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Official websites use. Share sensitive information only on official, secure websites. This article was submitted to Addictive Disorders, a section of the journal Frontiers in Psychiatry. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. The aim of this study was to explore the perceptions of women about their experience in using crack cocaine, discussing their motivations for using it and the repercussions in their lives. To investigate these experiences, a qualitative exploratory study was conducted, using the inductive thematic analyses of the content. Eight female crack cocaine users took part in this study. They were assessed by a semi-structured interview, addressing the crack cocaine use experience. The main perceptions reported by the users were related to a feeling of being disconnected to the world preceded by a pleasant experience, especially during the first moments of use. They revealed that the drug fulfills a key role of coping strategy to handle with negative thoughts, emotions or life experiences. An important influence of social issues was reported in relation to the onset of crack cocaine use. Negative consequences and significant impact on their lives appeared in their reports, regarding the loss of family ties, involvement with prostitution, traumatic experiences and violence. Taking together all women's perceptions suggests that beyond the positive immediate rewarding effect, the maintenance of use might be related to the dissociative experience and self-medication role, acting as negative reward by relieving of negative life experiences that, in turn, are both cause and consequence of the drug use. Keywords: substance use, crack cocaine, sex differences, qualitative study, thematic analyses. Cocaine Use Disorder CUD represents a serious public health problem with about 20 million people using the drug annually worldwide. Cocaine consumption has been increasing over the last decades. Despite there is a few studies of epidemiological data on specific increase of crack consumption, Brazilian drugs reports have been estimated that 1. Crack cocaine is produced with the same chemical base from cocaine, but with less amount of water, which results in a tropane alkaloid composition. Despite both forms having distinct ways of administration, time of action and half-life duration, they have similar active components, being capable to produce psychostimulant effects e. At high doses or in a chronic and prolonged use form, otherwise, both cocaine and crack cocaine could trigger negative emotions e. Clinical evaluation of crack cocaine users CCU has been suggested the presence of more pronounced symptoms and negative psychosocial effects when compared to those who consume the drug in powder form 7 , 8 or any other drugs, increasing the demand for CUD treatments. The CCU profile is not different from other drugs with prevalence rates being higher among men, however, in the last few years, drug reports and few studies have been suggested an increase of crack cocaine consumption among women 1 , 9 , This new perspective leads to an effort from the Brazilian scientific community to investigate potential sex specificities in a range of target-points, which is in line with an international tendency to explore and integrate on addiction studies sex and gender differences as a main issue for investigation 11 — Several factors are being highlighted as potential differences between sexes in relation to drug use and addiction, including the psychoactive effects of each drug, the patterns and motivations of use, the dependence and withdrawal symptoms and, finally, the treatment challenges and strategies 14 — Despite still incipient, some findings have been suggested that women have more severe pattern of drug use in association with higher rates of psychiatric comorbidities and psychosocial problems e. It might contribute to social stigmatization among women users, influencing the appearance of high-risk behavioral profile in this population 9 , 14 , 15 , 18 — A review of Brazilian crack cocaine studies, for example, reinforced such idea indicating that drug consumption among women increase their exposure to vulnerability regarding specific sex issues, including gestation health problems, intrapersonal and domestic violence, prostitution and moral judgment The motivations that lead women to seek the drug is also suggested to be different when compared to men. Evidence from studies with CCU women revealed that there is a lot of emotional drive involved in motivation for drug seeking-behavior, especially related to the attenuation negative emotions. In contrast, men are generally motivated to drug consumption for more positive reinforcement reasons, such as the pleasure experience and reward-related effects 22 , In this sense, it seems that different trajectories lead to crack cocaine use and progression to addiction among women and men. This could be influence by a range of factors that produce distinct experiences associated with the drug 11 , opening an interesting field for both quantitative and qualitative investigations. Qualitative studies allow us to explore and deeply comprehend the personal experiences, motivations, and thoughts of the users about their own addictive condition. Investigating these meanings might represent an important contribution for individual and community interventions and, at final step, public health policies, since highlight subjective personal experiences e. Also, exploring women's perceptions contribute to improve the knowledge