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The topic of human rights in the aspect of relations between the state and addicted patients (and in general relations in the sphere of circulation of drugs) remains scantily explored for modern Ukraine, which actualizes further scientific research. The purpose of the article is to determine the authors’ vision of compliance with international human rights standards of the legal anti-drug prohibitions established by the state. To achieve this goal, using the historical-legal, comparative, dialectical, systemic, hermeneutic, sociological methods and legal method of cognition, national and foreign legislation was critically analyzed, international experience in implementing various models of anti-drug policy was studied, and proposals for the draft of a new Criminal Code of Ukraine were formulated. The authors pay special attention to the problems of protecting the rights of drug addicts, legal liability in the field of drug trafficking, legalization of drugs for non-medical needs and compulsory treatment of drug addicts. El tema de los derechos humanos en el aspecto de las relaciones entre el Estado y los pacientes adictos (y en general las relaciones en la esfera de la circulación de drogas) sigue siendo escasamente explorado en la Ucrania moderna, lo que actualiza una mayor investigación científica. El objetivo del artículo es determinar la visión de los autores sobre el cumplimiento de las normas internacionales de derechos humanos de las prohibiciones legales antidroga establecidas por el Estado. Para lograr este objetivo, utilizando los métodos histórico-jurídico, comparativo, dialéctico, sistémico, hermenéutico, sociológico y el método jurídico de cognición, se han analizado críticamente la legislación nacional y extranjera, se ha estudiado la experiencia internacional en la aplicación de diversos modelos de política antidroga y se han formulado propuestas para el proyecto de un nuevo Código Penal de Ucrania. Los autores prestan especial atención a los problemas de la protección de los derechos de los drogodependientes, la responsabilidad jurídica en el ámbito del tráfico de drogas, la legalización de las drogas para necesidades no médicas y el tratamiento obligatorio de los drogodependientes.

Es fundamental conocer los procesos de reinserción de las personas drogodependientes, especialmente en las cárceles y desde una perspectiva de género. Este trabajo tiene como objetivo analizar las drogodependencias, el trato recibido por las mujeres penadas en las modalidades de régimen ordinario y régimen abierto del sistema penitenciario español y la relación con los factores que determinan sus procesos de reinserción. Se analiza una muestra de 756 mujeres penadas y 66 profesionales penitenciarios que cumplimentaron cuestionarios mixtos. Los resultados mostraron una gran presencia de drogodependencias en ambos regímenes. La mayoría de las mujeres con problemas de adicción recibieron tratamientos, aunque percibieron carencias en la perspectiva de género para reconocer sus necesidades. El tratamiento mejora la reinserción al fomentar la participación sociocomunitaria y la situación laboral, pero por su falta de continuidad dificulta la búsqueda de vivienda, la prevención de recaídas y reincidencia y perjudica la salud mental. En definitiva, se requiere la formación y sensibilización profesional en igualdad de género para desarrollar estrategias de acompañamiento y tratamiento adaptadas, prevenir las recaídas y reincidencia.

Abstract Introduction High rates of early hospital discharge are often observed in crack cocaine users and are related to adverse outcomes and increased public spending. This study evaluated clinical and sociodemographic factors associated with early treatment discharge among crack users. Methods The sample comprised 308 men diagnosed with crack cocaine use disorder (crack only), aged 18 to 65 years, admitted between 2013 and 2017 to a male-only hospital unit to treat substance use disorders. Sociodemographic and clinical data were obtained using the Addiction Severity Index, 6th version, and a Sociodemographic Questionnaire. Results Early discharge (within 7 days) was significantly associated with lack of own income, insufficient family support, being single, and recent homelessness. Regarding drug use, lower treatment retention was related to younger age of crack use onset, recent alcohol use, and nicotine use. Factors such as age, skin color, and educational level showed no relation to the outcome. Conclusion Our findings suggest that presence of characteristics verifiable at the time of admission may be related to crack users’ treatment retention. Identification of these factors can contribute to target interventions in order to improve treatment adherence in crack cocaine users.

