Abstract Objective: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. Methods: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conductedin73publicmiddleschoolsinthreeBrazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). Results: The present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. Conclusions: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations. Objective COVID19 COVID 19 COVID-1 AprilAugust April August 2021, 2021 , 2021) symptomatology Methods clusterrandomized cluster randomized trial conductedinpublicmiddleschoolsinthreeBrazilian conductedin publicmiddleschoolsinthreeBrazilian cities program 53 61% 61 (61 girls 152 15 2 15. years. years . years) preintervention pre intervention FebruaryMarch February March 2019, 2019 2019) NovemberDecember November December school alcohol, (alcohol drinking tobacco inhalants marijuana cocaine crack periods sex age status city control intervention. intervention) Results pastyear pastmonth but decelerating However initiated maintained Mainly problems hyperactivity Conclusions period factors manifestations COVID1 1 COVID- 202 5 6 (6 201 20 (

ABSTRACT Introduction: In 2020, some 284 million people used illicit drugs. To transport drugs there are those who use the inside of their body, called body packers, a dangerous practice that imposes challenges when facing them. Objectives: Describe the diagnosis and treatment of body packer. Methods: A descriptive cross-sectional study was carried out at the Dr. “Carlos J. Finlay” Central Military Hospital from January 2021 to October 2023. The population under study consisted of 9 patients diagnosed as body packers who attended the health care center. Variables used: age groups, sex, skin color, country of origin, clinical manifestations, complications, complementary exams, treatment, capsule evacuation time, number of capsules and substance transported. Results: Among human drug carriers, the highest incidence was in adult, mixed race and Latin American patients. Of these, 77.7% evolved asymptomatic and without complications. The computed tomography confirmed multiple images in the lumen of the digestive tract and the urine toxicological analysis reported: cocaine in 100% of the patients, in addition, among them, one positive for marijuana. The treatment used was conservative: oral polyethylene glycol, with high effectiveness and average evacuation time of 15 hours; quantity of capsules in the range of 22 to 146. Conclusions: Computed tomography is useful for the diagnosis and monitoring of body packers. Conservative treatment for asymptomatic patients, with multidisciplinary surveillance and the use of polyethylene glycol, is safe and efficient.

RESUMEN Introducción: En el año 2020 unos 284 millones de personas consumieron drogas ilícitas. Para su transportarte hay quienes emplean el interior de su cuerpo, llamados body packers, práctica peligrosa que impone desafíos al enfrentarlos. Objetivos: Describir el diagnóstico y tratamiento del body packer. Métodos: Se realizó un estudio descriptivo de corte transversal en el Hospital Militar Central Dr. “Carlos J. Finlay” desde enero de 2021 a octubre de 2023. La población objeto de estudio quedó constituida por 9 pacientes diagnosticados como body packers que acudieron al centro asistencial. Variables utilizadas: grupos etarios, sexo, color de piel, país de origen, manifestaciones clínicas, complicaciones, complementarios, tratamiento, tiempo de evacuación de las cápsulas, cantidad de cápsulas y sustancia transportada. Resultados: Entre los portadores humanos de drogas la mayor incidencia estuvo en los pacientes adultos, mestizos y latinoamericanos. De estos el 77,7 % evolucionó asintomático y sin complicaciones. La tomografía computarizada confirmó imágenes múltiples en la luz del tubo digestivo y la analítica-toxicológica en orina informó: cocaína en el 100 % de los pacientes, además, entre estos, uno positivo a marihuana. El tratamiento utilizado fue conservador: polietilenglicol vía oral, con alta efectividad y tiempo de evacuación promedio de 15 horas; cantidad de cápsulas en rango de 22 a 146. Conclusiones: La tomografía computarizada es útil para el diagnóstico y seguimiento de los body packers. El tratamiento conservador para el asintomático, con la vigilancia multidisciplinaria y el uso de polietilenglicol, es seguro y eficiente.

