Navegando por Palavras-chave "crack cocaine"
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- ItemSomente MetadadadosThe Brazilian 'Cracolandia' open drug scene and the challenge of implementing a comprehensive and effective drug policy(Wiley-Blackwell, 2016) Ribeiro, Marcelo [UNIFESP]|Duailibi, Sergio [UNIFESP]; Frajzinger, Rosana; Sala Alonso, Ana Leonor; Marchetti, Lucas; Williams, Anna V.; Strang, John; Laranjeira, Ronaldo [UNIFESP]Open air drug scenes represent very substantial challenges to health and law enforcement professionals around the world, especially in LAMI countries. Crack-cocaine users have gathered for 25 years in Cracolandia (Sao Paulo, Brazil), one of the world's largest open drug scenes. Several initiatives have provided treatment, employment and accommodation, but the Cracolandia problem is complex and impact has been limited, highlighting the need for a multi-dimensional perspective and multi-agency response.
- ItemSomente MetadadadosChanges in Dopamine Transpoter During Abstinence in Crack-cocaine Users: A Study with SPECT and TRODAT-1(Elsevier B.V., 2014-05-01) Batista, Ilza Rosa [UNIFESP]; Felicio, Andre Carvalho; Jackowski, Andrea Parolin [UNIFESP]; Reis, Marilia Alves dos [UNIFESP]; Ribeiro, Wagner Silva [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Castiglioni, Mario Luiz Vieira [UNIFESP]; Lacerda, Acioly Luiz Tavares de [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hosp Israelita Albert Einstein
- ItemSomente MetadadadosCocaine - Profiles, drug histories, and patterns of use of patients from Brazil(Marcel Dekker Inc, 1999-01-01) Dunn, J.; Laranjeira, R.; Universidade Federal de São Paulo (UNIFESP)We studied profiles and drug histories of 294 cocaine users from 15 treatment services in São Paulo, Brazil during 1996-1997. Mean age of subjects was 27 years, and 90% were male. Over 50% had used five different substances apart from cocaine, usually tobacco, alcohol, cannabis, tranquilizers, and solvents. Mean age at first cocaine use was 18.9 years by which time 87% had snorted the drug. Thirty-two percent had injected cocaine, 82% had smoked crack, and 74% reported a full route transition. Sixty-three percent reported daily cocaine use. Median duration of cocaine use was 6.3 years. Acts of acquisitive crime were common, and 56% had been arrested. Our finding are discussed in terms of implications for prevention and treatment.
- ItemSomente MetadadadosContingency Management Is Effective in Promoting Abstinence and Retention in Treatment Among Crack Cocaine Users in Brazil: A Randomized Controlled Trial(Educational Publishing Foundation-American Psychological Assoc, 2016) Miguel, Andre Q. C. [UNIFESP]; Madruga, Clarice S. [UNIFESP]; Cogo-Moreira, Hugo [UNIFESP]; Yamauchi, Rodolfo [UNIFESP]; Simoes, Viviane [UNIFESP]; da Silva, Claudio J. [UNIFESP]; McPherson, Sterling; Roll, John M.; Laranjeira, Ronaldo R. [UNIFESP]Crack cocaine dependence has become a severe public health problem in Brazil, and current psychosocial approaches to this problem have shown little or no effectiveness. Although contingency management is among the most effective behavioral treatments for substance use disorders, it has never been applied in the treatment of crack cocaine-dependent individuals in Brazil. The aim of this study was to evaluate the efficacy of incorporating contingency management into standard outpatient treatment for crack cocaine dependence, as well as the impact that doing so has on treatment attendance, retention in treatment, maintenance of abstinence, and the frequency of substance use. We evaluated 65 treatment-seeking, crack cocaine-dependent individuals, randomized to receive 12 weeks of standard treatment plus contingency management (STCM
