SciELO - Scientific Electronic Library Online

 
vol.16 issue3Novos usos de drogas: um estudo qualitativo a partir das trajectórias de vidaInteracções medicamentosas entre a metadona e os anti-retrovirais author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • Have no similar articlesSimilars in SciELO

Share


Toxicodependências

Print version ISSN 0874-4890

Toxicodependências vol.16 no.3 Lisboa  2010

 

Consumo de álcool em toxicodependentes em tratamento

 

Tânia Silva, Jorge Quintas

Instituto Superior Ciências da Saúde

CONTACTOS

 

RESUMO

Neste estudo pretende-se caracterizar o consumo de álcool nos toxicodependentes em tratamento bem como as repercussões psi­cológicas e sociais deste consumo. Foi elaborado um questionário sobre o consumo de substâncias, comportamentos de risco e activi­dade criminal, e foram também utilizados: The Alcohol Use Disorders Identification Test (AUDIT), Cut; Annoyed; Gilty; Eyer (CAGE), The Inventory of Drug Taking Situation (IDTS), Brief Symptom Inventory (BSI) e a Escala do Suporte Social. Dos resultados obtidos, destaca-se a elevada percentagem de toxicodependentes bebebores de risco, com consumo nocivo e depen­dentes (78% no AUDIT e no CAGE), e o facto de quer a necessidade de consumo, quer as diferentes medidas de frequência de consumo, serem actualmente superiores relativamente ao período anterior ao tratamento. Encontram-se ainda relações positivas significativas entre o consu­mo de álcool e a adopção de comportamentos de risco. Verificou-se ainda uma relação positiva muito significativa entre os sintomas psicopatológicos e o consumo de álcool. Relativamente ao suporte social, apesar destes indivíduos apresen­tarem um suporte social diminuto, não é encontrada uma relação significativa entre este e o consumo de álcool.

Palavras-chave: Toxicodependência; Programas de Substituição Opiácea; Consumos de Álcool; Comportamentos de Risco; Sintomas Psicopatológicos; Suporte Social.

 

RÉSUMÉ

Cette étude veut caractériser la consommation d’alcool par des toxicomanes pendant son traitement, ainsi que les conséquences psychologiques et sociales de cette consommation excessive d’alcool. Un questionnaire a été élaboré sur la toxicomanie, les comporte­ments à risque et les activités criminelles. Le Alcohol Use Disorders Identification Test (AUDIT), le Cut, Annoyed, Gilty; Eyer (CAGE), le Inventory of Drug-Taking Situation (IDTS), le Brief Symptom Inventory (BSI) et l’échelle de soutien social ont également été utilisés. De nos résultats, nous soulignons le pourcentage élevé de toxicoma­nes qui sont des buveurs de risque, avec une consommation nocif et une dépendance (78% dans AUDIT et CAGE) et le fait que tant la nécessité de consommation, tant les diverses mesures de la fréquence de consommation, soient actuellement plus élevés que dans la période avant le traitement. On a découvert encore des relations positives importantes entre la consommation d’alcool et l’adoption de comportements à risque. On a vérifié aussi une relation positive très significative entre les symptômes psychopathologiques et la consommation d’alcool. En ce qui concerne le soutien social, bien que ces individus présentent un support social minuscule, il n’y a pas une relation significative entre celle-ci et la consommation d’alcool.

Mots-clé: Toxicomanie; Programmes de Substitution Opiace; Consumes de Alcool; Comportements de Risque; Symptômes Psycho­pathologiques; Support Social.

 

ABSTRACT

This study aims to characterize the consumption of alcohol addicts in treatment as well as psychological and social consequences of this consumption. A questionnaire was developed on the substance use; risk behaviors and criminal activity were also used: The Alcohol Use Disorders Identification Test (AUDIT), Cut, Annoyed, Gilty; Eyer (CAGE), The Inventory of Drug-Taking Situation (IDTS), Brief Symptom Inventory (BSI) and the scale of social support. The results highlighted, show us high rates of harmful, dependent and risk consumption of alcohol (78% in AUDIT and the CAGE 78%), and the fact that both the need for consumption, whether the various measures of frequency of use, are currently higher when compared with the period prior to treatment. Still, was found a significant positive relationship between alcohol consumption and the adoption of risk behaviors, particularly with regard to sexual risks. The fact that they are living with HIV and hepatitis B correlates positively with the consumption of alcohol, this is not checking for hepatitis C. It was also found a very significant positive relationship between psychopathological symptoms and alcohol consumption. For social support, although these individuals make a small social support, is not found a significant relationship between this and the consumption of alcohol.