of specific sex factors underlying crack cocaine addiction that are still poorly described and understood. For this reason, the current study aimed to explore the perceptions of women about their experience in using crack cocaine, addressing their own motivations for use and the repercussions in their lives. For this purpose, a qualitative exploratory design was conducted using the inductive thematic analyses of the content. Eight female crack cocaine users, who were admitted into a detoxification unit for alcohol and other drugs in the city of Porto Alegre, Rio Grande do Sul, participated in this study. These exclusion criteria were not limited to this study specifically, being applied by our larger cohort from which this qualitative study derives. All participants remained during the day period of detoxification with no access to alcohol, tobacco, or any other drug, as prescribed by the mental health unit. Participants had a mean age of On average, the number of years of education was 8. Only one participant was married and the average number of children among them was 1. Participants reported a total number of 5. The mean age of crack cocaine onset use was All participants were invited and provided informed consent to participate in the study. The Informed Consent Form was presented, and the aims of the study were explained to the participants before the interviews took place. The interviews were individually performed by trained psychologists in a private room inside the unit. This study was approved by the Ethics and Research Committee of the institutions involved. Data were collected using a semi-structured interview, which aimed to explore and comprehend the crack cocaine consumption experiences of these women. Consequently, the following topics were also addressed: physiological, cognitive and emotional effects caused by the drug use; comparison of the effects of crack cocaine use with those of other drugs consumed; and comparison of current and initial effects of crack cocaine use. All interviews were recorded in audio format and transcribed for later analysis. The leading and additional questions are presented in Table 1. Inductive thematic analyses were conducted based on the proposal by Braun and Clarke 24 in six steps. In Step 1 data collection and recording , the recorded interviews were transcribed by two research assistants. In Step 2, a free reading of the transcribed text was performed, and, in the sequence, preliminary codes were created from the relevant data according to the study objectives. In Step 3, the coded data was sorted out by clustering extracts according to potential themes. In Step 4, the themes were reviewed, with the content of the data and consistency within emergent themes and subthemes being observed. At this stage, two independent judges, with expertise on substance use disorders, reviewed the themes and subthemes, considering the data and the content of excerpts from the analyzed interviews. Both analyses were compared to verify possible discrepancies in relation to themes and subthemes, and these disagreements were discussed until a consensus was reached. In Step 5, themes and subthemes were named and finalized, with examples of consistent and representative extracts. Finally, in Step 6, the results were formally written and interpreted considering the literature background 24 , Based on the thematic analysis, four main themes emerged: 1 Crack cocaine high experience; 2 Symptoms of substance use disorder; 3 Circumstances of crack cocaine use; and 4 Crack cocaine use consequences. In each theme, specific subthemes were identified as shown in Figure 1. This theme was divided into two subthemes: 1. The present study aimed to explore the perceptions of women regarding crack cocaine use and their thoughts about the representative role of it in their lives, including the motivations to use the drug and the consequences of it. Crack cocaine was considered a drug with distinct characteristics compared to other drugs, including cocaine itself. The main differences pointed by the users were related to intensity and rapid effects. Furthermore, users suggested that the onset of their use was influenced by interpersonal relationships, highlighting the progression of use as fast and uncontrolled. The risk exposure associated with both use and continued use are recognized, as exemplified by putting themselves on high-risk situations, joining sex work and family detachment. It is distinct to what is referred by men users, who usually tend to use the substance seeking pleasure 22 , There are discussions pointing out that, especially among women, the drug use could be characterized as a self-medication role to handle with negative feelings and life experiences, such as early childhood or posterior experiences. Self-medication hypothesis suggests that individuals attempt to mitigate and cope with negative symptoms induced by different psychological conditions, including Depression, Posttraumatic Stress Disorder PTSD , and drug addiction 28 — In this sense, the effects of crack cocaine were generally described as having a role related to the relief of different sensations considered unpleasant, such as tiredness, guilt, and day-to-day concerns. Some studies already evaluated that women are more likely to sustain beliefs related to not being able to deal with intense emotions, using drugs as an emotional regulation alternative 33 — Crack cocaine fits well in this regard since the users reported an intense and fast drug effect. However, these effects tend to present a short-time duration, followed