Uso y abuso de substancias en adultos mayores atendidos en Servicios de Salud Mental
DOI:
https://doi.org/10.18004/mem.iics/1812-9528/2022.020.01.73Palabras clave:
ASSIST, sustancias psicoactivas, prevención, adultos mayores, salud públicaResumen
El uso de drogas por los ancianos se caracteriza por ser un grave problema de salud pública. El número de usuarios de mayor edad ha aumentado a nivel internacional durante los últimos 40 años, pero el tema sigue siendo descuidado. Este estudio se centra en pacientes ancianos con síntomas de enfermedades mentales concomitantes. Así, se investigó el tiempo de uso, patrones de consumo de sustancias de abuso y el perfil sociodemográfico de los pacientes atendidos en los Centros de Atención Psicosocial por Alcohol y Drogas (CAPS-AD), ubicados en la ciudad de Río de Janeiro. Se trata de un estudio observacional descriptivo con un diseño cuantitativo transversal sobre la frecuencia de abuso de sustancias en la población mencionada. Las prevalencias obtenidas en este estudio son inferiores a las encontradas en la población general y a las reportadas en estudios internacionales. Esta diferencia puede estar relacionada con las características socioculturales de la muestra y el hecho de que los pacientes ya están en contacto con un servicio de salud mental, lo que puede indicar la importancia del contacto regular con los servicios de salud como factor protector y espacio de ayuda.
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Guedes da Paz E, Jesus da Silva Mendes D, Nogueira Brito S, Oliveira Barbosa W. Doenças neurodegenerativas em adultos e idosos: um estudo epidemiológico descritivo. Rev Neurocienc 2021; 29:1-11. Doi: 10.34024/rnc.2021.v29.12348 [ Links ]
Fahmy V, Hatch SL, Hotopf M, Stewart R. Prevalence of illicit drug use in people aged 50 years and over from two surveys. Age and Ageing. 2012; 41(4): 553-6. Doi: 10.1093/ageing/afs020 [ Links ]
Schlaerth KR, Splawn RG, Ong J, Smith SD. Change in the pattern of illegal drug use in an inner-city population over 50: an observational study. J Addict Dis 2004; 23(2): 95-107. Doi: 10.1300/J069v23n02_07 [ Links ]
European Monitoring Centre for Drugs and Drug Addiction. EMCDDA. Treatment and care for older drug users. Luxembourg: European Monitoring Centre for Drugs and Drug Addiction; 2010. [ Links ]
Beynon CM, McVeigh J, Roe B. Problematic drug use, ageing and older people: trends in the age of drug users in Northwest England. Ageing & Society. 2007; 27(6): 799-810. Doi: 10.1017/S0144686X07006411 [ Links ]
Crome I, Wu L, Rao R, Crome P. Substance use and older people. West Sussex: John Wiley and Sons Inc.; 2015. [ Links ]
Taylor MH, Grossberg GT. The growing problem of illicit substance abuse in the elderly: a review. Prim Care Companion CNS Disord 2012; 14(4): PCC.11r01320. Doi: 10.4088/PCC.11r01320 [ Links ]
Lofwall MR, Schuster A, Strain EC. Changing profile of abused substances by older persons entering treatment. J Nerv Ment Dis 2008; 196(12): 898-905. Doi: 10.1097/NMD.0b013e31818ec7ee [ Links ]
Lofwall MR, Brooner RK, Bigelow GE, Kindbom K, Strain EC. Characteristics of older opioid maintenance patients. J Subst Abuse Treat 2005; 28(3): 265-72. Doi: 10.1016/j.jsat.2005.01.007 [ Links ]
Beynon CM, Roe B, Duffy P, Pickering L. Self-reported health status, and health service contact, of illicit drug users aged 50 and over: a qualitative interview study in Merseyside, United Kingdom. BMC Geriatrics. (2009); 9(1):45. Doi: 10.1186/1471-2318-9-45 [ Links ]