The study aimed to verify the discriminant capacity of the factors of the Clinical Dimensional Personality Inventory 2 (IDCP-2) in the identification of people with substance dependence, as well as to compare this capacity with another instrument that evaluates pathological traits, the Personality Inventory for DSM-5 (PID-5). The sample was composed of 253 adults distributed in three groups: community sample, represented by 110 individuals with ages between 20 and 66 years (M = 32.3; SD = 10,1), 71.8% women; subclinical, 119 individual aged from 18 to 63 (M = 30.4; SD = 8.34), 61.3% women; clinical, 24 individual with ages between 19 and 59 (M = 36,4; SD = 11.2), 83.3% men. Two scales for substance dependence identification were administered (AUDIT and ASSIST), IDCP-2, and PID-5. Findings indicated that IDCP-2 is capable of discriminating between groups, mainly the extreme ones (i.e., clinical sample versus community sample). Moreover, similar discriminant capacity between IDCP-2 and PID-5 was observed. These findings are preliminary evidence that the IDCP-2 factors can identify people with substance dependence, with Hopelessness being the leading factor in the assessment of substance dependents.

Introduction: perceived social support (PSS) is considered an important factor to lessen the negative effects of stressful events. Likewise, the literature suggests a beneficial impact on the evolution of different diseases. However, little is known about the relationship between PSS and treatment completion in methamphetamine-dependent individuals who receive help in a forced manner. Objective: to evaluate the effect of perceived social support (PSS) on treatment completion in methamphetamine-dependent individuals. Methods: prospective study with a cohort of 67 men on whom PSS, addiction severity, anxiety, and depression were assessed. Results: analysis of variance of prospectively obtained data showed that age, years of drug use, and PSS differed between those who completed the treatment and those who did not. Logistic regression analysis showed that increases in PSS (Odds Ratio, OR = .970, Confidence Interval - CI 95 % = .943 - .999) were predictive of a decrease in the probability of completing the treatment, while age had the opposite effect (OR = 1.117, CI 95 % = .1.027 - 1.215). Discussion and conclusion: these results show that the role of social support in the treatment of chronic conditions is complex and suggest the need to study the nature and quality of the social interactions that lead to therapeutic success.

Objective: Teenagers are at high risk for drug addiction. Family resilience is important in preventing adolescent involvement in drug abuse. This qualitative study aims to explore the experience of family resilience based on the perspective of parents when their children are addicted to drugs. Method: This qualitative study used a phenomenological method, involving eight participants based on a purposive sampling technique with inclusion criteria of mothers who have experience caring for their teenage children who have been addicted to drugs. Data qualitative was collected through in-depth interviews, field notes and observations. The data collection process was discontinued after reaching data saturation, namely after interviewing eight participants. The process of interpreting meaning is carried out to obtain the significance of the results of in-depth interviews accompanied by triangulation of methods and data using interpretive phenomenological analysis. Researchers strive to ensure the validity and reliability of the study. This research was conducted for six months in mid-2019. Result: This study resulted in five themes that can be categorized into one supporting theme and four inhibiting themes. The supporting themes are acceptance of God's destiny, while the themes of limited financial conditions, lack of time together, the flexibility of a fragile family and harsh environment are categorized as inhibiting themes. Conclusion: Mothers have an important role in optimizing family resilience while caring for and improving the quality of life of their children who have experienced drug addiction.

Objective: To describe the relationship between psychologists and student users who attended the addiction prevention program offered by Universidad de Antioquia, at the Medellin campus, in 2014, and its influence on the perception of the quality of the program. Methodology: A qualitative research was conducted using tools of the method known as Grounded Theory. The primary information sources of this study were discourses resulting from interviews with students who had accessed the program. The Collection tools were a semi-structured interview and an in-depth interview. Results: Perceived program quality is conditioned significantly by the relationship between psychologists and student users, taking into account, on the part of the latter, aspects as a positive perception of services and the fulfillment of their needs and expectations. Conclusion: Good treatment, kindness and the trust that psychologists build with student users are recognized as determining elements in continuing the process and in service quality perception.