RESUMEN Objetivo: evaluar una aplicación móvil desarrollada para prevenir el consumo de alcohol y/u otras drogas por parte de estudiantes adolescentes. Método: estudio metodológico, con enfoque cuantitativo, realizado de julio de 2018 a julio de 2021, basado en las etapas del Diseño Instruccional Contextualizado para la construcción de tecnología: análisis, diseño, desarrollo, implementación y evaluación. La evaluación del contenido se llevó a cabo por 22 expertos. El aspecto gráfico y la usabilidad de la aplicación fueron testeados por 13 adolescentes que representaban al público objetivo. Resultados: la aplicación móvil “Educação Para Prevenção” (Educación para la Prevención) abordó sustancias psicoactivas: alcohol, marihuana, cigarrillos, éxtasis, crack, cocaína, inhalantes (pegamento/lanzaperfume) y anfetaminas, abordando temas como conceptos, efectos fisiológicos y conductuales, uso durante la adolescencia, estrategias de prevención y reducción de daños. El Índice de Validación de Contenido promedio fue de 0,87. Hubo un alto nivel de acuerdo entre los adolescentes sobre el aspecto gráfico y la usabilidad (96,6%) de la aplicación. Conclusión: los resultados demuestran que expertos y adolescentes consideraron válida la aplicación, por lo que los enfermeros podrán utilizarla como instrumento facilitador en acciones de educación en salud en la escuela, con el objetivo de prevenir el uso de alcohol y/u otras drogas entre los adolescentes. Se recomienda realizar un estudio de intervención para evaluar el efecto de la tecnología desarrollada. Objetivo yu u Método metodológico cuantitativo 201 2021 análisis diseño desarrollo 2 1 Resultados Educação Prevenção Educación Prevención psicoactivas marihuana cigarrillos éxtasis crack cocaína pegamento/lanzaperfume pegamentolanzaperfume pegamento lanzaperfume (pegamento/lanzaperfume anfetaminas conceptos conductuales adolescencia daños 087 0 87 0,87 96,6% 966 96 6 (96,6% Conclusión escuela 20 202 08 8 0,8 96,6 9 (96,6 0, 96, (96, (96 (9 (

RESUMO Objetivo: avaliar um aplicativo móvel desenvolvido para prevenir o uso de álcool e/ou outras drogas por estudantes adolescentes. Método: estudo metodológico, de abordagem quantitativa, realizado no período de julho de 2018 a julho de 2021, baseado nas etapas do Design Instrucional Contextualizado para construção de tecnologia: análise, desenho, desenvolvimento, implementação e avaliação. A avaliação de conteúdo foi realizada por 22 especialistas. O aspecto gráfico e a usabilidade do aplicativo foram testados por 13 adolescentes representantes do público-alvo. Resultados: o aplicativo móvel “EPP: Educação Para Prevenção” abordou as substâncias psicoativas: álcool, maconha, cigarro, ecstasy, crack, cocaína, inalantes (cola e lança-perfume) e anfetaminas, tratando de temas como conceitos, efeitos fisiológicos e comportamentais, uso durante a adolescência, estratégias de prevenção e redução de danos. A média do Índice de Validação de Conteúdo foi de 0,87. Verificou-se elevado nível de concordância entre os adolescentes quanto ao aspecto gráfico e à usabilidade (96,6%) do aplicativo. Conclusão: os resultados demonstram que os especialistas e os adolescentes consideraram o aplicativo válido, e os enfermeiros poderão utilizá-lo como um instrumento facilitador nas ações de educação em saúde na escola, visando à prevenção do uso de álcool e/ou outras drogas entre adolescentes. Recomenda-se a realização de um estudo de intervenção para avaliar o efeito da tecnologia desenvolvida. Objetivo eou ou Método metodológico quantitativa 201 2021 análise desenho desenvolvimento 2 1 públicoalvo. públicoalvo público alvo. alvo público-alvo Resultados EPP “EPP Prevenção psicoativas maconha cigarro ecstasy crack cocaína cola lançaperfume lança perfume lança-perfume anfetaminas conceitos comportamentais adolescência danos 087 0 87 0,87 Verificouse Verificou se 96,6% 966 96 6 (96,6% Conclusão válido utilizálo utilizá lo escola Recomendase Recomenda desenvolvida 20 202 08 8 0,8 96,6 9 (96,6 0, 96, (96, (96 (9 (