by a strong desire to administer and experiencing it again, corroborating the indicatives of high levels of craving and withdrawal symptoms, as well as a drug seeking and compulsive behavior 37 , Not sleeping, no food, no nothing. Fifteen days. I received from my workload, received my salary and ended up smoking. Such compulsive behavior and way of life led to several issues, especially those related to their relatives. The perceived negative impact of crack cocaine use mentioned before, however, was not referred in the same degree in relation to risk-behavior perception. So, I would do what they asked. In both described speeches, the previous awareness of negative consequences is absent and corroborating to risk-behavior exposure. The craving symptoms experience described by some participants indicated that such symptoms are enhanced following the pain relief experience, inducing the search and desire to experience the initial sensation of the crack cocaine high again. In CCU men, for example, it was reported that expectations about changes in craving sensations and negative feelings after crack cocaine high cessation are important for the maintenance of the crack cocaine consumption behavior CCU women findings suggested that crack cocaine use could be viewed as a behavior that is chosen for its reinforcing consequences. Thus, the attenuation of undesired craving symptoms was considered an additional reinforcement factor 34 , Specifically, our study participants demonstrated in their speeches that they also had to deal with other unpleasant symptoms, including insomnia and nightmares, suggesting that in addition to craving, withdrawal symptoms could also influence their addictive behavior pattern. Polysubstance use history was another characteristic reported in our sample. There are reports suggesting high prevalence of polysubstance use, such as alcohol and cannabis, among CCU, inducing higher problems with psychiatric symptoms and impulse control 43 , Indeed, both substances were the most referred beyond crack cocaine and were perceived as able to induce additional experiences in crack cocaine high. Alcohol use, for example, despite reported as able to reduce the craving symptom experience, was followed by an increase in aggressiveness and violent behaviors. You get that weed, you smoke that little weed, it gives you the couchlock, it gives you a feeling of pleasure, of relief. Sleepiness and dry mouth. And… gets you hungry, right? Weed is this. Weed is a sedative. Cocaine was also mentioned as related to increases in socialization during the use, which is reported rarely when crack cocaine was used alone. The participants along the interviews frequently pointed out the influence of the social context as one of the main reasons for starting their drug use. Relatives and friends who were cited as the most influences. Some findings already discussed that crack cocaine use among women were commonly influenced by close people 15 , 21 , Curiosity and attempt to enhance sociability, for example, were reported by women as one of the main motivations to the onset of use. Most of the users revealed similar history of crack cocaine use progression, in which use was sporadic at the beginning and quickly became daily and compulsive. The search for socialization was also suggested to be related to the maintenance of use. Interestingly, the users reported that they avoid using crack completely alone, which is different than what has been observed among CCU males According to participants, even without active communication, the presence of other users has a protective effect during the consumption. Higher social vulnerability experienced e. Moraes et al. The vulnerable condition of CCU women has been discussed by some studies, indicating that this population has a high-risk profile for traumatic exposure, as well as to sexually transmitted infections STIs , since they often engage in sex trade in order to obtain money to maintain drug consumption 49 — CCU women that often exchange sex for money or drugs were suggested to be three times more likely to develop syphilis as well as to be victim of violence when compared to men Crack cocaine use was also identified as a risk factor for trauma related disorders. Furthermore, the lack of physical care, such as not eating, not sleeping and not performing adequate hygiene was perceived as additional damage of the crack cocaine use, increasing the susceptibility for health and mental health concerns Regarding the aspects related to treatment seeking, family inquiry appeared as one of the main reasons for CCU women asking for help. Some participants, in their speech, demonstrated that the possibility of taking care of their children again or the reunification is the major motivation for engaging in substance use disorder treatment 15 , On the other hand, lack of family support, absence of children or the possibility of losing her own child have been identified as potential risk factors for relapse and a barrier to treatment enroll Among the cited reasons by women with children reported in a previous study 57 , the fearful of losing custody of their child was associated with less likely to enter in treatment programs. Women with CCU are known as a vulnerable group with complex unmet needs, for this reason, the risk of losing child care could represent additional challenge for substance use treatment. Interestingly, almost of half of women who are mothers receiving treatment already had experienced the least of care at least one time in their lives In this perspective, the