Navegando por Palavras-chave "Dependence"

Agora exibindo 1 - 14 de 14
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Associação entre polimorfismo SLC6A3 3 UTR VNTR e a resposta ao tratamento da dependência de nicotina
    (Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2011-01-01) Focchi, Gustavo Rubino de Azevedo [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; Scivoletto, Sandra; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the association between response to treatment of nicotine dependence with bupropion and the presence of the polymorphism SLC6A3 3 UTR VNTR, in the gene that codifies the dopaminergic transporter. Method: A hundred patients were treated in the Nicotine Dependence Outpatient Clinic of the Institute of Psychiatry, University of São Paulo Medical School. All patients were male, diagnosed as nicotine dependents and had no other diseases. All received bupropion until 300 mg a day for 12 weeks, combined with cognitive-behavioral group therapy. The Fagerström Scale was applied at the beginning and at the end of treatment. Cigarette cessation was evaluated in the last week of treatment and one month later. Patients had 10 ml blood extracted and genotiped for SLC6A3 3 UTR VNTR polymorphism. Results: There was no association between cigarettes cessation and the presence of polymorphism. Conclusion: More studies are needed to assess whether the presence of polymorphism SLC6A3 3 UTR VNTR could be associated with a better response to treatment of nicotine dependence.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Co-morbidade psiquiátrica em dependentes de substâncias psicoativas: resultados preliminares
    (Associação Brasileira de Psiquiatria - ABP, 1999-09-01) Silveira, Dartiu Xavier da [UNIFESP]; Jorge, Miguel Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Proper psychiatric evaluations are seldom performed on drug addicts. Failure in recognizing dual diagnosed patients frequently results in inadequate treatment interventions. The objective of the present study was to evaluate the incidence of psychiatric disorders in drug addicts. METHODS: Psychiatric morbidity was studied within a sample of 50 drug dependent men randomly selected from an outward treatment facility. Research Diagnostic Criteria (RDC) were used for diagnostic assessment. RESULTS: Lifetime and current prevalence of some mental disorder were of 77% and 72 %, respectively. Thirty-two percent of the subjects presented a depression diagnosis at the time and 44 % met diagnostic criteria for lifetime diagnosis of depression. Depressive disorders somehow seemed to precede drug dependence in 77,3 % of the cases. Also, frequencies of other psychiatric disorders were higher among addicts than within the community. Results from this study were compared with similar international studies. CONCLUSION: The link between psychopathology and drug dependence justifies the importance of specific strategies for the treatment of dual diagnosed addicts.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Dependência da prática de exercícios físicos: estudo com maratonistas brasileiros
    (Sociedade Brasileira de Medicina do Exercício e do Esporte, 2003-02-01) Rosa, Daniel Alves [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Souza-Formigoni, Maria Lucia Oliveira de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This study aimed at testing, in a sample of Brazilian marathon runners, the Brazilian adaptation of the Negative Addiction Scale (Haley & Bailey, 1982). Methods: 59 marathon runners of a team from São Paulo were asked to fill out the Brazilian version of the Negative Addiction Scale. Most of the sample was made up by men (72%) aged 34 ± 7; 77% of whom had been running four to five times a week (42.5%) for two to eight years; 81% spent one to two hours a day training. The average score in the Negative Addiction Scale was 5.2 ± 2.5 (the scale scores from 0 to 14). The correlation between total score in the scale and each of the 23 questions was significant in 10 of them. The positive answers which presented higher sensitivity were: I feel something is missing when I don't run (r = 0.61); Running has influenced my lifestyle (r = 0.58), and I experience a great pleasure when I run (r = 0.56). Conclusion: The mean score in the Brazilian sample was similar to that described by the authors of the original instrument, suggesting that the translation did not affect the sensitivity of the instrument and that it can be useful in the study of running or physical activity dependence in Brazilian athletes.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Dependência de opioide em pacientes com dor crônica