Introduction and the aim: Marijuana is the most commonly used drug in the world (excluding alcohol and tobacco). According to the literature about 16% of Poles at the age of 16 to 64 years old, at least once have used cannabis. The aim of study was to estimate the popularity of marijuana among students of Polish universities. We also asked questions about respondents’ attitude towards marijuana and opinions about its validation. Material and methods: The study was conducted in 2017 on 132 individuals – 60 men and 72 women. The results were analyzed in STATISTICA 10 at p

Introduction: addiction is considered a central nervous system disease that consists of three stages: intoxication, withdrawal and craving. The neurobiological model of addictions proposed by Volkow et al. (2003) includes the states of control, memory, motivation and reward, however, in order to generate an explicit and universal solution to this disease is necessary to mathematize theoretical models. Objective: to propose and to develop the mathematization of a stochastic model using Markov Chains in the phenomenon of psychoactive substances and addiction. Method: mathematization of a stochastic model using Markov Chains and differential equations. Results: using Markov Chains, models of two brains were compared, one healthy (no consumer of psychoactive substances) against one of a person with addiction and through transition probabilities we observed differences from one model to another. Differential equations were used to estimate the time of the effect of a drug in the body and combined with trigonometric equations we sought to estimate the best function to continue with an addiction and relapse. Discussion and conclusions: the obtained mathematical modeling indicates that the neurobiological model of addictions may be represented by a Markov Chain inhomogeneous. In the case of a healthy brain, it can pass with equal probability (p = 1/3) from one state to another, in the case of a person with addiction, the transition probabilities depend on time, drug type, dose and route of administration.----------------------- Introducción: la adicción es considerada una enfermedad del sistema nervioso central que consta de tres etapas: intoxicación, abstinencia y craving. El modelo neurobiológico de las adicciones propuesto por Volkow y colaboradores (2003) incluye los estados de control, memoria, motivación y recompensa, sin embargo, con el fin de generar una solución explícita y universal a dicha enfermedad es necesario matematizar los modelos teóricos. Objetivo: proponer y desarrollar la matematización de un modelo estocástico usando Cadenas de Markov en el fenómeno del consumo de sustancias psicoactivas y las adicciones. Método: matematización de un modelo estocástico usando Cadenas de Markov y ecuaciones diferenciales. Resultados: utilizando Cadenas de Markov, se compararon los modelos de dos cerebros, uno sano (de una persona no consumidora de sustancias psicoactivas) y otro perteneciente a una persona adicta, y por medio de las probabilidades de transición se observaron las diferencias entre ambos. Se utilizaron ecuaciones diferenciales para estimar el tiempo del efecto de una droga en el cuerpo y, en combinación con ecuaciones trigonométricas, se buscó la mejor función para estimar las probabilidades de continuar con una adicción y una recaída. Discusión y conclusiones: el modelaje matemático obtenido nos indica que el modelo neurobiológico de las adicciones puede ser representado por una Cadena de Markov no homogénea. En el caso de un cerebro sano se puede pasar con igual probabilidad (p = 1/3) de un estado a otro, mientras que en el caso de una persona adicta, las probabilidades de transición dependen del tiempo, el tipo de droga, la dosis y la vía de administración.

Objective. This article aims to offer a vision of the centers at a global level that use derivatives of plants or animals for the treatment of substance use disorders, and to offer a reflection on the concept of drugs as medicinal or toxicant agents depending on the context of use, culture and policy. Methodology. Some practices coming from Africa, Asia, Europe and the Americas were considered, carrying out a research based on scientific literature, exchange of information with treatment centers, internet search and the personal experience of the authors. Results and Discussion. Different cases of the use of natural medicines are described including psychoactive derivatives of Tabernanthe iboga and Bufo alvarius. Conclusions. The blurred boundaries between considering drug consumption as a crime or as a health issue could be overcome by being inspired by the ancient wisdom of traditional medicines.

Resumo Este estudo objetivou avaliar o nível de sobrecarga do cuidador em uma amostra composta por 115 mulheres, familiares de dependentes químicos que estavam realizando tratamento. Buscou-se verificar diferenças quanto à sobrecarga e o tipo de droga, local de tratamento e variáveis sociodemográficas. Utilizou-se questionário sociodemográfico e Inventário de Sobrecarga do Cuidador de Zarit, analisados com auxílio do SPSS 21. O nível de sobrecarga foi moderado a severo, não diferindo significativamente quanto ao tipo de droga (álcool ou crack), mas sim quanto ao local de tratamento dos usuários (maior para ambulatório) e ao parentesco (mães com maior sobrecarga). Espera-se que os dados encontrados possam auxiliar na assistência aos familiares que assumem o cuidado no tratamento da dependência química.

