Upon collection, the automated trap (A1) was found to be in good working order. The only noticeable damage was that the metal lid was slightly bent at approximately a 15 angle. The traditional Tauber traps did not fair as well, as trap T1 developed a crack in its base and the entire contents subsequently drained out. Because of this, trap T1 was not used in this study. T2 had similar cracks around the base of the trap, but the sample remained undisturbed. T3 was found in perfect working order. In the field, the acrylic lids of the traps showed no signs of shrinking, and all retained their 5 cm aperture.
Crack cocaine use is associated with polydrug abuse, and inpatients dependent on crack exhibit profiles of serious consumption patterns. Use of alcohol and tobacco and other drugs is a risk factor for experimentation of additional drugs, including crack cocaine.
spss 18 full crack
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The present study describes the characteristics and crack consumption patterns among inpatients in treatment during 2011 and 2012 at the Hospital Psiquiátrico São Pedro (Porto Alegre, Brazil). An additional objective was to identify the sequence of alcohol and tobacco consumption prior to crack use.
The participants were 53 male inpatients addicted to crack with a mean age of 27.57.3 years. A sociodemographic questionnaire; the Alcohol, Smoking and Substance Involvement Screening Test and the Mini Mental State Examination were all administered to participants. Inclusion criteria were crack cocaine dependency (based on the 10th edition of the International Classification of Diseases [ICD-10]) and being abstinent for 7 days. Patients with cognitive difficulties who were unable to understand and/or respond to the questionnaires were excluded from the sample.
The participants were young male adults with low educational level and low incomes and were polydrug users. The majority had made more than one attempt to quit. Use of legal drugs in early adolescence, prior to crack use, was identified.
The profiles of the inpatients addicted to crack treated at this hospital indicate a serious usage pattern among those who seek specialized support. Crack use is frequent and is associated with use of other drugs and with difficulty sustaining abstinence. The pattern of progression from alcohol and tobacco use to crack cocaine dependency demands the attention of those responsible for prevention policies.
O uso de crack continua associado ao abuso de múltiplas drogas, e o perfil do dependente de crack em tratamento tipo internação parece estar relacionado a um padrão grave de consumo. O consumo de álcool, tabaco e outras drogas é um fator de risco para a experimentação de novas drogas, como o crack.
Descrever características e padrão de consumo do crack em pacientes em tratamento tipo internação no Hospital Psiquiátrico São Pedro (Porto Alegre, Brasil) nos anos de 2011 e 2012. Além disso, identificar a sequência de consumo de álcool e cigarro prévio ao crack.
Participaram do estudo 53 homens dependentes de crack, com média de idade de 27.57.3 anos. Os participantes responderam a um questionário sociodemográfico, ao Alcohol, Smoking and Substance Involvement Screening Test e ao Mini Exame do Estado Mental. Os critérios de inclusão foram: dependência de cocaine (crack) baseada na 10ª edição da Classificação Internacional de Doenças (CID-10) e estar há mais de 7 dias em abstinência. Pacientes que apresentavam prejuízos cognitivos ou dificuldades de compreensão para o entendimento dos questionários foram excluídos da amostra.
Os participantes eram adultos jovens, com baixa escolaridade e renda, poliusuários de drogas. A maioria dos participantes realizou mais de uma tentativa de parar o consumo. Uso de drogas lícitas no início da adolescência, antes da experimentação do crack, foi identificado.
O perfil do dependente de crack tratado nesse hospital aponta para um grave padrão de consumo entre usuários que procuram assistência. O uso continua frequente, associado ao consumo de outras drogas e à dificuldade de manter-se em abstinência. O padrão de progressão do uso de álcool e tabaco para a dependência de crack requer atenção quanto a políticas de prevenção.
Use of crack cocaine in Brazil has been growing over the last two decades.11 . Pulcherio G, Stolf AR, Pettenon M, Fensterseifer DP, Kessler F. Crack - da pedra ao tratamento. Rev AMRIGS. 2010;54:337-43. Crack, or freebased cocaine, is a volatile form of stimulant drug that can be smoked in a pipe when heated. Cocaine is absorbed through the lungs, moving quickly to the heart and brain.22 . Masur J, Carlini, EA. Drogas: subsídios para uma discussão. São Paulo: Brasiliense; 2004. The result is that crack has a high potential for dependency.11 . Pulcherio G, Stolf AR, Pettenon M, Fensterseifer DP, Kessler F. Crack - da pedra ao tratamento. Rev AMRIGS. 2010;54:337-43. The main effects of chronic use of crack include aggression, decreased self-care, insomnia, propensity to lung infections, weight loss, tremors, seizures, strokes, psychosis, confused states and diseases.33 . Figlie N, Bordin S, Laranjeira R. Aconselhamento em dependência química. São Paulo: Roca; 2004.