participants highlighted that one of most perceived negative consequence of crack cocaine use was the loss of family, especially for those who are mothers. In the review study of Doab 58 , it was discussed that keeping the mother with their children could improve rates of treatment adherence, since women spend more time enrolled in drug treatments. Thus, it can be suggested that family and social detachment might aggravate the vulnerability condition of these women and consequently increase the risk to crack cocaine use, relapse during detoxification processes or dropout health care treatment programs for substance use 59 , This study revealed that the crack cocaine high is a very personal experience, being associated with a pleasant feeling, at the intoxication moment. The progression to continued use and, consequently, addiction might represent a coping strategy to attenuate trauma and negative emotions experienced throughout life. In comparison to the powder form, crack cocaine was perceived as stronger and associated with more negative outcomes, including family and social support abandonment, sex trade involvement and exposure to violence traumatic experiences. Despite our findings contributing to better understand the subjective experience of CCU, it should be interpreted with some limitation and not generalized to larger groups of users. Our study was based on the analysis of the perception from a small sample of CCU women, valuing their own meaning and interpretation of the experience. The sample itself was unique and, for this reason, explore such subjectivity could open questions and potential targets for more directed intervention e. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. ST contributed with conceptualization, methodology, investigation, analysis, and writing of original draft and reviewed draft. JS contributed with methodology, investigation, and writing of original draft. BM contributed with analysis and writing of reviewed draft. CB contributed with investigation and analysis. BK-S contributed with conceptualization, methodology, investigation, analysis, and writing reviewed draft. TC contributed with conceptualization, supervision of methodology, and analysis. LH contributed with conceptualization, supervision, and writing reviewed draft and RGO contributed with conceptualization, supervision and project administration, and reviewing all writing steps. All authors read, and approved the submitted version. The funding sources had no involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Front Psychiatry. Find articles by Saulo G Tractenberg. Find articles by Jaluza A Schneider. Find articles by Bernardo P de Mattos. Find articles by Carla H M Bicca. Find articles by Bruno Kluwe-Schiavon. Find articles by Thiago G de Castro. Find articles by Rodrigo Grassi-Oliveira. Received Mar 17; Accepted Apr 6; Collection date Open in a new tab. Themes Subthemes Representative thematic unit 1. Crack high experience 1. To not have to think, sons or anything else, just I daydream about people I want to hit them, react, hit this way move both hands as is hitting something Substance use disorder symptoms 2. The more I use, more I want to use, understood? When I start, I do not want to stop. And I was already Smoking repeatedly and smoking. Circumstance of crack use 3. Firstly, the addiction. The addiction, the desire of use again and again and again Feel the high. To be on my trip again. To not feel any guilty. Cocaine you aspirate a little and you feel well The crack already punches like that, you know? He wants to have sex with me, so I had sex with him, right? I got my twenty reais and went away. I got ten and I smoked it. I got more ten and also smoked it. After finished, I was like this, right? No money. Then I had sex with I kind of Just one or two alone, like a selfish. Crack use consequences 4. After, there is a time that I started to disappear, all night long and I lost completely the control of that Until I ended up in the hospital. You smoke one and get locked. You look at yourself in the mirror, your face are all dirty, gray I stabbed myself in the foot and took six stitches. In addition to stab me, I still put my finger inside my wound and started to move, like this, and did not feel anything, nothing, no pain So I have sex to him because I can get crack. So I have a relationship with him because of it. Because he helps me, because he gives me crack. You know? But he helps me at home too. I hope you stop before. Then I started to want to be hospitalized. Because there, outside, the death passed nearby and not take me. I have consecutive hospitalizations and some short time relapses Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

The Perceptions of Women About Their High Experience of Using Crack Cocaine