Objective. This article aims to give an overview of the major American centers using traditional herbal medicine or their derivatives in the treatment of substance dependence. Methodology. For the purpose of this article we have considered a small number of plants hailing from South, Central and North America. The research has been based on scientific literature, information exchange with treatment centers, internet searches and the personal experience of the authors. Results and discussion. Results show the relevance of certain psychoactive plants well known also for inducing modified states of consciousness (MSCs) including Ayahuasca, Coca, Wachuma, Tobacco, Psilocybe mushrooms, Salvia divinorum and Peyote. Conclusions. Plant based assisted therapy for the treatment of substance use disorders appear to be a promising field of research, although validation of the clinical outcomes need to be improved for the majority of the analyzed cases.

Introduction and the aim: Marijuana is the most commonly used drug in the world (excluding alcohol and tobacco). According to the literature about 16% of Poles at the age of 16 to 64 years old, at least once have used cannabis. The aim of study was to estimate the popularity of marijuana among students of Polish universities. We also asked questions about respondents’ attitude towards marijuana and opinions about its validation. Material and methods: The study was conducted in 2017 on 132 individuals – 60 men and 72 women. The results were analyzed in STATISTICA 10 at p

It is commonly assumed that increasing drug problem is caused by global and multicultural changes, as well as infiltration of trends from more developed European countries. Effects of drug abuse are alarming, among others in development of psychoses, depressive and anxiety conditions, as well as viscera defects – mainly kidneys, liver, hematopoietic necrosis. The problem of drug addiction regards also people from the sick environment, because by their behavior affects destructively on the other individuals. It is related with growing public expenditures for activities associated with the restriction of drug addiction development in Poland. Therefore it is not a surprise that this issue is widely analyzed and often brought up in social discussion. The problem of drug addiction in Poland, as in the world, assumes stronger form, and hence it is necessary to reflect over the questions concerning this addiction. An aim of the study is to describe the phenomenon of drug addiction in Poland and compare the scale of problem in relation to other European countries.

Estudo exploratório de abordagem qualitativa cujo objetivo foi compreender o papel do profissional técnico de enfermagem em comunidades terapêuticas na Região de Valparaíso, Chile, segundo a percepção dos participantes. A coleta de dados foi realizada em 2012, utilizando entrevistas semiestruturadas, aplicadas a quatro técnicos em tratamento e reabilitação, já que nas comunidades terapêuticas não existe o profissional enfermeiro. A análise dos dados foi realizada através de análise de conteúdo, identificando os eixos temáticos em torno do significado que os participantes atribuem ao seu trabalho e à percepção da relação terapêutica desenvolvida. Utilizou-se o relacionamento terapêutico como referencial teórico metodológico. Os resultados mostram que o trabalho de interação com os dependentes é considerado trabalho difícil frustrante, mas também gratificante. O técnico cuida da pessoa e sua família num trabalho colaborativo de motivação e apoio junto com a equipe multiprofissional. ABSTRACT This exploratory qualitative research aims to describe the role that the professional nurse plays in therapeutic communities according to the perception of its participants in the Region of Valparaiso in Chile. The gathering of the data was done through semi-structured interviews to rehabilitation and treatment technicians, since there were no professional nurses in the therapeutic communities in January/2012. The methodology used for the data analysis was content analysis. It focused on the identification of the main themes that surrounded the meaning that participants give to their work as well as the perception of the therapeutic relationship they develop. The methodological framework used was therapeutic relationship. The findings show that the working with addicts in an interactional basis is hard and frustrating, but at the same time, rewarding. The technician takes care of the person and his/her family in a collaborative work centred on motivations and support with a multi-professional team. RESUMEN Estudio exploratorio de abordaje cualitativo, cuyo objetivo fue conocer el rol del profesional técnico de enfermería en las comunidades terapéuticas según la percepción de los participantes en la Región de Valparaíso-Chile, en 2012. La pesquiza de datos se realizó a través de entrevistas semiestructuradas, aplicadas a cuatro técnicos en tratamiento y rehabilitación, ya que en las comunidades terapéuticas no se cuenta con profesional enfermero. El tratamiento de datos se realizó en 2012, a través del análisis de contenido, identificando ejes temáticos en torno al significado que los participantes otorgan a su trabajo y a la percepción de la relación terapéutica desarrollada. Se utilizó el relacionamiento terapêutico como marco teórico metodológico. Los resultados muestran que el trabajo interaccional con adictos es considerado un trabajo difícil, frustrante y a la vez gratificante. El técnico realiza el cuidado a la persona y su familia en un trabajo colaborativo de motivación y apoyo con el equipo multiprofesional.