    (Sociedade Brasileira para o Estudo da Dor, 2011-06-01) Nascimento, Daiana Ciléa Honorato [UNIFESP]; Sakata, Rioko Kimiko [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Although opioids are useful to treat chronic non-oncologic pain, there are caveats, especially due to abuse and dependence. This study aimed at reviewing the use of opioids in chronic non-oncologic pain. CONTENTS: Definitions of tolerance, abuse and dependence, the incidence of opioid use and dependence in chronic pain patients, risk factors, dependence signs, strategies to decrease risk and pain treatment in dependent patients were described. CONCLUSION: Both diagnosis and treatment of opioid-dependent patients may be difficult. However, pain cannot be subtracted and the physician must be aware of changes indicating abuse. So, the medical understanding about opioids dependence has to be accurate to allow for better management.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Dependentes de amor e sexo: um estudo aproximativo
    (Universidade Federal de São Paulo, 2019-12-12) Oliveira, Paulo José [UNIFESP]; Thomaz, Silvia Maria Tagé [UNIFESP]; Estevão, Ana Maria Ramos [UNIFESP]; http://lattes.cnpq.br/2205537046844581; http://lattes.cnpq.br/2147936574575153; http://lattes.cnpq.br/9870050710486759; Universidade Federal de São Paulo (UNIFESP)
    Desenvolver um trabalho de monografia envolvendo um tema de inexplicável densidade como a dependência de amor e sexo, trazendo à luz do conhecimento a inquestionável relevância do tema e a emergência da promoção de sua discussão, reflexão e debates, não constituiu uma tarefa nada fácil, ficando a incerteza de qual o melhor caminho para construir esse chamamento. Portanto a metodologia aplicada foi a da busca de literatura que dialogasse e promovesse uma aproximação com o tema, num processo de construção de pensamento empírico e cognitivo sobre os textos de referência utilizados. Houve que extrair destes a indicação do melhor caminho a ser percorrido, num ambiente de total anonimato e sigilo, envolvido numa bruma espessa, sem referências específicas, o que indica na própria construção do saber, que os dependentes de amor e sexo, contam com eles próprios, ou em ação conjunta por entre iguais, pressupõe-se ser um número ínfimo de pessoas que cheguem aos grupos de apoio, até por se colocarem numa condição de total invisibilidade por motivos aparentemente evidentes, o silêncio imposto ao sexo e a sexualidade, e que é apontado neste trabalho. O agir dos dependentes de amor e sexo são uma expressão desta condição. Precisam juntar forças sós, seguir abatidos pelos desgastes emocionais intermináveis e também pelos ininterruptos enfrentamentos consigo mesmo e com sua “consciência”. Outro desafio permanente é sensível construção do convívio e das relações sociais que precisam estabelecer, frente a dependência que possuem; faz-se imprescindível estabelecer o controle de suas inquietações, impulsos e rompantes ao máximo. E nesta perspectiva ficarem isolados e sós buscarem meios de atenderem seus chamamentos, sua “autoajuda”, buscarem por si os meios de cuidados e assistências que requerem as suas demandas específicas, sem de modo algum deixar transparecer a natureza de tais. E alguns, contando com a sorte; num ato desesperado, por serem mais articulados e/ou impetuosos, busquem ajuda alheia, com a esperança de encontrarem pessoas sensíveis e abnegadas, que estejam dispostas a dar escuta, e mais, possam e queiram empaticamente estenderem suas mãos, para tentar próximos aos dependentes, encontrar meios para a atenção das situações-problema e demandas apresentadas, por que as soluções, estas até onde esta pesquisa pode alcançar, não as terão.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies
    (Elsevier B.V., 2015-04-01) Fischer, Benedikt; Blanken, Peter; Da Silveira, Dartiu [UNIFESP]; Gallassi, Andrea; Goldner, Elliot M.; Rehm, Juergen; Tyndall, Mark; Wood, Evan; Ctr Addict & Mental Hlth; Simon Fraser Univ; Univ Toronto; Parnassia Addict Res Ctr; Universidade Federal de São Paulo (UNIFESP); Fed Univ Brasilia; British Columbia Ctr Dis Control; Univ British Columbia; BC Ctr Excellence HIV AIDS
    There are an estimated several million crack-cocaine users globally; use is highest in the Americas. Most crack users are socio-economically marginalized (e.g., homeless), and feature elevated risks for morbidity (e.g., blood-borne viruses), mortality and crime/violence involvement, resulting in extensive burdens. No comprehensive reviews of evidence-based prevention and/or treatment interventions specifically for crack use exist. We conducted a comprehensive narrative overview of English-language studies on the efficacy of secondary prevention and treatment interventions for crack (cocaine) abuse/dependence. Literature searches (1990-2014) using pertinent keywords were conducted in main scientific databases. Titles/abstracts were reviewed for relevance, and full studies were included in the review if involving a primary prevention/treatment intervention study comprising a substantive crack user sample. Intervention outcomes considered included drug use, health