ABSTRACT Objective: to evaluate a mobile application developed to prevent the use of alcohol and/or other drugs among adolescent students. Method: methodological study with a quantitative approach carried out from July 2018 to July 2021 based on the stages of Contextualized Learning Design for technology development: analysis, design, development, implementation and evaluation. The content evaluation was carried out by 22 experts. The application’s graphic design and usability were tested by 13 teenagers representing the target audience. Results: the mobile application “Educação Para Prevenção” [Education For Prevention] addressed the following psychoactive substances: alcohol, marijuana, cigarettes, ecstasy, crack, cocaine, inhalants (glue and poppers) and amphetamines, dealing with topics such as concepts, physiological and behavioral effects, use during adolescence, prevention and harm reduction strategies. The average Content Validity Index score was 0.87. There was a high level of agreement among adolescents regarding the graphic design and the usability (96.6%) of the application. Conclusion: the results show that the experts and the adolescents considered the application valid, and nurses will be able to use it as a facilitating instrument in health education actions in schools, aiming to prevent the use of alcohol and/or other drugs among adolescents. It is recommended that an intervention study be carried out to evaluate the effect of the technology developed. Objective andor or students Method 201 202 development analysis 2 applications s 1 audience Results Educação Prevenção Education Prevention substances marijuana cigarettes ecstasy crack cocaine glue poppers amphetamines concepts effects adolescence strategies 087 0 87 0.87 96.6% 966 96 6 (96.6% Conclusion valid schools 20 08 8 0.8 96.6 9 (96.6 0. 96. (96. (96 (9 (

Abstract Objective: To know the consumption of tobacco, marijuana and cocaine in Mexican adolescents in times of COVID-19. Materials and methods: Quantitative, descriptive and cross-sectional study carried out with 265 Mexican adolescents between 12 and 19 years of age, chosen through a non-probabilistic sampling. The information was collected using the SurveyMonkey digital platform, the data was processed in the SPSS 23.0 statistical program. Descriptive statistics were used to obtain frequencies, proportions, measures of central tendency and variability. Results: The average age was 17.8 years, the start of alcohol consumption was at 16.7 years, tobacco at 16.8 years, marijuana at 17 years and cocaine at 17.3 years. The average number of alcoholic beverages consumed on a typical day was 3.3, the average number of cigarettes consumed on a typical day was 2.2, the average use of marijuana was 1.2, and that of cocaine was 2.5. 66.8% of the participants have consumed alcohol at some time in their life, 49.9% have consumed alcohol in the last year. 18.5% have consumed cigarettes at least once in their life and only 13.6% consumed it in the last year. 7.2% of adolescents have used marijuana at some time in their life and only 3.8% used it in the last year. 3.4% have used cocaine at some time in their life and 1.9% in the last year. Conclusions: The prevalence of licit and illicit drug use shows a significant increase, which is worrying, since during adolescence any amount consumed is risky and harmful to physical and mental health.

Resumen Objetivo: Conocer el consumo de tabaco, mariguana y cocaína en adolescentes mexicanos en tiempos de la COVID-19. Materiales y métodos: Estudio cuantitativo, descriptivo y transversal realizado con 265 adolescentes mexicanos entre 12 y 19 años de edad, elegidos mediante un muestreo no probabilístico. La recolección de la información se llevó a cabo mediante la plataforma digital SurveyMonkey, los datos fueron procesados en el programa estadístico SPSS 23.0. Se utilizó estadística descriptiva para obtener frecuencias, proporciones, medidas de tendencia central y de variabilidad. Resultados: El promedio de edad fue de 17.8 años, el inicio de consumo de alcohol fue a los 16.7 años, tabaco a los 16.8 años, marihuana a los 17 años y cocaína a los 17.3 años. El promedio de bebidas alcohólicas consumidas en un día típico fue de 3.3, la media de cigarrillos consumidos en un día típico fue de 2.2, la media del consumo marihuana fue de 1.2 y la de cocaína de 2.5. El 66.8 % de los participantes han consumido alcohol alguna vez en la vida, 49.9% ha consumido alcohol en el último año. El 18.5% han consumido cigarrillos al menos una vez en la vida y solo el 13.6% lo consumió en el último año. El 7.2% del adolescente han consumido marihuana alguna vez en la vida y solo el 3.8% consumió en el último año. El 3.4% ha consumido cocaína alguna vez en la vida y 1.9% en el último año. Conclusiones: Las prevalencias del consumo de drogas lícitas e ilícitas denotan un incremento significativo, lo cual es preocupante, debido que durante la adolescencia cualquier cantidad consumida es riesgosa y dañina para la salud física y mental.