Чугунов В. В., Курило В. О., Данілевська Н. В. Особливості застосування електросудомної терапії при наркологічній патології = Features of the application of electroconvulsive therapy in the treatment of drug abuse pathology Journal of Education, Health and Sport. 2016;6(9):893-901. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.162962 http://ojs.ukw.edu.pl/index.php/johs/article/view/3953 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.09.2016. Revised 24.09.2016. Accepted: 30.09.2016. Особливості застосування електросудомної терапії при наркологічній патології В. В. Чугунов, В. О. Курило, Н. В. Данілевська Запорізький державний медичний університет МОЗ України FEATURES OF THE APPLICATION OF ELECTROCONVULSIVE THERAPY IN THE TREATMENT OF DRUG ABUSE PATHOLOGY V. V. Chugunov, V. A. Kurilo, N. V. Danilevska Zaporizhzhya State Medical University Ministry of Healthcare of Ukraine Summary Objective: to examine the possibility of electroconvulsive therapy (ECT) use for the treatment of patients with addiction to psychoactive substances (PAS). The algorithm of ECT, which consists of 3 stages and IX sub-stages is given. The study of the therapeutic viability of ECT in the case of broad spectrum of addictive pathology (F10-F19) in the context of the relief of addictive attraction to PAS and comorbid disorders, including emotional disorders and resistant to pharmacotherapy of pain syndrome is made. ЕСТ is an effective method for additions therapy and comorbide psychopathological states. High therapeutic effect is connected with sanogenetic effect achieved in stopping of poorly curable pathology and achievement of sustained remission even in the cases where other methods are noneffective. Key words: addiction, substance abuse, drug addiction, alcoholism, electroconvulsive therapy

Introducción: las drogadicciones constituyen un problema de salud que en algunos países desarrollados, supera en morbilidad y casi alcanzan en letalidad, a las enfermedades cardiovasculares y oncológicas. Objetivo: identificar el nivel de conocimientos sobre drogadicción en médicos generales integrales venezolanos, que laboran en los consultorios populares del municipio Iribarren, en el estado Lara, Venezuela. Métodos: se realizó un estudio descriptivo, transversal y retrospectivo, en el periodo comprendido entre diciembre de 2006 y junio de 2007. El universo de estudio estuvo constituido por los 46 médicos que laboran en los consultorios de este municipio. Para la recogida de los datos se aplicó una encuesta, previo consentimiento informado. Se trabajó con números absolutos y porcentajes, como medida para cada variable utilizada. Resultados: se obtuvo un predominio de 28 galenos con experiencia laboral entre 6 y 10 años para un 60,9 %. La totalidad de los médicos reconoció como drogas a la marihuana, la heroína y la cocaína, todos refirieron que solo se debe tratar con prioridad al paciente enfermo, además predominó el criterio de que el tratamiento médico, se debe realizar con el paciente hospitalizado para un 56,6 %. Existió escasa experiencia en el manejo de estos pacientes para un 91,3 % y el 100 % de los encuestados, refirió no conocer el Programa Nacional de Drogadicción. Conclusiones: existe un escaso conocimiento con respecto al manejo de la drogadicción en la atención primaria de salud, se identificaron necesidades de aprendizaje por parte de los médicos generales integrales venezolanos.Introduction: the drug addictions are a health problem that in some developed countries overtakes in morbility and almost to achieve the lethality to cardiovascular and oncologic diseases. Objective: to identify the level of knowledge on drug addiction in Venezuelan integral general physicians working in popular consulting rooms of Iribarren municipality in Lara State, Venezuela. Methods: a retrospective, cross-sectional and descriptive study was conducted from December, 2006 to June, 2007. Study universe included 46 physicians working in consulting rooms of this municipality. To data collection a survey was applied previous informed consent. Absolute numbers and percentages were used as a measure by each variable used. Results: there was predominance of 28 physicians with a 6 and 10 years working experience for a 60.9 %. Total of physicians recognized as drugs the marihuana, heroin and cocaine. All declared that only the ill patient must to receive priority; also, the was predominance of the criterion that the treatment must to be applied when the patient is hospitalized for a 56.6 %. The was an scanty experience on the management of these patients for a 91.3 % and the 100 % of polled persons declared its total knowledge of the existence of the Drug Addiction National Program. Conclusions: there is a scanty knowledge regarding the management of drug addiction in the primary health care; the needs of learning by Venezuelan integral general physicians were identified.