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The consumption of psychotropic drugs among Brazilian secondary school students was examined by comparing data from four surveys using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence. Students filled out the form in their classrooms without the presence of teachers. There was also a significant increase in frequent use of alcohol six times or more per month in 6 of the cities, from an average of 9. With respect to illegal drugs, there was a significant increase in lifetime use of marijuana a 3-fold increase from 2. Cocaine use increased 4-fold over the survey period 0. Lifetime use of cocaine significantly increased in eight capitals except Recife and Rio de Janeiro. Lifetime use of medications such as anxiolytics and amphetamines increased 2-fold on average over the survey period. Comparing the four studies, the main conclusion is that there were significant increases in the frequencies for lifetime use, frequent use and heavy use of many drugs. Trends in drug use among students in Brazil: analysis of four surveys in , , and Patients and Methods. There is widespread concern about drug use among students in many parts of the world. An indication of the magnitude of this use may be obtained from epidemiological surveys, which are essential to the framing of public policies and are internationally acknowledged as useful Many regional studies in Brazil have expressed concern over the use of psychotropic drugs among students Unfortunately, surveys tend to use different instruments so it is not always possible to compare their findings; furthermore, there are methodological problems involved in some studies. In , and , three further studies were performed using the same methodology and in the same cities, thus enabling us to compare student drug use at different points in time. A comparison of the findings of these four surveys is extremely important to understand the behavior of Brazilian students concerning psychotropic drugs over time. This paper reports on trends in drug use among Brazilian students and compares results from four nationwide prevalence studies. CEBRID used the same questionnaire for the four surveys in the same cities which was anonymously filled out in classrooms without the presence of teachers, after the organizers had briefly explained the aims of the survey. Students were free to answer in any way or to hand in a blank questionnaire. The questionnaire collected socio-demographic data gender, age, school grade, socioeconomic level , frequency of school attendance, use of non-prescription psychotropic drugs anxiolytics, amphetamines, anticholinergics, barbiturates, codeine-based cough syrups, and opiate analgesics , alcohol, tobacco and illegal drugs inhalants, marijuana and cocaine. A fictitious drug was included in the questionnaire to test for authenticity. Socio-economic status was measured using the scale of the Brazilian Association of Market Survey Institutes, which is based on consumption items and on the educational level of the head of the household. The scale classifies respondents in classes A to E, with A being the highest and E the lowest. Sampling was clustered by school and stratified for different neighborhoods in each city and their socio-economic characteristics into two stages, first by school then by class as proposed by Kish Data correction basically included three separate sub-phases. Since all questions contained several items, split-half reliability testing was applied to eliminate inconsistencies such as answering no to item 'a' lifetime use and yes to item 'b' used in the last year. We checked whether the drug mentioned was psychotropic or not or even if it belonged to the set of drugs in question. Typing errors were corrected, inconsistencies were reviewed manually and drugs were reallocated to their proper categories. All questionnaires containing affirmative responses for the fictitious drug, or containing more than three invalidated or blank responses were excluded from the questionnaire. Better analysis of the data related to psychotropic drug consumption over many years is required, in the form of a sequence of events. This presentation enables us to analyze developments and detect future trends. Therefore, the chi-square test for trends with a 5. This test is used 'if the table of data has two columns and three more rows or two rows and three or more columns , and the categories can be quantified' 19, This test determines 'whether there is a linear trend between row or column number and the fraction of subjects in the left column or top row ' Data were presented in an expanded form. In probabilistic sampling such as that used for the four surveys, results may be expanded to the entire population surveyed using sample weighting. The expansion fraction was the result of division of the total number of classrooms by the number of schools sampled. The sample design predicted that each student would have the same probability of being selected 19, Sample sizes were 16, in , 19, in , 24, in , and 15, in A larger number of female students were included in all four surveys, which is in line with the proportions recorded by the census in Brazil. In the fourth survey, Table 1 shows the frequency of lifetime use of psychotropic drugs in general by city. Nevertheless, taking the ten cities as a whole last line in Table 1 , it may be inferred that there was no change in the lifetime use frequency over the four studies. On the other hand, Figure 1 shows that inhalants were most frequently indicated as 'lifetime use' in all four surveys , , and , excluding tobacco and alcohol from the analysis. Note that, with the exception of Porto Alegre, where marijuana appears for the first time as the most frequently used drug for lifetime use, in the other cities surveyed, inhalants continued to be the drugs most frequently used for lifetime use. Among the six most frequently used drugs, a statistically significant increase in the number of students using these drugs was observed for three of them - marijuana, anticholinergics and cocaine. Noto, S. Nappo and E. Brazilian Journal of Medical and Biological Research, 37 4 : , The analysis of the frequency for lifetime use of drugs by sex comparing the four studies can be seen in Table 2. Table 3 shows drug consumption in general lifetime use by age group