UK as having the largest market of NPS use anywhere in Europe. These substances have a short history of consumption and consequently little is known about their effects and health implications. Despite this, the sale of NPS is easily achieved through the internet and street dealers. Increased reports of negative health consequences from NPS consumption and research findings highlighting the willingness of young people to consume drugs without knowing what they are, mean it is vital that we investigate young people's understandings and perceptions of them. At present there are very few in-depth qualitative studies on NPS. A series of 7 focus groups with a range of young people (40=N: aged 16- 24 years) across the Merseyside area were carried out. Research sites included colleges, youth groups, supported living accommodations, and youth drug and alcohol services. Focus group interviews explored participants' perceptions of NPS and were followed up with a few semi structured interviews with selected participants. The direction of the study focused on mainly on synthetic cannabinoids which may reflect the age of the study's population. Using thematic analysis informed by a social constructionist perspective, three main themes were identified around stigma and identity, attractive features of NPS and risk. Findings showed that young people's perceptions of these substances were dependent on their level of experience with illegal substances and NPS. A novel finding was that synthetic cannabinoid use is employed in the normalisation of cannabis use. Local, national and policy recommendations are made on how youth and health services in both educational and specialised services could work more closely and effectively with young people NPS. They also identify a need among young people for specific guidelines on how to use the Internet and Print media in relation to previous knowledge and experience.

O trabalho é uma atividade que sempre fez parte da humanidade, sendo um importante fator para a qualidade de vida, contudo, pode também produzir sofrimentos e gerar adoecimentos, em especial quando as relações que se dão neste ambiente não oferecem o apoio necessário para o combate do estresse e desgastes do dia-a-dia. Esta pesquisa teve por objetivo investigar a influência das relações de trabalho e do apoio social na saúde mental de mulheres costureiras. Trata-se de um estudo transversal, descritivo e exploratório com combinação de abordagens quantitativas e qualitativas que foi realizado com 56 costureiras de quatro fábricas de costura do município de Formiga - MG. Os dados relacionados ao apoio social e condições de saúde mental foram obtidos através de três escalas psicométricas, a saber: Escala de percepção de Suporte Social no Trabalho (EPSST), SRQ - 20 (Self-Report Questionarie) e Teste de Triagem do Envolvimento com Álcool, Tabaco e Outras Substâncias (ASSIST). Os scores obtidos de cada escala foram submetidos aos testes estatísticos não paramétricos de Qui-quadrado (chi-square tests) e teste exato de fisher (fisher`s exact tests) juntamente com os dados sociodemográficas, com objetivo de verificar a associação entre as variáveis. Foi também realizado um grupo focal com o objetivo de averiguar a partir da percepção das costureiras se as relações de trabalho contribuem para o adoecimento mental dessas mulheres. Durante a realização do estudo, foram considerados, todos os aspectos éticos das diretrizes e normas propostos pela resolução 466/2012 do Conselho Nacional de Saúde para as pesquisas envolvendo seres humanos, com aprovação do Comitê de Ética e Pesquisa da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo. Quanto aos resultados, houve predominância de trabalhadoras com baixa escolaridade, que se autodeclaravam brancas e que não possuíam companheiro. Baseando-se no score do SRQ -20 foi identificado que mais da metade das costureiras entrevistadas (53,6%) apresentaram sintomas indicativos de transtornos mentais comuns, sendo que a maioria destas, referiram não receber ou ter dúvidas sobre o apoio social no trabalho, porém, não foi identificado associação significante entre o score dessas variáveis. Houve uma baixa prevalência do uso de substâncias psicoativas entre as mulheres entrevistadas. Foi também possível identificar que a atividade de costureira apresenta muitas características de precarização e que essas trabalhadoras percebem suas relações de trabalho como apoiadoras e também identificam nestas relações situações estressantes que contribuem para o desgaste e sofrimento / Work is an activity that has always been part of humanity, being an important factor in one\'s quality of life, however, it can also produce suffering and generate illnesses, especially when the relationships that occur in working environment do not offer the necessary support to fight stress and distress from work routine. This research aimed to investigate the influence of labor relations and social support on the mental health of seamstresses. This is a cross-sectional descriptive study with combination of quantitative and qualitative approaches and was conducted with 56 seamstresses of four sewing factories from Formiga- MG. The data relating to social support and mental health conditions were obtained by applying three psychometric scales, namely: the perceived social support scala (EPSST), SRQ - 20 (Self- Report questionarie) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The scores obtained from each scale were submitted to nonparametric statistical tests Chi-square and Fisher\'s exact test with the sociodemographic data, in order to verify the association between those variables. A focus group has been conducted in order to ascertain wether labor relations contribute to mental illness of these women from their perception. During the study, all ethical guidelines and standards proposed by Resolution 466/2012 of the National Health Council for research involving human subjects have been considered, with the approval by the Ethics and Research Committee of the Ribeirão Preto School of Nursing University of São Paulo. Regarding the results, there was a predominance of female workers with low education, which self-declared white and had no husband or non-marital partner. Relying on the SRQ -20 score it has been identified that more than half of the interviewed seamstresses (53.6%) had indicative symptoms of common mental disorders, and most of them, said they did not receive or have doubts about the social support at work. Significant association between the scores of these two latter variables was not identified. There was a low prevalence of substance use among the interviewed women. It was also possible to identify that the sewing activity has many precarious features and that these workers perceive their labor relationships as supportive and also identify stressful situations in these relationships that contribute to the distress and suffering