ABSTRACT Objective To estimate the prevalence of syphilis and its associated factors in women who were treated at public maternity hospitals and received prenatal care in a primary healthcare unit. Methods This cross-sectional study included 399 postpartum women. Interviews were conducted, and additional data were extracted from the pregnant woman’s booklet, medical records, and printed tests. The dependent variable was a gestational syphilis diagnosis. The independent variables were grouped into socioeconomic and demographic, behavioral, reproductive, and prenatal blocks. The prevalence, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The χ 2 test was also performed (p≤0.05). Multivariate analysis was performed using Poisson regression models. Results The prevalence of gestational syphilis was 9.61% (95%CI: 7.14-12.83). We identified the following determining factors (adjusted prevalence ratios): history of sexually transmitted infections (2.3), first sexual intercourse by the age of 15 (2.42), partner having a history of syphilis (5.98), partner using crack/cocaine (6.42) and marijuana and others (3.02), not having a partner (3.07), low income (2.85), history of stillbirth (5.21), beginning prenatal care in the third trimester (3.15), and prenatal care received in a primary healthcare unit (without a Family Health Strategy team) (0.35). Conclusion Individual and prenatal factors were associated with gestational syphilis. To control congenital syphilis, targeted interventions are needed to control syphilis in the adult population including expansion of access to quality prenatal care with identification of risks for syphilis and connection between prevention and treatment actions, implementation of strategies focused on early sexual education, effective establish prenatal care involving both partners, and effective implementation of the National Men’s Health Policy (PNAISH - Política Nacional de Atenção Integral à Saúde dos Homens ). crosssectional cross sectional 39 conducted womans woman s booklet records tests diagnosis demographic behavioral reproductive blocks ratios 95 95%CI 95CI CI (95%CI calculated p≤0.05. p005 p p≤0.05 . 0 05 (p≤0.05) models 961 9 61 9.61 7.1412.83. 7141283 7.14 12.83 7 14 12 83 7.14-12.83) adjusted ratios) 2.3, 23 2.3 , 3 (2.3) 1 2.42, 242 2.42 42 (2.42) 5.98, 598 5.98 5 98 (5.98) crackcocaine crack cocaine 6.42 642 6 (6.42 3.02, 302 3.02 02 (3.02) 3.07, 307 3.07 07 (3.07) 2.85, 285 2.85 85 (2.85) 5.21, 521 5.21 21 (5.21) 3.15, 315 3.15 (3.15) without team 0.35. 035 0.35 35 (0.35) actions education partners Mens Men PNAISH ) p00 p≤0.0 (p≤0.05 96 9.6 1412 7.1412.83 714128 714 7.1 1283 12.8 8 7.14-12.83 2. (2.3 24 2.4 4 (2.42 59 5.9 (5.98 6.4 64 (6.4 30 3.0 (3.02 (3.07 28 2.8 (2.85 52 5.2 (5.21 31 3.1 (3.15 03 0.3 (0.35 p0 p≤0. (p≤0.0 9. 141 7.1412.8 71412 71 7. 128 12. 7.14-12.8 (2. (2.4 5. (5.9 6. (6. 3. (3.0 (2.8 (5.2 (3.1 0. (0.3 p≤0 (p≤0. 7.1412. 7141 7.14-12. (2 (5. (6 (3. (0. p≤ (p≤0 7.1412 7.14-12 ( (5 (3 (0 (p≤ 7.141 7.14-1 (p 7.14-