A relação entre Estado e atendimento às demandas dos adolescentes sofreram mudanças históricas, tendo como importante marco a criação do Estatuto da Criança e do Adolescente (ECA). Analisamos, com enfoque qualitativo, como os serviços de saúde mental e drogadição de um município do Estado de São Paulo compreendem a demanda dos adolescentes em situação de vulnerabilidade social. As cinco instituições participantes informaram, por meio de questionários, as características dos serviços oferecidos e sua aproximação com a população atendida. Identificamos a fragmentação entre as ações públicas, havendo ora sobreposição de serviços, ora ausência desses, além do distanciamento das necessidades dos adolescentes, o que impossibilita que essas ações ofereçam elementos para que esse público mantenha uma relação positiva frente aos elementos vulnerabilizantesThe relationship between the State and the demands of the adolescents has historically changed, having as a landmark the establishment of "Child and Adolescent Statute" (ECA). We have analyzed under the scope of qualitative research how mental health services and drug addiction of a city of São Paulo State comprehended the demands of adolescents under social vulnerability. The five participating institutions in this study have reported through questionnaires the characteristics of their services and how they approach the population served. We identified the fragmentation of public actions, with either overlapping of services, sometimes their absence, besides the distance of the needs of adolescents, avoiding public action to raise elements capable of keeping a positive relationship between this public and the elements that turn them vulnerable.

Objetivos: Explorar la perspectiva de los usuarios y analizar los factores que influyen en su vinculación en un programa de reducción de daños (REDAN) que presta los siguientes servicios: intercambio de jeringuillas, espacio educativo de calor y café, programa de mantenimiento con metadona, sala de consumo higiénico supervisado, espacio para la higiene personal y seguimiento sanitario y psicosocial. Este programa presenta la particularidad de estar integrado en un ambulatorio de drogodependencias situado en un recinto hospitalario. Métodos: Estudio descriptivo realizado con metodología cualitativa. Se realizó un muestreo teórico. Se saturaron los contenidos mediante 12 entrevistas en profundidad y un grupo focal con ocho participantes. El análisis de la información se basó en la Grounded Theory. Las transcripciones literales fueron codificadas descriptivamente y luego se generaron categorías amplias. Este procedimiento se realizó en un principio por tres investigadores y finalmente un cuarto investigador trianguló la información. Resultados: Emergen cinco dimensiones (accesibilidad, servicios, relación, localización e identidad) compuestas por diferentes temas valorados desde las expectativas y experiencias de los usuarios. La dimensión «identidad» otorga un elemento distintivo respecto a la vinculación con el programa. Conclusión: En general, los usuarios valoran positivamente el programa REDAN. Respecto a la vinculación, describen aspectos facilitadores y otros deficitarios que pueden suponer barreras, frente a las cuales realizan sugerencias. Aspectos como la convivencia entre los usuarios del programa REDAN y los pacientes en tratamiento orientado a la abstinencia generan ambivalencia, pero se identifica que la gestión por parte del equipo minimiza estas dificultades.Objectives: We analyzed the perspective of users enrolled in a harm reduction program that provides syringe exchange, an educational room for «warmth and coffee», a methadone maintenance program, a room for supervised drug consumption, a place for personal hygiene, and medical and psychosocial follow-up. The particularity of this program lies in its integration within an outpatient drug treatment center forming part of a general hospital. Methods: We performed a descriptive study using qualitative methods. Theoretical sampling was conducted. Twelve in-depth interviews and one focus group composed of eight users were carried out. Information analysis was based on grounded theory. Literal transcriptions were coded and subsequently sorted into broad categories. Three researchers participated in this process and finally a fourth researcher triangulated the results. Results: Five dimensions were identified in the users´ discourse: accessibility, service, relationship, localization, and identity. Each consisted of several topics that were evaluated based on the participants´ experiences and expectations. The dimension of identity emerged as a distinctive element in patient-program bonding. Conclusions: The users´ overall evaluation of the program was positive. Facilitators and barriers influencing patient-program bonding were identified and participants suggested ways to remove barriers. The coexistence among users of the harm reduction program and patients treated conventionally provoked ambivalence but the team's management was deemed helpful in easing the difficulties arising from this situation.