- ItemSomente MetadadadosContingency Management Targeting Abstinence Is Effective in Reducing Depressive and Anxiety Symptoms Among Crack Cocaine-Dependent Individuals(Amer Psychological Assoc, 2017) Miguel, Andre Q. C. [UNIFESP]; Madruga, Clarice S. [UNIFESP]; Cogo-Moreira, Hugo [UNIFESP]; Yamauchi, Rodolfo [UNIFESP]; Simoes, Viviane [UNIFESP]; Ribeiro, Ariadne [UNIFESP]; da Silva, Claudio J. [UNIFESP]; Fruci, Andrew; McDonell, Michael; McPherson, Sterling; Roll, John M.; Laranjeira, Ronaldo R. [UNIFESP]Although contingency management (CM) is effective in promoting abstinence and treatment retention among crack cocaine users who meet the criteria for cocaine dependence, less is known about its off-target effects. In this secondary analysis, we evaluated the impact of CM on depressive and anxiety symptoms in a sample of cocaine-dependent individuals under treatment. Sixty-five crack cocaine users who met the criteria for cocaine dependence were randomly assigned to receive 12 weeks of standard treatment alone (STA; n = 32) or 12 weeks of standard treatment plus CM (STCM; n = 33). The outcome measures of the secondary analysis were depressive and anxiety symptoms assessed with the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). At baseline, 59 (90.8%) of the participants reported at least mild depressive symptoms and 47 (72.5%) reported at least mild anxiety symptoms. The mean BDI-II (24.5 +/- 12.1) and BAI (20.7 +/- 13.5) scores in the sample as a whole was moderate. After treatment, the reported levels of depressive symptoms (beta = -9.6, p < .05 ) and anxiety symptoms (beta = -9.9, p < .05) were lower among the individuals receiving STCM than among those receiving STA. This study provides evidence that an STCM intervention targeting crack cocaine abstinence also produces significant reductions in depressive and anxiety symptoms. This low cost intervention also demonstrated significant promise and optimization potential for crack cocaine users in a setting of scarce resources and high mental health comorbidity. Relevance Statement: We found that the prevalence of depressive and anxiety symptoms were extremely high among crack cocaine users, and that, among such individuals, contingency management (CM) reduced depressive and anxiety symptomatology to a greater degree than did standard treatment. Our results suggest that CM targeting crack cocaine abuse can have off-target effects on psychiatric symptomatology. Public Health Significance The prevalence of depressive and anxiety symptoms are extremely high among crack cocaine users. Among such individuals, we found that contingency management (CM) reduced depressive and anxiety symptomatology while standard treatment did not. Our results suggest that CM targeting crack cocaine abuse can have off-target effects on psychiatric symptomatology. This study offers further support for the incorporation of CM interventions among treatment services for substance use disorders.
- ItemSomente MetadadadosCrack cocaine - A two-year follow-up of treated patients(Haworth Press Inc, 2001-01-01) Laranjeira, R.; Rassi, R.; Dunn, J.; Fernandes, M.; Mitsuhiro, S.; Universidade Federal de São Paulo (UNIFESP)Objectives: To investigate the 2-year outcome of the first 131 crack cocaine users who had been admitted for a period of inpatient treatment.Design: Follow-up study of consecutive patients admitted between 1992 and 1994.Setting: Inpatient detoxification unit of a public general hospital in São Paulo City, Brazil.Participants: 131 consecutive crack cocaine users.Measures: Reported crack use during last 12 months, incarceration and death.Findings: After 2 years, 50 patients reported crack use in the last 12 months, 29 said that they had not used it during this period, 9 were in prison, 13 had died, 2 had disappeared and no information was available on 28.Conclusions: Crack cocaine use seems to be associated with a high mortality rate and criminal involvement but about one-third of patients give up using the drug within 2 years of inpatient treatment.