Abstract In much of the West, including Brazil, drug use has increased since social distancing began in response to the pandemic. Use of smoked and modified drugs, and their impacts on health, may contribute to aggravate the effects of the pandemic. However, studies on the relationship between use of smoked drugs and the new coronavirus are still scarce and have not received enough attention in global health recommendations. This paper aims to briefly review the relationship between use of smoked drugs and acute respiratory syndrome coronavirus 2 [SARS-CoV-2]. Recent studies also suggest that drug consumption increases the risk of contamination by SARS-CoV-2 and leads to worse prognosis, particularly consumption of drugs that affect lung function. Use of smoked drugs, especially tobacco, is strongly associated with lung diseases that are risk factors for contamination by SARS-CoV-2. It is essential to develop strategies based on specific characteristics of drug users and for mental health professionals to be included in strategic teams. It is also necessary to invest in information campaigns regarding risks and prevention of harm caused by smoked drugs as well as to design strategies that facilitate access to psychosocial treatment during the pandemic. West Brazil pandemic However recommendations SARSCoV2. SARSCoV2 SARSCoV SARS CoV . [SARS-CoV-2] SARS-CoV- prognosis function tobacco 2. teams [SARS-CoV-2 SARS-CoV [SARS-CoV- [SARS-CoV

El objetivo de este estudio fue estimar la prevalencia de consumo de sustancias psicoactivas por adolescentes de escuelas públicas brasileñas. Se trata de un estudio transversal, realizado con una muestra aleatoria de adolescentes de cinco escuelas públicas, ubicadas en una ciudad de la región centro-oeste de la Región Metropolitana de São Paulo, Brasil. La información sobre las características demográficas, socioeconómicas y de consumo de drogas se recabó de cuestionarios autoinformados. La muestra estuvo compuesta por 1.460 estudiantes; 716 (49%) de los cuales eran varones, con edades entre 10 y 19 años (13,19±2,04 años). La prevalencia de consumo de sustancias psicoactivas en el último mes fue: para analgésicos 51%; alcohol 48,8%; tabaco 37,3%; tranquilizantes 30,8%; marihuana 23,1%; esteroides anabólicos 22,6%; éxtasis 21,6%; anfetaminas/estimulantes 15,3%; fenciclidina 13,4%; cocaína/crack 12,9%; inhalantes/disolventes 12,6%; opiáceos 11,5%; alucinógenos 11,4%; y otras drogas no clasificadas 16,2%. Los estudiantes de primaria fueron los más propensos a consumir tabaco (OR = 2,306; IC95%: 1,733-3,068; p < 0,001), y los varones los más propensos a consumir cualquier tipo de sustancia. Se identificó un alto consumo de sustancias psicoactivas entre los participantes, con mayor prevalencia entre los estudiantes del sexo masculino. brasileñas transversal centrooeste centro oeste Paulo Brasil demográficas autoinformados 1460 1 460 1.46 71 49% 49 (49% 13,19±2,04 1319204 13 2 04 (13,19±2,0 años. . años) 51% 51 48,8% 488 48 8 37,3% 373 37 3 30,8% 308 30 23,1% 231 23 22,6% 226 22 6 21,6% 216 21 anfetaminasestimulantes anfetaminas estimulantes 15,3% 153 15 13,4% 134 4 cocaínacrack cocaína crack 12,9% 129 12 9 inhalantesdisolventes inhalantes disolventes 12,6% 126 11,5% 115 11 5 11,4% 114 162 16 16,2% OR 2,306 2306 306 IC95% IC95 IC 1,7333,068 17333068 1,733 3,068 733 068 1,733-3,068 0,001, 0001 0,001 , 0 001 0,001) sustancia participantes masculino 146 46 1.4 7 (49 13,19±2,0 131920 (13,19±2, 48,8 37,3 30,8 23,1 22,6 21,6 15,3 13,4 12,9 12,6 11,5 11,4 16,2 2,30 230 IC9 7333 1,7333,06 1733306 1733 1,73 3068 3,06 73 06 1,733-3,06 000 0,00 00 14 1. (4 13,19±2, 13192 (13,19±2 48, 37, 30, 23, 22, 21, 15, 13, 12, 11, 16, 2,3 1,7333,0 173330 173 1,7 3,0 1,733-3,0 0,0 ( 13,19±2 1319 (13,19± 2, 1,7333, 17333 17 1, 3, 1,733-3, 0, 13,19± 131 (13,19 1,7333 1,733-3 13,19 (13,1 1,733- 13,1 (13, (13 (1