risks/status (e.g., HIV or sexual risks) and select social outcome indicators. Targeted (e.g., behavioral/community-based) prevention measures show mixed and short-term effects on crack use/HIV risk outcomes. Material (e.g., safer crack use kit distribution) interventions also document modest efficacy in risk reduction; empirical assessments of environmental (e.g., drug consumption facilities) for crack smokers are not available. Diverse psychosocial treatment (including contingency management) interventions for crack abuse/dependence show some positive but also limited/short-term efficacy, yet likely constitute best currently available treatment options. Ancillary treatments show little effects but are understudied. Despite ample studies, pharmacotherapeutic/immunotherapy treatment agents have not produced convincing evidence; select agents may hold potential combined with personalized approaches and/or psycho-social strategies. No comprehensively effective 'gold-standard' prevention/treatment interventions for crack abuse exist; concerted research towards improved interventions is urgently needed. (C) 2015 Elsevier B.V. All rights reserved.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    The Effectiveness of Treatments for Cocaine Dependence in Schizophrenic Patients: A Systematic Review
    (Bentham Science Publ Ltd, 2013-09-01) Sabioni, Pamela [UNIFESP]; Ramos, Anna Carolina [UNIFESP]; Galduróz, José Carlos Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To evaluate and compare the effectiveness of available treatments for cocaine dependence in schizophrenic patients.Method: We searched articles published between May 2002 and June 2012 in the following databases: Scopus, Pubmed and Web of Knowledge. The key words utilised were schizophrenia, dementia praecox, schizophrenic disorder, cocaine related disorder, cocaine abuse, cocaine addiction, cocaine dependence, treatment, therapeutic, and drug therapy.Selection of studies and data extraction: Original articles in English, Portuguese and Spanish were selected. Controlled, double-blind and open-label studies involving only human subjects were included in this review.Data Synthesis: We found studies on typical and atypical antipsychotics and one monoamine transporter antagonist. There were few indications of the effectiveness of atypical antipsychotic medications for the treatment of cocaine dependence in patients with schizophrenia.Conclusions: We suggest that further studies be conducted with atypical antipsychotic medicationsand greater methodological strictness, including using a placebo group in the studies, so that health professionals can determine the real effectiveness of this class of medication for the treatment of cocaine dependence in schizophrenic patients.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Estudo da desprescrição do psicotrópico benzodiazepínico nas Unidades Básicas de Saúde do município de Diadema
    (Universidade Federal de São Paulo, 2022-12-20) Maia, Rafaela Silva [UNIFESP]; Fegadolli, Claudia [UNIFESP]; http://lattes.cnpq.br/6541145627909917; https://lattes.cnpq.br/6588099547407422
    Este estudo aborda a desprescrição do uso de benzodiazepínicos (BZD) para usuários crônicos desta classe de medicamentos. O uso de BZD por mais de quatro semanas pode ser prejudicial ao usuário, devido à sua capacidade de desenvolver tolerância e gerar dependência, além de provocar perda de memória, sedação excessiva e aumentar risco de queda, principalmente em idosos. O estudo foi conduzido pela Universidade Federal de São Paulo (UNIFESP) em parceria com a Secretaria Municipal de Saúde de Diadema, com a participação de sete farmacêuticos atuantes na atenção básica do município e das equipes de saúde. Todas as estratégias de ação foram delineadas no contexto do grupo de pesquisa interinstitucional e incluíram protocolos de acolhimento, atendimento e seguimento interprofissional, com abordagens individuais e coletivas. Os usuários foram avaliados clinicamente antes e depois do acompanhamento, através de escalas que mensuram níveis de ansiedade; sonolência diurna; qualidade do sono; dependência a benzodiazepínicos e qualidade de vida. O modelo de desprescrição tem se mostrado viável na abordagem clínica de usuários de benzodiazepínicos no tratamento da dependência e na interrupção do uso injustificável. Dentre os principais desafios enfrentados para a ampliação do alcance do programa estão a necessidade de ações de educação permanente para que os profissionais da atenção básica possam reorganizar práticas assistenciais a fim de considerarem o tratamento e prevenção da dependência a psicofármacos uma estratégia necessária e possível no contexto do trabalho interprofissional em saúde.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Famílias afetadas pelo parente usuário problemático de substâncias psicoativas, procurando por ajuda: quem são elas?