- ItemSomente MetadadadosCrack cocaine: A five-year follow-up study of treated patients(Karger, 2007-01-01) Ribeiro, M.; Dunn, J.; Sesso, R.; Lima, M. S.; Laranjeira, R.; Universidade Federal de São Paulo (UNIFESP); Camden & Islington Mental Hlth & Social Care Trus; Fed Univ PelotasObjectives: To follow-up a group of 131 crack cocaine users and examine drug use, treatment experience, employment status, involvement in crime and mortality at 2 and 5 years. Methods: Consecutive crack-dependent patients who were admitted to a detoxification unit in São Paulo between 1992 and 1994 were re-interviewed on two occasions: 1995-1996 and 1998-1999. Results: 5 years after treatment information was obtained on 124 (95%) of the original cohort. 39.7% (n = 52) of the patients reported having been abstinent from cocaine for at least the last year, and 21.4% (n = 28) had used the drug. of those subjects not using cocaine at 2 years, 19 (62%) were still abstinent at 5 years. Twenty-three (17.6%) patients had died by the 5-year follow-up with homicide, due to firearms or other weapons, being the commonest cause ( n = 13). the annual adjusted mortality rate for the sample was 24.92 deaths/1,000 individuals, the excess mortality rate was of 21.64 deaths/1,000 individuals, and the standardized mortality ratio was 7.60. A history of injecting drug use, unemployment at the time of the index admission and administrative discharge at the index admission were factors that contributed to the risk of dying over the next 5 years. Conclusions: There was a progressive movement towards abstinence over the follow-up period, and there was evidence that once abstinence had been achieved it was maintained. On the other hand, the mortality rate was extremely high and was higher among those who were still using crack at 2 years. Copyright (c) 2007 S. Karger AG, Basel.
- ItemSomente MetadadadosCrack use in São Paulo(Marcel Dekker Inc, 1996-01-01) Nappo, S. A.; Galduroz, JCF; Noto, A. R.; Universidade Federal de São Paulo (UNIFESP)Documented crack use emerged in São Paulo, Brazil, from 1991 onward. Therefore, it is a recent behavior among drug users. the present work draws a profile of São Paulo crack users, employing an ethnographic approach. Twenty-five crack users were interviewed on selected social and demographic characteristics, on the drug itself and its consumption, and on the consequences of this use. Crack cocaine is harmful for the user, leading within a short period to a condition of dependence. the crack users reported ultimately lapsing into ''marginality'' due to social isolation, neglect of bodily needs, and breakdown of family ties and other relationships.
- ItemSomente MetadadadosFactors associated with adverse reactions to cocaine among a sample of long-term, high-dose users in São Paulo, Brazil(Elsevier B.V., 2004-02-01) Ferri, C. P.; Dunn, J.; Gossop, M.; Laranjeira, R.; Inst Psychiat; UCL Royal Free & Univ Coll Med Sch; Universidade Federal de São Paulo (UNIFESP)This cross-sectional survey investigates the frequency of adverse cocaine reactions and associated factors among regular cocaine misusers. A sample of 332 cocaine misusers from a range of treatment and nontreatment settings in São Paulo, Brazil, were interviewed using a questionnaire that includes the Severity of Dependence Scale (SDS), the General Health Questionnaire (GHQ-28), the CAGE, and an eight-item questionnaire investigating the frequency of specific adverse cocaine reactions. the most commonly described reactions were hot flushes (84%), uncontrollable shaking (76%), and feeling ill (75%). the most severe symptoms and least common were convulsions or fits (18%) and passing out (21%). Frequency of adverse reactions to cocaine was positively associated with out-of-treatment status, severity of cocaine dependence, ever having injected cocaine, using tranquilisers with cocaine, and GHQ score. Adverse reactions to cocaine are common among regular cocaine users. Some of the adverse effects, especially those on the heart and central nervous system, are potentially fatal. Preventive strategies should be developed to reduce the risk of adverse cocaine reactions. the findings are discussed in relation to the type of