Gossop M, Moos R. Substance misuse among older adults: a neglected but treatable problem. Addiction. 2008; 103(3): 347-48. Doi: 10.1111/j.1360-0443.2007.02096.x [ Links ]
Wu LT, Blazer DG. Illicit and nonmedical drug use among older adults: A review. J Aging Health 2011; 23(3): 481-504. Doi: 10.1177/0898264310386224 [ Links ]
Roibás AL, Melendro AIL, Montes MJG. Perspectivas de futuro y propuestas de recursos terapéuticos para adictos de edad avanzada. Revista Española de Drogodependencias. 2010; 35(2): 170-81. Doi: 10.5144/0256-4947.2018.319 [ Links ]
Kuerbis A, Sacco P, Blazer DG, Moore AA. Substance abuse among older adults. Clin Geriatr Med 2014; 30(3): 629-54. Doi: 10.1016/j.cger.2014D.04.008 [ Links ]
Bachi K, Sierra S, Volkow ND, Goldstein RZ, Alia-Klein N. Is biological aging accelerated in drug addiction? Current Opinion in Behavioral Sciences. 2017; 13:34-39. Doi: 10.1016/j.cobeha.2016.09.007 [ Links ]
Gfroerer J, Penne M, Pemberton M, Folsom R. Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort. Drug and Alcohol Dependence. 2003; 69(2): 127-135. Doi: 10.1016/s0376-8716(02)00307-1 [ Links ]
Simoni-Wastila L, Yang HK. Psychoactive drug abuse in older adults. The American Am J Geriatr Pharmacother 2006; 4(4): 380-94. Doi: 10.1016/j.amjopharm.2006.10.002 [ Links ]
Han B, Gfroerer JC, Colliver JD, Penne MA. Substance use disorder among older adults in the United States in 2020. Addiction. 2009; 104(1): 88-96. Doi: 10.1111/j.1360-0443.2008.02411.x [ Links ]
Pirona A, Guarita B, Montanari L, Noor A. Ageing and addiction: challenges for treatment systems. In: Proceedings of the Lisbon Addictions Conference 2015. Lisbon, Portugal; 2015. [ Links ]
Lowe DJE, Sasiadek JD, Coles AS, George TP. Cannabis and mental illness: a review. Eur Arch Psychiatry Clin Neurosci 2019; 269(1): 107-20. Doi: 10.1007/s00406-018-0970-7 [ Links ]
Brady KT, Sinha R. Co-occurring mental and substance use disorders: The neurobiological effects of chronic stress. Am J Psychiatry 2005; 162(8): 1483-93. Doi: 10.1176/appi.ajp.162.8.1483 [ Links ]
Arias F, Szerman N, Vega P, Mesias B, Basurte I, Morant C, Ochoa E, Poyo F, Babín F. Estudio Madrid sobre prevalencia y características de los pacientes con patología dual en tratamiento en las redes de salud mental y de atención al drogodependiente. Adicciones. 2013; 25(2):118-27. [ Links ]
Ibrahim Y, Hussain SM, Alnasser S, Almohandes H, Sarhandi I. Patterns and sociodemographic characteristics of substance abuse in Al Qassim, Saudi Arabia: a retrospective study at a psychiatric rehabilitation center. Annals of Saudi Medicine. 2018; 38(5): 319-25. Doi: 10.5144/0256-4947.2018.319 [ Links ]
Karlin B, Duffy M, Gleaves D. Patterns and predictors of mental health service use and mental illness among older and younger adults in the United States. Psychological Services. 2008; 5(3): 275-94. Doi: 10.1037/1541-1559.5.3.275 [ Links ]
LaBarre C, Linn BK, Bradizza CM, Bowen EA, Stasiewicz PR. Conceptualizing recovery capital for older adults with substance use disorders. Journal of Social Work Practice in the Addictions. 2021; 21(4): 417-27. Doi: 10.1080/1533256X.2021.1973827 [ Links ]
Germack HD, Weissinger G, Bizhanova Z, Martsolf GR. Psychiatric medication changes associated with increased rate of medical readmissions in patients with serious mental illness. J Nerv Ment Dis 2020; 209 (3): 166-73. Doi: 10.1097/NMD.0000000000001282 [ Links ]
Gregg L, Barrowclough C, Haddock G. Reasons for increased substance use in psychosis. Clin Psychol Rev 2007; 27(4): 494-510. Doi: 10.1016/j.cpr.2006.09.004 [ Links ]