    (Universidade Federal de São Paulo (UNIFESP), 2016-08-17) Sakiyama, Helena Miyaco Takeyama [UNIFESP]; Laranjeira, Ronaldo Ramos [UNIFESP]; http://lattes.cnpq.br/4152477223577402; http://lattes.cnpq.br/5995511770107164; Universidade Federal de São Paulo (UNIFESP)
    Background: This study proposes to describe “Affected Family Members” (AFMs) by the “Substance Misuse Relatives”, (SMRs) in the city of São Paulo who are seeking support in Mutual Self­Help Group “Amor Exigente” and know how do they deal with addiction circunstances in the family. Method: This was a cross­sectional cohoort study of 500 families (one participant per family) applying a structured questionnaire adopted from British studies, and containing sociodemographic information, lengh of time taken to seek help, and where they sought help. Participant were recruited from the Mutual Self­Help Grupo “Amor Exigente” in the City of São Paulo, Brasil. Results: The Affected Families Members (AFM): The family members were 77% female and 23% male; most participants 63,6% were at the 45­64 age group. In total, 67.6% of the SMRs were children of the participants. Marital Status: in total, 57.5% of the participants were married in a stable union, 20.4% were divorced, 14,2% were single and 7,8% widower. Ethnic Group: 87,6 were white/caucasian, 8,2% African Brasilian, 2,8% mixted race and 1,4% Asian. The participant classification breakdown by social class was A (19.4%), B (47.8%) and C (20.6%); Admission for treatment: 72.4% of families experienced admission of their SMRs mostly in Community Therapeutics, and 72% of the families are responsible for the treatment. A range of 3,35 person live with the SMR.69% of the families had another addicted family member. Those relationships were: 38% uncle, 29% father, 27% cousins, 18% brothers, 16% grand father (mother), 10% grand father (father), 5% mothers, 6% grandmother and 1% nephews. 62% of the families didn’t know the services of CAPS AD (Centro de Atenção Psicossocial – Alcool e Drogas). 98% of the families desire total sobriety of their SMRs. Educational Level: respondents with fundamental school, 12,4%, complete secondary and incomplete higher education comprised 34.6% of the total, and those with complete higher education comprised 33.2%. The Substance misuse relatives (SMRs): 91,6% were male and 8,4% female. Age group: 7% correspond to 13 to 17 years old, 31% to 18 to 24 years old, 43% 25 to 34 years old, and 11% correspond to 35 to 44 years old . The average of age was 28,4 years old. In total, 67.6% of the SMRs were children of the participants, 11% spouse, 8,6% brothers, 4% nephew and 2,8%boy­friend or fiancée, 2% father and 4% others. On average, 2.4 substances were used, including marijuana (67.6%), cocaine (64.2%), alcohol (47.6%), and crack (38.8%). The average duration of substance abuse was 10.1 years and The average time AFM know the drug uses was 6,5 years. Crack users: 80% used marijuana, 71% used cocaine and 42% alcohol. 23% presents SMRs Psiquiatric Comorbidities: 27% depression, 21% TDHA, 16% bipolar disorder, 11% TDA, 5% anxiety. Conclusion: Families without assistance from the Public Health Authority were disoriented, suffer burden of substance use disease, and present coping styles by tolerance and covering­up of use, or withdrawal strategy denying or hiding drug use. An average of 2.6 years passes between AFMs discovering drug abuse and seeking help, and the SMRs continues to abuse drugs for 6.3 years without treatment on average. The AFMs experiences sadness, helplessness, and anguish in the face of addiction, AFMs seek help in support groups.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Percepções dos usuários de crack sobre suas relações familiares
    (Universidade Federal de São Paulo (UNIFESP), 2015-04-24) Barros, Naiara Alves de [UNIFESP]; Tucci, Adriana Marcassa [UNIFESP]; Silva, Eroy Aparecida da [UNIFESP]; http://lattes.cnpq.br/8738343026653952; http://lattes.cnpq.br/6278405456405903; Universidade Federal de São Paulo (UNIFESP)