Moreover, crack addicts are at a higher risk of death than the general population; homicide and AIDS are the most frequent causes.44 . Ribeiro M, Dunn J, Sesso R, Dias AC, Laranjeira R. Causes of death among crack cocaine users. Rev Bras Psiquiatr. 2006;28:196-202. , 55 . Inciardi JA, Surrat HL, Pechansky F, Kessler F, von Diemen L, da Silva EM, et al. Changing patterns of cocaine use and HIV risks in the south of Brazil. J Psychoactive Drugs. 2006;38:305-10. The neuropsychological impairments66 . Kolling NM, Silva CR, Carvalho JCN, Cunha SM, Kristensen CH. Avaliação neuropsicológica em alcoolistas e dependentes de cocaína. Aval Psicol. 2007;6:127-37.that result from the progressive effects of crack use include deficits in intellectual abilities and slower psychomotor processing.77 . Lavtala A, Castaneda AE, Peräla J, Saarni SI, Aälto-Setala T, Lönnqvist J, et al. Cognitive functioning in substance abuse and dependence: a population-based study of young adults. Addiction. 2009;104:1558-68.Psychosocial problems, such as poor self-care, family problems, disruption of social and emotional bonds, job loss and exposure to risk behaviors are also observed among crack addicts.88 . Chaves TV, Sanchez ZM, Ribeiro LA, Nappo SA. Fissura por crack: comportamentos e estratégias de controle de usuários e ex-usuários. Rev Saude Publica. 2011;45:1168-75. , 99 . Rodrigues DS, Backes DS, Freitas HMB, Zamberlan C, Ghellen MH, Colomé JS. Conhecimentos produzidos acerca do crack: uma incursão em dissertações e teses brasileiras. Cienc Saude Coletiva. 2012;17:1247-58.
During the 1990s, crack users became the largest group of patients in hospital outpatient drug dependency treatment clinics.1010 . Dunn J, Laranjeira R, Da Silveira DX, Formigoni ML, Ferri CP. Crack cocaine: an increase in use among patients attending clinics in São Paulo: 1990-1993. Subst Use Misuse. 1996;31:519-27. By the 2000s, crack had become the most prevalent illicit drug used among inpatients in a psychiatric hospital for treatment of drug dependency.1111 . Borini P, Guimarães RC, Borini SB. Usuários de drogas ilícitas internados em hospital psiquiátrico: padrões de uso e aspectos demográficos e epidemiológicos. J Bras Psiquiatr. 2003;52:171-9. In a study that analyzed data from an inpatient facility for drug dependency in Porto Alegre, Brazilian researchers found an increase in hospital admissions of crack addicts; the percentage grew from 21.8 to 61.9% of all patients admitted from 2002 to 2006.1212 . Formiga LT, Santos RCS, Dumcke TS, Araújo RB. Comparação do perfil de dependentes químicos internados em uma unidade de dependência química de Porto Alegre/RS em 2002 e 2006. Rev HCPA. 2009;29:120-6. Attempting to deal with this problem, in 2010 the Brazilian government launched the Plano Integrado de Enfrentamento ao Crack e Outras Drogas (Integrated Plan for Combating Crack and Other Drugs). In 2011, it initiated the program Crack é Possível Vencer (Crack Can be Beaten), which comprises measures for prevention, treatment, social reintegration, and tackling drug trafficking.1313 . Brasil, Secretaria Nacional Antidrogas (SENAD), Fundação Osvaldo Cruz (FIOCRUZ). Estimativa do número de usuários de crack e/ou similares nas capitais do país. Brasília: Rio de Janeiro; 2013.