This study aimed to estimate the prevalence of psychoactive substance use by adolescents from public schools. This is a cross-sectional study that used a random sample of adolescents from five public schools located in a municipality in the central-west region of the São Paulo Metropolitan Area, Brazil. Information on demographic, socioeconomic, and drug use was collected using self-report questionnaires. The sample consisted of 1,460 students, 716 (49%) males, aged 10-19 years (13.19±2.04 years). The prevalence of psychoactive substance use in the last month was 51% for analgesics; 48.8% for alcohol; 37.3% for tobacco; 30.8% for tranquilizers; 23.1% for marijuana; 22.6% for anabolic steroids; 21.6% for ecstasy; 15.3% for amphetamines/stimulants; 13.4% for phencyclidine; 12.9% for cocaine/crack; 12.6% for inhalants/solvents; 11.5% for opiates; 11.4% for hallucinogens; and 16.2% for other unclassified drugs. Elementary and middle school students were more likely to consume tobacco (OR = 2.306; 95%CI: 1.733-3.068; p < 0.001), and male students were more likely to consume any type of substance. We identified a high use of psychoactive substances among this study participants, with a higher prevalence among male students. crosssectional cross sectional centralwest central west Area Brazil demographic socioeconomic selfreport self report questionnaires 1460 1 460 1,46 71 49% 49 (49% males 1019 10 19 10-1 13.19±2.04 1319204 13 2 04 (13.19±2.0 years. . years) 51 analgesics 488 48 8 48.8 alcohol 373 37 3 37.3 308 30 30.8 tranquilizers 231 23 23.1 marijuana 226 22 6 22.6 steroids 216 21 21.6 ecstasy 153 15 15.3 amphetamines/stimulants amphetaminesstimulants amphetamines stimulants 134 4 13.4 phencyclidine 129 12 9 12.9 cocaine/crack cocainecrack cocaine crack 126 12.6 inhalants/solvents inhalantssolvents inhalants solvents 115 11 5 11.5 opiates 114 11.4 hallucinogens 162 16 16.2 drugs OR 2.306 2306 306 95%CI 95CI CI 95 1.7333.068 17333068 1.733 3.068 733 068 1.733-3.068 0.001, 0001 0.001 , 0 001 0.001) participants 146 46 1,4 7 (49 101 10- 13.19±2.0 131920 (13.19±2. 48. 37. 30. 23. 22. 21. 15. 13. 12. 11. 16. 2.30 230 7333 1.7333.06 1733306 1733 1.73 3068 3.06 73 06 1.733-3.06 000 0.00 00 14 1, (4 13.19±2. 13192 (13.19±2 2.3 1.7333.0 173330 173 1.7 3.0 1.733-3.0 0.0 ( 13.19±2 1319 (13.19± 2. 1.7333. 17333 17 1. 3. 1.733-3. 0. 13.19± 131 (13.19 1.7333 1.733-3 13.19 (13.1 1.733- 13.1 (13. (13 (1