    Drug use is a matter of public health, and the use of crack generates individual, family and social consequences, now getting worrying dimensions to the State and society in general. However, few national studies on family relationships of crack users although it is known that the family can be both a protective factor as a risk in relation to the abuse of alcohol or other drugs. This study aimed to understand the crack users perception of their family relationships. And the specific objectives were to understand the dynamics and family composition in childhood and adolescence of crack users, analyze drug use history, identify the access to health and social care services in the city of Santos / SP; and see how the public policies of health and social care are responding to the needs of crack users and their families. The method used was qualitative and the data were analyzed through content analysis. We interviewed 29 crack users of both sexes and aged eighteen years through semistructured interviews. The analysis categories were: family relationships and the fragility of bonds; crack and other drugs in the family context; family support network and access to health and social care services. Various problems faced by households related to drug use was reported, with the support of this was reported by users as an important form of motivation to control the use of this drug. The perception of crack users on its relations with the family of origin reveals the presence of several factors associated with increased vulnerability to drug use. The result of this study can help implement new forms of prevention and intervention with crack users, strengthening for public policies to take effect according to the issues presented by crack users and their families.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Superexploração da força de trabalho, uma categoria em disputa
    (Universidade Federal de São Paulo (UNIFESP), 2013-10-21) Massa, Andrei Chikhani [UNIFESP]; Amadeo, Javier [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This work is focused on exhibition and the context of the work of Ruy Mauro Marini, especially with regard to the formulation of the Marxist Theory of Dependency, which involves, in particular, the concept of overexploitation of labor power. The historical context in which the author developed his theory has significant relevance in the work and will be addressed primarily by the emergence of the Economic Commission for Latin America and the Caribbean (Cepal) and the Brazilian Communist Party (PCB), major builders and debaters of social theories in Latin America. From this exposure, the work aim to establish the importance of the legacy of Ruy Mauro Marini, pointing to several studies of his work for the present time.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    THC inhibits the expression of ethanol-induced locomotor sensitization in mice
    (Elsevier Science Inc, 2017) Filev, Renato [UNIFESP]; Engelke, Douglas S.; Da Silveira, Dartiu X. [UNIFESP]; Mello, Luiz E. [UNIFESP]; Santos-Junior, Jair G.
    The motivational circuit activated by ethanol leads to behavioral changes that recruit the endocannabinoid system (ECS). Case reports and observational studies suggest that the use of Cannabis sp. mitigates problematic ethanol consumption in humans. Here, we verified the effects of the two main phytocannabinoid compounds of Cannabis sp., cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), in the expression of ethanol-induced locomotor sensitization in mice. Male adult DBA/2 mice were exposed to locomotor sensitization by daily intraperitoneal injections of ethanol (2.5 g/kg) for 12 days; control groups received saline. After the acquisition phase, animals were treated with cannabinoids: CBD (2.5 mg/kg); THC (2.5 mg/kg); CBD + THC (1:1 ratio), or vehicle for 4 days with no access to ethanol during this period. One day after the last cannabinoid injection, all animals were challenged with ethanol (2.0 g/kg) to evaluate the expression of the locomotor sensitization. Mice treated with THC alone or THC + CBD showed reduced expression of locomotor sensitization, compared to the vehicle control group. No effects were observed with CBD treatment alone. Our findings showing that phytocannabinoid treatment prevents the expression of behavioral sensitization in mice provide insight into the potential therapeutic use of phytocannabinoids in alcohol-related problems. (C) 2017 Elsevier Inc. All rights reserved.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Use of alcohol among the inhabitants of the 107 largest cities in Brazil - 2001