in the four surveys. No changes were observed over the years in any of the age groups studied. The most significant percentage of users was detected among students older than There were some extremely high percentages among very young students who had already used some kind of psychotropic drug during their lives. In a total of In the study of the lifetime use of psychotropic medications for the ten cities as a whole, there was a statistically significant increase in the use of amphetamines and anxiolytics. The same applied to marijuana and cocaine when comparing the four studies Table 4. Note also that lifetime use of alcohol and tobacco remained relatively stable in the comparison between the four surveys Table 4. The analysis of the frequent use trend in general six or more times in the 30 days preceding the survey for the ten cities is shown in Table 5. Table 6 illustrates the frequency of frequent use in percentage for the seven drugs most used by the students. Comparison of the four studies indicated that there was an increase in the frequent use of marijuana, amphetamines, anxiolytics and cocaine in the analysis of the 10 cities as a whole. Although inhalants showed the highest percentages for lifetime use, their frequent use remained stable between 1. Legal drugs followed the same trend as inhalants, and their frequent use varied from Concerning the use of heroin, 12 students in a universe of over 15, reported having injected this drug. Figure 1. Comparison among the surveys , , and for the six most used drugs in ten Brazilian capitals. There was a steep decline in percentage rates when analyzing lifetime use compared to heavy use. Lifetime use of alcohol and tobacco remained stable over the four surveys, although the percentages were always substantial, e. These numbers are far in excess of the usage of the other drugs and show that in Brazil the major public health problem concerning drug use involves legal drugs. Any prevention program must necessarily include these two substances. As far as the other drugs are concerned, comparison of the four surveys shows an upward trend in frequent use defined as more than six times per month for many drugs in many cities. It is important to emphasize that the use of marijuana increased in the 10 cities surveyed. Furthermore, for the first time ever, the Porto Alegre data showed that lifetime use of marijuana moved into first place in front of inhalants, which were relegated to second position. Inhalants have traditionally been the most widely used drugs in lifetime use. In this respect, the Porto Alegre data resemble those reported in many studies conducted in other countries such as the United Kingdom, Denmark, France, Spain, Portugal and the United States 22, In an attempt to explain changing frequencies of the use of marijuana in terms of lifetime use and heavy use, one must understand the behavior of young people towards drugs in general, since until recently there were many taboos and prejudices attached to drugs. One of the hypotheses that can be raised to explain this increase in consumption is that young people may feel freer to admit to a habit that has always been relatively frequent despite not being reported in surveys. The media has been taking a less prejudiced approach to marijuana users and different segments of the population have been involved in broader discussion of making the use of marijuana non-criminal. Another hypothesis is that the authorities have turned a blind eye to marijuana use, thus contributing to increased consumption. Reinforcing this idea are the reduced numbers of marijuana apprehensions by the Federal Police in recent years, in contrast to cocaine, for which apprehensions and hospital admissions have increased 24, Cocaine use has also grown over the four surveys. Lifetime use of cocaine increased in eight cities except Recife and Rio de Janeiro. Although the final numbers are relatively small, lifetime use of cocaine in was reported by only students 1. However, this 1. Regardless of these findings about the increased use of marijuana and cocaine, it is important to emphasize that the use of inhalants among students still remains an intractable problem and is sometimes overlooked and neglected. It is important to note that these drugs are potential causes of death, and some investigators have stated that use of inhalants is the gateway to the world of illegal drugs 15, In general, reports indicate increased use of psychotropic drugs by males, particularly illicit drugs 15,30, In fact, an analysis of the four surveys clearly shows a distinct preference for marijuana and cocaine among males compared to women. Males are also less fearful of being in contact with crime. Women prefer to make use of drugs in the form of pills, such as anxiolytics and amphetamines. One possible hypothesis for this result could be that females are brought up in a way that induces them to use these medications and are normally praised exclusively for their physical appearance. This 'upbringing' is probably related to the attitudes of their mothers and society in general, which demands that women be 'calm and skinny' These observations on gender-related differences in preference should not be overlooked when devising an effective prevention plan. Analysis of the four surveys on drug use according to the various age groups showed no increasing frequency of lifetime use for any of the age groups. This precocity may lead to a major risk of abusive use or even to future drug dependency. This is the period in their lives when teenagers are most vulnerable to