Key Words: Addiction; Opioid Substitution Programs; Alcohol Consumption; Risk Behaviors; Psychopathological Symptoms; Social Support.

 

RESUMEN

En este estudio se pretende caracterizar el consumo de alcohol en los drogodependientes en tratamiento bien como las repercu­siones psicológicas y sociales de este consumo. Fue elaborado un cuestionario sobre el consumo de sustancias, comportamientos de riesgo y actividad criminal, y fueran también utilizados: The Alcohol Use Disorders Identification Test (AUDIT), Cut; Annoyed; Gilty; Eyer (CAGE), The Inventory of Drug-Taking Situation (IDTS), Brief Symptom Inventory (BSI) y la Escala del suporte social. De entre los resultados obtenidos se destaca el elevado porcentaje de drogodependientes que son bebedores de riesgo con un consumo nocivo y dependientes (78% en el AUDIT y en el CAGE), bien como el facto de que tanto la necesidad de consumo como las diferentes medidas de frecuencia de consumo sean actualmente superiores en lo que respecta al periodo anterior al tratamiento. Aún se destacan relaciones positivas significativas entre el consumo de alcohol y la adopción de comportamientos de riesgo. Se verificó también una relación positiva muy significativa entre los síntomas psicopatológicos y el consumo de alcohol. Relativamente al suporte social, a pesar de que estos sujetos presen­ten un suporte social diminuto, no se verifica que tengan una relación significativa con el consumo de alcohol.

Palabras Clave: Drogodependencia; Programas de Sustitución Opiácea; Consumos de Alcohol; Comportamientos de Riesgo; Síntomas Psicopatológicos; Suporte Social.

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

REFERÊNCIAS BIBLIOGRÁFICAS

Agra, (1980). Entre Droga e Crime, Actores, Espaços, Trajectórias. Lisboa: Notícias Editorial

Annis, H.; Martin, G. (1985). Inventory of Drug Taking Situations – Addiction Research Foundation, Toronto.

Anglin, M.; Almong, I.; Fisher, D., & Peters, R. (1989). “Alcohol use by heroin addicts: Evidence for an inverse relationship. A study of methadone maintenance and drugs free treatment sample”. American Journal of Drug and Alcohol Abuse, 15, 191-207.

Babor, Thomas F. et al. (2001). The alcohol use disorders identification test: Guidelines for use in primary care. 2ª Ed. Geneva: Word Health organization – Department of mental health and substance dependence.

Barol, T. F., Hofmann, M., DelBoca, F. K., Hesselbrock, V., Meyer, R. E., Dolinsky, Z. S., & Rounsaville, B.(1992). “Types of alcoholics:I. Evidence for an empirically derived typology based on indicators of vulnerability and severity”, Archives of General Psychiatry, 49, 599-608.

Backmund, Markus et al. (2003). “Alcohol consumption in heroin users, methadone – substituted and codeine – substituted patients – frequency and correlates of use”. European and addition research. 9.1, 45-50.

Batki, Steven et al. (2002). “A controlled trial of methadone treatment combined with directly observed isoniazid for tuberculosis prevention in injection drug users”. Drug and Alcohol Dependence. ELSEVIER. 66, 283-293.

Bickel, W. K.; Marion, I.; Lowinson, J. (1987). “Treatment of alco­holic methadone patients: a review”. Journal os Subtance Abuse and Treatment. 4, 15-19.

Bickel, W. & Rizzuto, P. (1991). “The naturalistic patterns of Alcohol consumption in alcoholic methadone patients”. Journal Study Alcohol, 52 (5), 454-457.

Caputo, F. et al. (2002). “Short-term, methadone administration reduces alcohol consumption in non-alcoholic heroin addicts”. Alcohol & Alcoholism. 37 (2), 164-168.

Canavarro, M. C. (1999). Inventário de Sintomas psicopatológicos – B.S.I.. In Mário R. Simões, Miguel M. Gonçalves, & Leandro. S. Almeida (Eds.), Testes e provas psicológicas em Portugal, 2, 87-109.

Costa, Nuno Felix da; Marques, Rui (2002). “Representações mentais de substâncias psicoactivas”. Revista Toxicodependências, Lisboa, 8 (1): 3-12.         [ Links ]

Cunningham, C. O., Kunins, H. V., Roose, R. J., Elam, R. T., & Sohler, N. L. (2007). “Barriers to obtaining waivers to prescribe buprenorphine for opioid addiction treatment among HIV physicians”, Journal of General Internal Medicine, (22), 1325-1329.