This research evaluated the program “La aventura de la vida” (Adventure of Life), a joint work between University of Antioquia and Surgir, a nongovernmental organization in charge of the program in Medellín. Participants were interviewed to understand what happens with the knowledge, perceptions and relations in the educative community where it was applied. It was possible to establish that components of the program can account for practices and interactions of their actors producing effects and impacts. The study looked for these effects and impacts in terms of social process and as transforming tool of citizen culture facing drug addition problem. Community conceptions and meanings on prevention of socially relevant problems associated to drugs and healthy life styles promotion. With a qualitative and ethnographic approach, the study allowed to understand the real development of the program, using different techniques such as comprehensive interviews, participant observations and focal groups with children and their significant people

Within the core of capitalist discourse, some contemporary symptoms, anorexia and drug addiction, are taken into consideration from the clinic of the real. This is a new lacanian-oriented clinic in psychoanalysis that takes over from the clinic of the symbolic, which has essentially been Freud’s clinic, exceeding the limits in the era of hypermodernity. Drug addict’s pressure to consume the object drug contrasts with a radical negative of the anorexic persons who consume themselves. // Sobre el fondo del discurso capitalista se reflexiona alrededor de los síntomas contemporáneos, la anorexia y la toxicomanía, a partir de la clínica de lo real, clínica nueva en psicoanálisis de orientación lacaniana que toma el relevo de la clínica del sentido, que ha sido esencialmente la clínica freudiana, desbordada en la hipermodernidad. El empuje al consumo del objeto droga del toxicómano contrasta con la negativa radical de la anoréxica que se consume a sí misma.

O uso de drogas atualmente é considerado um grave e complexo problema de saúde pública. Falar sobre drogadição é discutir o processo saúde/doença, considerando-se os modelos que contribuem para a compreensão do fenômeno no momento atual e das estratégias de intervenção estabelecidas. Discutir a dependência química hoje exige uma reflexão sobre como a droga foi encarada ao longo da história, tendo em vista as questões de saúde/doença e os paradigmas hegemônicos em cada momento. Este estudo visa: a) mostrar as bases teórico-conceituais de três eixos (saúde, doença e dependência química) e suas interseções; b) propiciar uma reflexão crítica sobre a questão da promoção da saúde frente à dependência de drogas, de acordo com o modelo biopsicossocial presente na atualidade. Esse modelo considera o ser humano integral, dotado de subjetividade, de saberes e fazeres próprios, ativo no processo saúde/doença, ressaltando a necessidade de rompimento com o modelo cartesiano ainda predominante na saúde.

RESUMO A clínica psicanalítica sempre esteve conectada à realidade social, já que, a cada tempo, alteram-se as demandas e suas formas de endereçamento. Atualmente, contudo, o enfraquecimento do simbólico põe em xeque a crença no Outro, fazendo vacilar o lugar do sujeito e o conceito de clínica em si. Este artigo busca extrair, a partir de um caso clínico que aborda a questão da toxicomania, um esforço da psicanálise de orientação lacaniana para assegurar a importância do sujeito.

Las drogadicciones constituyen una de las grandes tragedias en el mundo actual, por lo cual su prevención es una necesidad imperiosa. A tales efectos se detallan algunos elementos relacionados con el consumo de Mimosa pudica (moriviví) como una modalidad de sustancia de abuso, o mezclada con marihuana, así como características de la planta, propiedades, usos y cuadro clínico que ocasiona la intoxicación, entre otros aspectos de interés

Por meio das abordagens sistêmica e psicossocial, o presente estudo tem como objetivo descrever e discutir a relação entre os níveis de dependência relacional das drogas e a prática de atos infracionais entre os jovens, na perspectiva do adolescente em conflito com a lei. As informações foram coletadas por entrevistas semi-estruturadas, aplicadas em 29 adolescentes, autores de infração, da Vara da Infância e Juventude de Brasília. O método de análise refere-se à análise de conteúdo do tipo construtivo-interpretativo. Os resultados apontam várias conexões entre os níveis de dependência relacional das drogas (efeitos, crenças, relações afetivas, pares, provedores, fornecedores) e a prática de infrações. Os diferentes níveis de dependência identificados na voz dos adolescentes mostram a multiplicidade e complexidade das relações entre a drogadição e a prática de atos infracionais entre jovens e, portanto, a necessidade de um trabalho de intervenção em rede.