O objetivo foi estimar a prevalência de uso de substâncias psicoativas por adolescentes de escolas públicas. Trata-se de um estudo transversal com uma amostra aleatória de adolescentes de cinco escolas públicas localizadas em um município da zona centro-oeste da Região Metropolitada de São Paulo, Brasil. Informações sobre as características demográficas, socioeconômicas e de uso de drogas foram coletadas por meio de questionários autorreferidos. A amostra foi composta por 1.460 estudantes, sendo 716 (49%) meninos, com idade entre 10 e 19 anos (13,19±2,04 anos). A prevalência de uso de substâncias psicoativas no último mês foi de 51,0% para analgésicos; álcool 48,8%; tabaco 37,3%; tranquilizantes 30,8%; maconha 23,1%; esteroides anabolizantes 22,6%; ecstasy 21,6%; anfetaminas/estimulantes 15,3%; fenciclidina 13,4%; cocaína/crack 12,9%; inalantes/solventes 12,6%; opiáceos 11,5%; alucinógenos 11,4%; e outras drogas não classificadas 16,2%. Alunos do Ensino Fundamental foram mais propensos a consumir tabaco (OR = 2,306; IC95%: 1,733-3,068; p < 0,001), e os estudantes do sexo masculino foram mais propensos a consumir qualquer tipo de substância. Identificou-se um alto uso de substâncias psicoativas entre os participantes deste estudo, com maior prevalência entre os estudantes do sexo masculino. Tratase Trata se centrooeste centro oeste Paulo Brasil demográficas autorreferidos 1460 1 460 1.46 71 49% 49 (49% meninos 13,19±2,04 1319204 13 2 04 (13,19±2,0 anos. . anos) 510 51 0 51,0 analgésicos 48,8% 488 48 8 37,3% 373 37 3 30,8% 308 30 23,1% 231 23 22,6% 226 22 6 21,6% 216 21 anfetaminasestimulantes anfetaminas estimulantes 15,3% 153 15 13,4% 134 4 cocaínacrack cocaína crack 12,9% 129 12 9 inalantessolventes inalantes solventes 12,6% 126 11,5% 115 11 5 11,4% 114 162 16 16,2% OR 2,306 2306 306 IC95% IC95 IC 1,7333,068 17333068 1,733 3,068 733 068 1,733-3,068 0,001, 0001 0,001 , 001 0,001) substância Identificouse Identificou 146 46 1.4 7 (49 13,19±2,0 131920 (13,19±2, 51, 48,8 37,3 30,8 23,1 22,6 21,6 15,3 13,4 12,9 12,6 11,5 11,4 16,2 2,30 230 IC9 7333 1,7333,06 1733306 1733 1,73 3068 3,06 73 06 1,733-3,06 000 0,00 00 14 1. (4 13,19±2, 13192 (13,19±2 48, 37, 30, 23, 22, 21, 15, 13, 12, 11, 16, 2,3 1,7333,0 173330 173 1,7 3,0 1,733-3,0 0,0 ( 13,19±2 1319 (13,19± 2, 1,7333, 17333 17 1, 3, 1,733-3, 0, 13,19± 131 (13,19 1,7333 1,733-3 13,19 (13,1 1,733- 13,1 (13, (13 (1

ABSTRACT Objective: To compare lung function between adolescents with and without substance use disorder (SUD). Methods: This was an observational, cross-sectional exploratory study. The sample consisted of 16 adolescents with SUD and 24 age-matched healthy controls. The adolescents in the clinical group were recruited from a psychiatric inpatient unit for detoxification and rehabilitation; their primary diagnosis was SUD related to marijuana, cocaine, or polysubstance use. Questionnaires and pulmonary function tests were applied for clinical evaluation. Results: We found that FVC, FEV1, and their percentages of the predicted values were significantly lower in the adolescents with SUD than in those without. Those differences remained significant after adjustment for BMI and the effects of high levels of physical activity. The largest effect size (Cohen’s d = 1.82) was found for FVC as a percentage of the predicted value (FVC%), which was, on average, 17.95% lower in the SUD group. In addition, the years of regular use of smoked substances (tobacco, marijuana, and crack cocaine) correlated negatively with the FVC%. Conclusions: This exploratory study is innovative in that it demonstrates the early consequences of smoked substance use for the lung health of adolescents with SUD. Objective . (SUD) Methods observational crosssectional cross sectional 1 2 agematched age matched controls rehabilitation marijuana cocaine evaluation Results FEV1 FEV activity Cohens Cohen s 1.82 182 82 FVC%, FVC% , (FVC%) average 1795 17 95 17.95 addition tobacco, tobacco (tobacco Conclusions (SUD 1.8 18 8 (FVC% 179 9 17.9 1. (FVC 17.

RESUMO Objetivo: Comparar a função pulmonar de adolescentes com e sem transtornos relacionados ao uso de substâncias (TUS). Métodos: Trata-se de um estudo exploratório transversal observacional. A amostra foi composta por 16 adolescentes com TUS e 24 controles saudáveis emparelhados pela idade. Os adolescentes do grupo clínico foram recrutados em uma unidade de internação psiquiátrica para desintoxicação e reabilitação; seu diagnóstico primário era o de TUS (maconha, cocaína ou polissubstâncias). Foram aplicados questionários e testes de função pulmonar para a avaliação clínica. Resultados: A CVF, o VEF1 e seus valores em porcentagem do previsto foram significativamente mais baixos nos adolescentes com TUS do que naqueles sem TUS. Essas diferenças permaneceram significativas após os ajustes para levar em conta o IMC e os efeitos de altos níveis de atividade física. O maior tamanho de efeito (d de Cohen = 1,82) foi o observado em relação à CVF em porcentagem do previsto (CVF%), que foi, em média, 17,95% menor no grupo TUS. Além disso, os anos de uso regular de substâncias fumadas (tabaco, maconha e crack) correlacionaram-se negativamente com a CVF%. Conclusões: Este estudo exploratório é inovador na medida em que demonstra as consequências precoces do uso de substâncias fumadas para a saúde pulmonar de adolescentes com TUS. Objetivo . (TUS) Métodos Tratase Trata se observacional 1 2 idade reabilitação maconha, (maconha polissubstâncias. polissubstâncias polissubstâncias) clínica Resultados VEF física d 1,82 182 82 CVF%, CVF% , (CVF%) média 1795 17 95 17,95 disso tabaco, tabaco (tabaco crack correlacionaramse correlacionaram Conclusões (TUS 1,8 18 8 (CVF% 179 9 17,9 1, (CVF 17,