Davis, W. R., & Johnson, B. D. (2008). “Prescription opioid use, misuse, and diversion among street drug users in New York City”, Drug and Alcohol Dependence, (92), 267-276.

Dias, C. A. (1980). A influência Relativa dos Factores Psicológicas e Sociais no Evolutivo Toxicómano. Dissertação de Doutoramento, Coimbra.

Driessen, M., Veltrup, C., Wetterling, T., Ulrich, J., & Dilling, H. (1998). “Axis I and Axis II comorbidity in alcohol dependence and the two types of alcoholism”, Alcoholism: Clinical and Experimental Research, (22), 77-86.

El-Bassel, N.; Schiling, R.; Turnbull, J., & Su, K. (1993). ”Correlates of alcohol use among methadone patients”. Alcoholism: Clinical and Experimental Research, 17 (3),681-686.

Etter, Jean François (2004). “Asking about quantity and frequency of alcohol consumption before asking the CAGE-question produces lower rating on de CAGE-test”. Drug Alcohol Dependence. 74:2, 211-214.

Ewing, Ja. (1984). Detecting alcoholism: the CAGE questionnaire. JAMA 252: 1905-7.

Fromberg, Eric (2004). “Os riscos fazem parte da vida”. European AIDS Treatment News. 13:1. 22-24.

Gossop, Michael et al. (1993). Severity of heroin dependence and HIV risk sharing injecting equipment. AIDS care. 5:2

Gossop, Michael et al. (2002). “Patterns of drinking and drinking outcomes among drug misurers. 1 – year follow-up results”. Journal of substance abuse. 19:1 (2002): 45-50.

Gossop, Michael; Marsden, John; Stewart, Duncan (2002). “Dual dependence upon alcohol and illicit drugs, and the relationship of alcohol dependence among drug misusers to patterns of drinking, illicit drug use and health problems”. Addiction. Society for the study of addiction alcohol and others drugs. ISBN 0965-2140. 97:2, 169-178.

Guerra, M. e Agra, C. (1996). A prova da existência. A adaptação psicológica de toxicodependentes seropositivos ao vírus HIV em liberdade e em meio prisional: um estudo comparativo tendo em vista a reinserção social. Droga e Crime: Estudos Interdisciplinares. Lisboa: Ministério da Justiça, Gabinete de Planeamento e de Coordenação do Combate à Droga.

Guerra, M. P. (1998). Sida: Implicações Psicológicas. Lisboa: Fim de Século Edições Lda.

Guerra. M. P. (1995). Uma escala de avaliação do suporte social: Sua aplicação numa população seropositiva ao vírus HIV. In: Avaliação psicológica: Formas e Contextos; 3: 25-34.

Hillebrand, Jennifer et al. (2001). “Excessive alcohol consumption and drinking expectation among clients in methadone maintenance”. Journal of substance abuse treatment. National Addiction Centre Institute of Psychiatry. ISSN 0740-5472. 21: 3. 155-160.

Kendler, K. S., Prescott, C. A., Myers, J., & Neale, M. C. (2003). “The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women”. Archives of General Psychiatry, (60), 929-937.

Lopes, Rosa (2004). “Consumo de álcool nos jovens – estudo da influência das características psicológicas: alexitimia, auto-conceito e locais de controlo”. In Revista Arquivos de Psiquiatria, Suplemento de Arquivos de Medicina, vol. 18, Supl. 4, Faculdade de Medicina da Universidade do Porto.

Lowenstein, William et al. (1998). A metadona e os tratamentos de subs­tituição. 1ª Edição. Colecção Alcoolismo e Toxicomanias Modernas 3. Lisboa: Climepsi Editores. ISBN 972-8449-04-6.150.

L. K., Muller, M. C. M., Nascimento, C. A. M., Noal, M. H. O., Plein, F. A. S., & Zadra, C. N. (1995). “Depressão em alcoólicos hospitalizados”. Jornal Brasileiro de Psiquiatria, 44 (12), 625-629.

MacManus, E. & Fitzpatrick, C. (2007). “Alcohol dependence and mood state in a population receiving methadone maintenance treatment”. Irish Journal of Psychology Medical, 24 (1), 19-22.

Madianos, M. G; Gefou-Madianou, D; Stefanis. (2004). “Drinking prac­tices of illicit and licit drug users in the general population across Greece”. American Journal of Drug and Alcohol Abuse. 20:4, 547-559.