An article profiling cocaine and crack users in Brazil1414 . Dualibi LB, Ribeiro M, Laranjeira R. Profile of cocaine and crack users in Brazil. Cad Saude Publica. 2008;24:s545-57. reported that typical crack users were young adult men with poor education and low incomes who had social and health problems associated with their consumption and that onset of abuse often occurs during adolescence. Although consumption of crack is more prevalent among low-income individuals, it has increased in all social classes in Brazil.99 . Rodrigues DS, Backes DS, Freitas HMB, Zamberlan C, Ghellen MH, Colomé JS. Conhecimentos produzidos acerca do crack: uma incursão em dissertações e teses brasileiras. Cienc Saude Coletiva. 2012;17:1247-58. Easy access to crack in São Paulo was described in the 2000s, including strategies by the trafficking market to increase accessibility, such as home delivery.1515 . Oliveira LG, Nappo SA. Crack na cidade de São Paulo: acessibilidade, estratégias de mercado e formas de uso. Rev Psiquiatr Clin. 2008;35:212-8. In Porto Alegre, consumption of crack cocaine has increased since 2001 and crack addicts have reported that the drug is supplied from São Paulo.55 . Inciardi JA, Surrat HL, Pechansky F, Kessler F, von Diemen L, da Silva EM, et al. Changing patterns of cocaine use and HIV risks in the south of Brazil. J Psychoactive Drugs. 2006;38:305-10.
Previous research with crack inpatients, conducted at the Hospital Psiquiátrico São Pedro (HPSP), described the profile of users as single young adults with poor education, low incomes and dependency on and abuse of other drugs.1616 . Balbinot AD, Araújo RB. Análise do perfil de dependentes de crack em internação hospitalar. Saude Pesq. 2012;5:471-80. Crack-dependent inpatients in Porto Alegre have reported using other psychoactive substances1717 . Freire SD, Santos PL, Bortolini M, Moraes JFD, Oliveira MS. Intensidade e uso de crack de acordo com a classe econômica de usuários internados na cidade de Porto Alegre/Brasil. J Bras Psiquiatr. 2012;61:221-6. and describe consumption of crack mixed with tobacco or marijuana.1818 . Seleguim MR, Oliveira MLF. Padrão do uso de drogas de abuso em usuários de crack em tratamento em uma comunidade terapêutica. Rev Neurocienc. 2013;21:339-48. In the southern region of Brazil it has been found that crack-dependent patients treated at either health centers1919 . Horta RL, Horta BL, Rosset AP, Horta CL. [Crack cocaine users who attend outpatient services]. Cad Saude Publica. 2011;27:2263-70. or therapeutic communities1818 . Seleguim MR, Oliveira MLF. Padrão do uso de drogas de abuso em usuários de crack em tratamento em uma comunidade terapêutica. Rev Neurocienc. 2013;21:339-48. used tobacco, alcohol, and other drugs prior to onset of their crack use. This progressive pattern of drug use from legal to illegal drugs has also been described elsewhere in the literature.1414 . Dualibi LB, Ribeiro M, Laranjeira R. Profile of cocaine and crack users in Brazil. Cad Saude Publica. 2008;24:s545-57. , 2020 . Kandel D. Stages in adolescent involvement in drug use. Science. 1975;190:912-4. The first substances used by crack-dependent inpatients are alcohol and tobacco,2121 . van der Meer Sanchez Z, Nappo SA. [Progression on drug use and its intervening factors among crack users]. Rev Saude Publica. 2002;36:420-30. which is reported to begin at 12 to 13 years of age.1717 . Freire SD, Santos PL, Bortolini M, Moraes JFD, Oliveira MS. Intensidade e uso de crack de acordo com a classe econômica de usuários internados na cidade de Porto Alegre/Brasil. J Bras Psiquiatr. 2012;61:221-6. Recently, another study revealed that nicotine acts as a gateway drug and has a potential priming effect for cocaine in the sequence of drug use.2222 . Kandel DB, Kandel ER. A molecular basis for nicotine as a gateway drug. N Engl J Med. 2014;371:2038-9. Additionally, the same study found a biological and molecular mechanism to explain these patterns; priming with nicotine enhanced the effects of cocaine in the reward circuitry and in expression of the fosB gene.2222 . Kandel DB, Kandel ER. A molecular basis for nicotine as a gateway drug. N Engl J Med. 2014;371:2038-9. 2ff7e9595c
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