interventions that might be developed and lines of future research. (C) 2003 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosHigh mortality among young crack cocaine users in Brazil: a 5-year follow-up study(Blackwell Publishing Ltd, 2004-09-01) Ribeiro, M.; Dunn, J.; Laranjeira, R.; Sesso, R.; Universidade Federal de São Paulo (UNIFESP); Camden & Islington Mental Hlth & Social Care TrusAims Follow-up studies show that smokers, alcoholics and heroin addicts have high mortality rates, but there is little information on crack users. We have investigated the mortality rate among this population, including its risk factors and causes of death.Design A 5-year follow-up study.Participants and setting A cohort of 131. crack-dependent patients, admitted to a public detoxification unit in São Paulo between 1992 and 1994.Measurements Data collected from a structured personal interview and from a review of patients' hospital records, confirming the deaths from records held at the Municipal Offices.Findings of the 124 (94.69%) patients located, 23 (18.5%) had died (a mortality ratio of 7.6). Homicide was the most common cause of death (n = 13). Observed mortality rate, adjusted for age and sex, was 24.92 per 1000, while the expected all-cause mortality rate in São Paulo, also adjusted for age and sex, was 3.28 per 1000, giving an excess mortality rate of 21.64 per 1000. Survival analysis showed that the probability of being alive 5 years post-treatment was 0.80 (95%, CI=0.77-0.84). Cox's proportional hazards regression showed three factors predicted mortality: history of intravenous drug use (hazard ratio 3.28, 95% Cl 1.42-7.59), unemployment at index admission (hazard ratio 3.48, 95% Cl 1.03-11.80) and premature discharge from index admission (hazard ratio 2.21, CI 0.94-5.18).Conclusions Community-based and tailored interventions should be considered to improve those patients' social support and permanence in treatment.
- ItemSomente MetadadadosNeuropsychological Assessment of Current and Past Crack Cocaine Users(Informa Healthcare, 2009-01-01) De Oliveira, Lucio Garcia; Barroso, Lucia Pereira; Silveira, Camila Magalhaes; Sanchez, Zila Van Der Meer [UNIFESP]; Ponce, Julio de Carvalho; Vaz, Leonardo Jose [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Universidade de São Paulo (USP); Ctr Informat Hlth & Alcohol CISA; Brazilian Ctr Informat Psychotrop Drugs CEBRID; Universidade Federal de São Paulo (UNIFESP)Background: Cognitive changes due to crack cocaine consumption remain unclear Methods: for clarification, 55 subjects were assigned to three groups: control group, crack cocaine current users, and ex-users. Participants were submitted to Mini-Mental State Examination (MMSE) and tasks evaluating executive functioning and verbal memory Mood state was also measured. Intergroup comparisons were carried out. Results: Control group performance on the MMSE was better than that of users and ex-users. Verbal memory performance for logical memory of users was impaired. Ex-users scored lower on DSST and Trail Making Test (Part B). Conclusion: Chronic crack cocaine use seems to disrupt general cognitive functioning (MMSE), verbal memory, and attentional resources, but findings suggest that some of these effects could be reversed by abstinence.
- ItemSomente MetadadadosRoute of cocaine administration: Patterns of use and problems among a Brazilian sample(Elsevier B.V., 1999-11-01) Ferri, C. P.; Gossop, M.; Natl Addict Ctr; Universidade Federal de São Paulo (UNIFESP)Route of administration has important implications for the understanding of drug addiction and related-problems. This cross-sectional study investigates patterns of consumption and cocaine-related problems among snorting and crack cocaine users in São Paulo and outlines changes in route of cocaine administration in Brazil between 1980-1997. Crack cocaine users had more social and health problems and higher involvement in crime than intranasal users. These problems, compounded by the larger doses being used and their greater involvement in prostitution, place crack cocaine users at higher risk from HIV infection and other sexually transmitted diseases as well as other physical risks. (C) 1999 Elsevier B.V.