Marllat, A., & Gordon, J. (1985); Prevenção da Recaída: Estratégia e manutenção no tratamento de comportamentos adictivos, New York: Guilford Press.

Masur, J.; Monteiro, M. G. (1983). “Validation of the “CAGE” Alcoholism Screening Test in a Brazilian Psychiatric Inpatient Hospital Setting”. Brazilian Journal of Medical and Biological Research 16: 215-218.

McCUSKER, Monica (2001). “Influence of hepatitis C status on alcohol consumption in opiate users in treatment”. Addiction. London: Chelsea and Westminster Menthal health NHS Trust Substance Misuese Service. 96:7, 1007-1016.

McCUSKER, Monica et al. (2002). “Hazardous and harmful drinking: a comparison of the Audit and Cage screening questionnaires”. Q. Journal Medicine. London. 95, 591-596.

Mello, Maria Lucília; Barrias, José; Breda (2001). “Álcool e problemas ligados ao álcool em Portugal. Lisboa: Direcção Geral de Saúde. ISBN 925-9425-93-0. 115-120.

Mórel, Alain; Hervé, François; Fontaine, Bernard (1998). Cuidado ao toxicodependente. Colecção Alcoolismo e Toxicomanias Modernas 4. 1ª Edição. Lisboa: Climepsi Editores. ISBN 972-8449-15-1. 563.

Observatório Europeu da Droga e da Toxicodependência (2008). “A evolução do fenómeno da droga na Europa”. Relatório Anual 2008, Lisboa, Portugal.

OMS (2000). Classificação de transtornos mentais e de compor­tamentos da CID – 10. Porto Alegre: Artes Médicas.

Ottomanelli, G. (1999). “Methadone patients and alcohol abuse”. Journal of Substance Abuse and Treatment, 16 (2), 113-121.

Patrício, L. (1997). Face à droga: como (re)agir? Lisboa: Figueirinhas.

Patrício, L. (2002). Droga para que se saiba. Lisboa: Figueirinhas.

Pessione, F. et al. (1998). “Effect of alcohol consumption on serum hepatitis C virus RNA and histological lesions in chronic hepatitis C”. Journal Hepatology. 27.

Rehm, J. et al. (2001). “Steps towards constructing a global com­parative risk analysis for alcohol consumption: determining indicators and empirical Weights for patterns os drinking, deciding about theo­retical minimum, and dealing with different consequences. European Addiction Research. 7:3. 138-147.

Rittmannsberger, H.; Silberbauer, C.; Lehner, R., & Ruschak, M. (2002). “Alcohol consumption during methadone maintenance treat­ment”. European Addiction Research, 6 (1), 2-7.

Roche, A. M. Richard G. P. (1991). “Doctors ’willingness to intervene in patients’ drug and alcohol problems”. Social Science Medicine, 33 (9): 1053-61.

Roche, A. M, Guray C, Saunders J. B. (1991). “General practitioners’ experiences of patients with drug and alcohol problems. Br J Addict. 86 (3): 263-75.

Ross, H.; Glasser, F.; Germanson, T., et al. (1988). “The prevalence of psychiatric disorders in patients with alcohol and other drug problems”. Archives of General Psichiatry, 45 (11), 1023-1031.

Skipsey, Kitera; Burleson, Joseph; Kranzler, Henry. (1997). “Utility of the Audit for identification of hazardous or harmful drinking in drug-dependent patients”. Drug and alcohol Dependence. Elsevier. (45) .157­163.

Stein, M; Maksad, J.; Clarke, J. (2001). “Hepatitis C disease among injection drug users: Knowledge, perceived risk and willingness to receive treatment”. Drug and Alcohol Dependence. (61). 211-215.

WHO (2004). “Neurocience of psychoactive substance use and depen­dence”. World Health Organization: Geneva.

 

CONTACTOS:

TÂNIA PATRÍCIA TAVARES DA SILVA

Psicóloga Clínica Instituto Superior Ciências da Saúde – Norte Rua Central de Gandra Telemóvel: 962706955 | E-mail: tsilva082@gmail.com

JORGE ALBINO QUINTAS DE OLIVEIRA

Doutorado em Criminologia Prof. Instituto Superior Ciências da Saúde – Norte Rua Central de Gandra Telemóvel: 912168980 | E-mail: jorge.quintas@iscsn.cespu.pt

 

Artigo recebido em 24/08/10; versão final aceite em 12/11/10.