Resumo O que a psicanálise tem a dizer sobre tantas questões que envolvem as drogas, que de longe ultrapassam a questão de seu uso? Questões, diríamos, históricas, clínicas e políticas. O objetivo desse texto é discutir vicissitudes que as perpassam. Não apenas nos acercarmos do “problema drogas”, mas pensar como a presença da psicanálise pode fazer frente a determinados discursos que se presentificam nesse campo de atuação e que estão longe de pôr o sujeito em questão. Trabalhar com a psicanálise é levar em conta a pulsão de morte. É lançar mão de um saber que nos permite uma orientação de tratamento que leve em conta o que há de mortífero no uso de drogas nas toxicomanias, pondo em relevo a posição de gozo do sujeito. É, além disso, pôr em questão o que há de mortífero em determinados direcionamentos políticos que transformam o sujeito em objeto.

A hipótese de “miopia emocional” constitui uma reflexão teórica de compreensão da vulnerabilidade psicológica identificada em muitos toxicodependentes. Propõe-se uma cooperação, mas não incorporação, de níveis de conhecimento em torno dos determinantes do neurodesenvolvimento, de perspectivas psicanalíticas e de vinculação e de modelos psicobiológicos das toxicodependências. Salientam-se influências ambientais sobre as mudanças na morfologia cerebral, não apenas o trauma precoce ou a privação de cuidados, mas também as decorrentes de consumos abusivos como cernes de vulnerabilidade. Propõe-se que a hipótese Damasiana dos marcadores somáticos participe nessa formulação. A parca qualidade das interações precoces pode sustentar o desligamento afetivo progressivo, a hipomaturação do cérebro social, o incremento de um padrão alexitímico e a procura urgente de sensações, todos potenciais propiciadores da busca do prazer nas drogas.

Introducción: en el curso del presente siglo se afectará la tercera parte de la población mundial debido a la drogodependencia. Además de sus consecuencias legales, este fenómeno supone importantes alteraciones biopsicosociales. Objetivo: caracterizar el consumo de drogas que afectan la conciencia y la personalidad en el policlínico "Ana Betancourt", del municipio Playa. Métodos: se aplicó un cuestionario a 80 pacientes seleccionados utilizando el muestreo por criterios, en el que se exploran aspectos como son: las razones que propician el consumo, principales factores de riesgo, trastornos comórbidos más frecuentes, los cuales posibilitan el logro del objetivo propuesto. Resultados: el 25,0 % de la muestra no posee vínculo ocupacional. El 43,7 % tuvo o mantiene una ocupación vinculada a la fabricación, distribución o expendio de bebidas alcohólicas. El 50,0 % tiene antecedentes familiares de primer grado de drogadicción. El 60,0 % afirmó, que en algún momento de sus vidas, presentó déficit de atención con hiperactividad. El 85,0 % señaló haberse iniciado en el consumo de drogas en la adolescencia tardía. El trastorno de personalidad es el desorden comórbido más frecuente. La búsqueda del placer persistió, en el 100 % de la muestra, como la principal razón del consumo reiterado de drogas, en las diferentes etapas de la vida. Conclusiones: la vía hedónica fue la principal responsable de las toxicomanías. Los trastornos comórbidos radicaron en expresiones variadas del estado de ánimo, siendo la depresión uno de los cuadros más comunes. Las dificultades en las relaciones interpersonales constituyen el principal factor de riesgo familiar para el consumo.

The present article opens the issue of Etudes Caribéennes dedicated to the study of social movements and analyzes the theoretical significance of emotion within the emergence and maintenance of these sociological phenomena. Rejected by classical theorists as dangerous aberration, emotion will be consecutively reintegrated by neo-classical theorists, then once again rejected by modern rationalists or ignored by constructivists, and finally totally reintegrated, even centered within the theoretical framework adopted by certain contemporary post-modern sociologists. Contributions to this issue of Etudes Caribéennes reflect the new strides made by emotion within the integrative post-modern theory of social movements.