Bizzarri JV, Rucci P, Sbrana A, Miniati M, Raimondi F, Ravani L, Massei GJ, Milani F, Milianti M, Massei G, Gonnelli C, Cassano GB. Substance use in severe mental illness: self-medication and vulnerability factors. Psychiatry Res 2009; 165 (1-2): 88-95. Doi: 10.1016/j.psychres.2007.10.009 [ Links ]
Konkoly Thege B, Horwood L, Slater L, Tan MC, Hodgins DC, Wild TC. Relationship between interpersonal trauma exposure and addictive behaviors: A systematic review. BMC Psychiatry. 2017; 17(1): 164. Doi: 10.1186/s12888-017-1323-1 [ Links ]
Köck P, Walter M. Personality disorder and substance use disorder-An update. Mental Health and Prevention. 2018; 12:82-9. Doi: 10.1016/j.mhp.2018.10.003 [ Links ]
Morisano D, Babor TF, Robaina KA. Co-occurrence of substance use disorders with other psychiatric disorders: Implications for treatment services. Nordic studies on alcohol and drugs. 2014; 31(1):5-25. Doi: 10.2478/nsad-2014-0002 [ Links ]
Dahlberg LL, Krug EG. Violência: um problema global de saúde pública. Ciência & Saúde Coletiva. 2006; 11(suppl.): 1163-78. Doi: 10.1590/S1413-81232006000500007 [ Links ]
Gil AC. Como elaborar projetos de pesquisa. 4. ed. São Paulo: Atlas; 2008. [ Links ]
Fletcher RH, Fletcher SW. Epidemiologia clínica - elementos essenciais. 4. ed. Porto Alegre: Artmed Editora; 2006. [ Links ]
Trevisan ER, Castro SS. Centros de Atenção Psicossocial - álcool e drogas: perfil dos usuários. Saúde em Debate. 2019; 43 (121): 450-63. Doi: 10.1590/0103-1104201912113 [ Links ]
Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução nº 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União. Brasília, nº 12, p. 59, 13 jun 2013. Seção 1. Disponível: http://bit.ly/1mTMIS3 [ Links ]
World Health Organization. ICD-10: international statistical classification of diseases and related health problems: tenth revision, 2nd ed. World Health Organization. 2004. https://apps.who.int/iris/handle/10665/42980 [ Links ]
WHO ASSIST Working Group. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Development, Reliability and Feasibility. Addiction. 2002; 97:1183-194. [ Links ]
Humeniuk RE, Ali RA, Babor TF, Farrell M, Formigoni ML, Jittiwutikarn J, et al. Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Addiction. 2008; 103(6):1039-47. [ Links ]
Humeniuk RE, Dennington V, Ali RL. The effectiveness of a brief intervention for illicit drugs linked to the ASSIST Screening Test in Primary Health Care Settings: A Technical Report of Phase III Findings of the WHO ASSIST Randomised Controlled Trial. Geneva, World Health Organization; 2008. [ Links ]
Tantirangsee N, Assanangkornchai S. Prevalence, patterns, associated factors and severity of substance use among psychotic patients in southern Thailand. Asian Journal of Psychiatry. 2015; 13: 30-37. Doi: 10.1016/j.ajp.2014.11.006 [ Links ]
Le Breton D. Antropologia do Corpo. Ed. Vozes: Petrópolis; 2003. [ Links ]
Korper S, Council C. Substance Use by Older Adults: Estimates of Future Impact on the Treatment System. DHHS Publication No. SMA 03-3763, Analytic Series A-21. Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Rockville, USA; 2002. [ Links ]
Hubbard RL, Craddock SG, Anderson J. Overview of 5-year follow-up outcomes in the drug abuse treatment outcome studies (DATOS). J Subst Abuse Treat 2003; 25: 125-34. Doi: 10.1016/s0740-5472(03)00130-2 [ Links ]