    (Associação Brasileira de Divulgação Científica, 2007-03-01) Galduróz, José Carlos Fernandes [UNIFESP]; Carlini, Elisaldo Araujo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Alcohol is part of the history of humanity, seemingly as a result of countless factors including the easy production of alcoholic beverages in practically all regions of the world. The authors studied aspects of the use of and the dependence on alcohol in Brazil, through a household survey conducted by Centro Brasileiro de Informações sobre Drogas Psicotrópicas (CEBRID). A total of 8,589 interviews were held in 107 of the largest cities in Brazil, all of them with more than 200 thousand inhabitants. The study was planned to gather information within the household environment about a stratified probabilistic sample obtained in three selection phases: 1) the censitaire sectors for each municipality, 2) a systematic randomized sampling, and 3) drafting a respondent by lot in each household to provide information. Approximately 11.2% of the subjects were concerned with their own consumption of alcohol. The signs/symptoms of the syndrome of dependence evident in a greater percentage were the desire to stop or reduce the use of alcohol and to stop or reduce resorting to alcoholic beverages more often than desired, as reported by 14.5 and 9.4% of the respondents, respectively. The regions in Brazil with the highest percentage of dependents were the North (16.3%) and the Northeast (19.9%). According to the estimates obtained in the survey, 5.2% of the teenagers were concerned about the use of alcohol. The estimates obtained in this survey reveal a need to implant specific preventive programs for the problem of alcohol, especially for the very young.
  • Nenhuma Miniatura disponível
    Item
    Restrito
    O uso de terapias de substituição como prática de redução de danos na dependência de analgésicos opioides
    (Universidade Federal de São Paulo, 2021-08-06) Cotrim, Isabelle Scarpini [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; http://lattes.cnpq.br/4675292090990088
    Introdução: Opioides são substâncias importantes para o tratamento da dor em decorrência de seu potente efeito analgésico. Entretanto, o uso contínuo dessas substâncias pode desenvolver rapidamente um quadro de dependência, além disso, associa-se a síndrome de abstinência, com diversos sintomas desagradáveis. A síndrome de dependência por opioides é um problema de saúde pública atualmente nos EUA e é interessante que sirva de alerta para outros países sobre este cenário de risco. A terapia de substituição é uma prática de redução de danos importante para o tratamento da dependência por analgésicos opioides, no qual utiliza-se de medicamentos da mesma classe, porém com maior segurança para o indivíduo. Objetivo: Compreender o uso de analgésicos opioides e o emprego da terapia de substituição nos casos de dependência causados por esta classe terapêutica de medicamentos, através de uma revisão bibliográfica. Método: Para a elaboração do presente trabalho, foi realizada uma revisão da literatura disponível para os temas específicos: analgésicos opioides, dependência, redução de danos, terapias de substituição e terapias de manutenção. Revisão bibliográfica: A alta capacidade dos analgésicos opioides em desenvolver dependência está associada a interação destas substâncias com os receptores específicos, e facilmente acomete indivíduos que fazem o uso crônico do medicamento, seja um paciente em tratamento ou funcionários da área da saúde que possuem fácil acesso a estas substâncias. O cenário brasileiro indica uma crescente no número de pessoas que utilizam os analgésicos opioides, contudo, é nos Estados Unidos que se observa a criticidade desta síndrome de dependência. A terapia de substituição fornece uma possibilidade de tratamento para os dependentes de maneira segura, individual e não punitiva. A metadona e buprenorfina são dois medicamentos amplamente conhecidos e utilizados para este fim, mas há outros medicamentos importantes que agregam e diversificam as possibilidades de tratamento. Conclusão: É possível identificar a necessidade do olhar atento ao tema de terapias de substituição empregadas em casos da síndrome de dependência de analgésicos opioides; a possibilidade de manutenção do uso de um analgésico opioide de forma adequada, oferece ao indivíduo autonomia e segurança. Apesar de existirem estudos que embasem a segurança e importância dos medicamentos nesta prática, no Brasil não há um programa atenda a este grupo de dependentes e nem a execução da prática da terapia de substituição.