drugs Although Brazil is a country of continental dimensions, no striking differences were observed concerning the use of drugs in general in the cities surveyed, which represent the five geographical regions. However, certain peculiarities were observed in some of the cities, probably due to local habits or to a larger supply of certain drugs. In the three cities in the Northeast Fortaleza, Recife and Salvador an upward trend in lifetime use was observed regarding the use of anticholinergic substances mainly Trihexyphenidyl. This peculiarity of the Northeast region is also seen in studies involving other segments of the population, such as street children Another interesting regional aspect is the use of benzamide an anti-inflammatory and cycloplegic eye drops eye drops with a benzydamine chlorhydrate base used by ophthalmologists to dilate pupils , which is abusively used nasally and presents anticholinergic effects. There is no control over the sale of these medications in this country. It is therefore important to take into account cultural peculiarities in the elaboration of programs of drug abuse prevention. The media has overreacted to a hypothetical 'explosion of heroin usage' in Brazil. This trend was not observed in the present statistical data. This raises the question of whether the media functions as a promoter, popularizing certain drugs. Nevertheless, the determination of whether or not heroin is present in our daily lives is a matter that must be looked into urgently. Finally, another aspect of the results that should be emphasized was the discrepancy between student age groups and school years. Some studies have associated drug abuse with poor school performance, failure to pass to the next grade and dropping out 36, In Brazil the discrepancy between school year and student age is so significant that one cannot draw any conclusions as to whether drug abuse is related to it or not. Nevertheless, we may state that the elementary school system of this country is flawed in many aspects and has no appeal to the students, so that half of the total number of students are not in the school year corresponding to their age group. When comparing the four studies the major conclusion is that there were significant increases in the lifetime use, frequent use and heavy use for many drugs. These results also indicate the need for more regular studies of this nature that will permit us to monitor drug use trends over the years and ensure the means of providing preventive measures which are adequate to our reality. Address for correspondence: J. E-mail: galduroz psicobio. Open menu Brazil. Brazilian Journal of Medical and Biological Research. Open menu. Text EN Text English. Key words: Students, Trends, Inhalants, Cocaine, Marijuana, Surveys, Brazilian students Introduction There is widespread concern about drug use among students in many parts of the world. Qualitative analysis Since all questions contained several items, split-half reliability testing was applied to eliminate inconsistencies such as answering no to item 'a' lifetime use and yes to item 'b' used in the last year. Drug analysis We checked whether the drug mentioned was psychotropic or not or even if it belonged to the set of drugs in question. Statistical analysis Better analysis of the data related to psychotropic drug consumption over many years is required, in the form of a sequence of events. Results Sample sizes were 16, in , 19, in , 24, in , and 15, in Substance misuse among native and rural high school students in Quebec. International Journal of the Addictions , Edwards RW Drug use among 8th grade students is increasing. Salud Mental , Prevalence of volatile inhalant inhalation among junior high school students in Japan and background life style of users. Addiction , Inhalant use in the United States. Substance use among schoolchildren in the north of England. Drug and Alcohol Dependence , Murad JE Drug abuse among students in the State of Minas Gerais, Brazil. Bulletin on Narcotics , Parte II: Meninos de rua e menores internados. Aspectos sociofamiliares do consumo de tabaco por adolescentes escolares da rede privada do Distrito Federal. Souza DPO Zar JH Biostatistical Analysis 2nd edn. Prentice Hall, Inc. National Institute on Drug Abuse Trends in Drug Use Among 8th, 10th, and 12th Grades. Jornal Brasileiro de Psiquiatria , A review of solvent abusers and their management by a child psychiatric outpatient service. Human Toxicology , 1: Inhalant abuse and heroin addiction: a comparative study on opiate addicts with and without a history of sniffing. Addictive Behaviors , A new trend in solvent abuse deaths? Medicine, Science and the Law , Recreational use of inhalant drug by adolescents: a challenge for family physicians. Family Medicine , Barnes GE Solvent abuse: a review. Morton HG Occurrence and treatment of solvent abuse in children and adolescents. Pharmacology and Therapeutics , Early drinking onset and its association with alcohol use and problem behavior in late adolescence. Preventive Medicine , Carlini EA Addiction , News and Notes. The residual cognitive effects of heavy marijuana use in college students. Journal of the American Medical Association , The impact of alcohol consumption and marijuana use on high school graduation. Health Economics , 5: History Accepted 05 Jan Received 24 Apr This work is licensed under a Creative Commons Attribution 4. Figures 1 Tables 6. Stay informed of issues for this journal through your RSS reader. PDF English. Google Google Scholar.

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