Ghadigaonkar DS, Kandasamy A, Sivakumar PT. Forensic aspects of substance use in older adults. J Subst Abuse Treat 2021; 43(5):128-33. doi: 10.1177/02537176211047957 [ Links ]
Gryczynski J, Schwartz RP, Mitchell SG, O'Grady KE, Ondersma SJ. Hair drug testing results and self-reported drug use among primary care patients with moderate-risk illicit drug use. Drug and Alcohol Dependence. 2014; 141: 44-50. Doi: 10.1016/j.drugalcdep.2014.05.001 [ Links ]
Antoniazzi RP, Zanatta FB, Ardenghi TM, Feldens CA. The use of crack and other illicit drugs impacts oral health-related quality of life in Brazilians. Oral Dis. 2018; 24(3): 482-8. Doi: 10.1111/odi.12786 [ Links ]
Kuerbis A, Sacco P, Blazer DG, Moore AA. Substance abuse among older adults. Clin Geriatr Med 2014; 30(3): 629-54. Doi: 10.1016/j.cger.2014.04.008 [ Links ]
Sacco P, Kuerbis A, Goge N, Bucholz KK. Help seeking for drug and alcohol problems among adults age 50 and older: a comparison of the NLAES and NESARC surveys. Drug Alcohol Depend 2013; 131(1-2): 157-61. Doi: 10.1016/j.drugalcdep.2012.10.008 [ Links ]
Fahmy V, Hatch SL, Hotopf M, Stewart R. Prevalence of illicit drug use in people aged 50 years and over from two surveys. Age Ageing 2012; 41(4): 553-56. [ Links ]
The United Nations Office on Drugs and Crime (UNODC). Drugs and Age. Drugs and associated issues among young people and older people. United Nations; 2018. Disponible en: http://www.odc.gov.co/Portals/1/publicaciones/pdf/internacionales/IN1022018_drugs_and_age_2018.pdf [ Links ]
Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol 2003; 38(8): 843-53. Doi: 10.1016/s0531-5565(03)00133-5 [ Links ]
Romero Ayuso DM. Actividades de la vida diaria. Anales de Psicología. 2007; 23(2): 264-71. Disponible en: https://revistas.um.es/analesps/article/view/22291 [ Links ]
Beynon C, McVeigh J, Hurst A, Marr A. Older and sicker: changing mortality of drug users in treatment in the North West of England. International Journal of Drug Policy. 2010; 21(5): 429-31. Doi:10.1016/j.drugpo.2010.01.012 [ Links ]
Dowling GJ, Weiss SR, Condon TP. Drugs of abuse and the aging brain. Neuropsychopharmacology 2008; 33: 209-18. Doi: 10.1038/sj.npp.1301412 [ Links ]
Ferreira AP. Dependência química e o cenário dos usuários de drogas atendidos nos Centros de Atenção Psicossocial Álcool e Drogas: A política de saúde na atenção integral aos idosos. Revista Interfaces: Saúde, Humanas e Tecnologia. 2021; 9: 1147-57. [ Links ]
Elwyn G, Edwards A, Kinnersley P, Grol R. Shared decision making and the concept of equipoise: the competences of involving patients in healthcare choices. British Br J Gen Pract 2000; 50: 892-9. [ Links ]
Elwyn G, Frosch D, Rollnick S. Dual equipoise shared decision making: definitions for decision and behaviour support interventions. Implement Sci 2009; 4:75. Doi: 10.1186/1748-5908-4-75 [ Links ]
Pillon SC, Cardoso L, Pereira GAM, Mello E. Perfil dos idosos atendidos em um centro de atenção psicossocial - álcool e outras drogas. Esc. Anna Nery 2020; 14(4): 742-748. Doi: 10.1590/S1414-81452010000400013 [ Links ]
Chait R, Fahmy S, Caceres J. Cocaine abuse in older adults: An underscreened cohort. Journal of the American Geriatrics Society. 2020; 58: 391-2. Doi:10.1111/j.1532-5415.2009.02697.x [ Links ]
Chhatre S, Cook R, Mallik E, Jayadevappa R. Trends in substance use admissions among older adults. BMC Health Serv Res 2017; 17(1): 584. Doi: 10.1186/s12913-017-2538-z [ Links ]
Lehmann S, Fingerhood M. Substance-use disorders in later life. N Engl J Med 2018; 379(24): 2351-60. Doi: 10.1056/NEJMra1805981 [ Links ]