Resumen Introducción: El riesgo de suicidio aumenta durante la adolescencia por factores que actúan acumulativamente. El estudio tuvo como objetivo identificar los factores asociados al peligro de suicidio en adolescentes escolarizados. Materiales y métodos: En una muestra de 565 adolescentes escolarizados se midió el riesgo de suicidio a través de la escala de Plutchick y se identificó su asociación con el género, funcionamiento familiar, ser víctima de desplazamiento forzado, tener antecedentes familiares de intento y/o suicidio consumado, síntomas psiquiátricos, dependencia a sustancias psicoactivas, acoso escolar y adicción al internet, por medio de la aplicación de instrumentos válidos y confiables. Resultados: Un 28,8 % de los adolescentes escolarizados presentó riesgo de suicidio. La mayoría de los factores estudiados se asociaron al riesgo de suicidio, tales como el género (χ² = 14,539a; gl = 1; p = 0,000), víctima de desplazamiento (χ² = 4,095a; gl = 1; p = 0,043), antecedentes familiares de suicidio e intento de suicidio (χ² = 54,891a; gl = 1; p = 0,000), funcionalidad familiar (χ² = 82,819a; gl = 3; p = 0,000), síntomas psiquiátricos (χ² = 187,915a; gl = 1; p = 0,000), consumo de riesgo de marihuana (χ² = 6,830a; gl = 1; p = 0,009), cocaína (χ² = 6,023a; gl = 1; p = 0,014) y tranquilizantes (χ² = 6,354a; gl = 1; p = 0,012), acoso escolar (χ² = 8,754a; gl = 1; p = 0,003) y adicción al internet (χ² = 16,486a; gl = 1; p = 0,000). Conclusión: El riesgo de suicidio en los adolescentes escolarizados está asociado a varios factores, es decir es un fenómeno multifactorial, por lo que se sugiere estrategias integrales de prevención con enfoque de gestión integral de riesgos, que permitan identificar tempranamente el riesgo de suicidio para priorizar las medidas preventivas y terapéuticas como parte integral del proceso educativo de los adolescentes.

Abstract Introduction: The risk of suicide increases during adolescence due to risk factors that act cumulatively. The objetive of the study was to identify the factors associated with the risk of suicide in adolescents enrolled in school. Materials and methods: In a sample of 565 adolescents enrolled in school, the risk of suicide was measured using the Plutchick scale and its association with gender, family functioning, being a victim of forced displacement, having a family history of attempted and / or completed suicide, psychiatric symptoms, psychoactive substances dependence, bullying and internet addiction, through the application of valid and reliable instruments. Results: 28,8 % of school adolescents presented risk of suicide. Most of the factors studied were associated with risk of suicide, such as gender (χ² = 14,539a; gl = 1; p = 0,000), victim of displacement (χ² = 4,095a; gl = 1; p = 0,043), family history of suicide and suicide attempt (χ² = 54,891a; gl = 1; p = 0,000), family functionality (χ² = 82,819a; gl = 3; p = 0,000), psychiatric symptoms (χ² = 187,915a; gl = 1; p = 0,000), risky consumption of marijuana (χ² = 6,830a; df = 1; p = 0,009), cocaine (χ² = 6,023a; df = 1; p = 0,014) and tranquilizers (χ² = 6,354a; gl = 1; p = 0,012), bullying (χ² = 8,754a; gl = 1; p = 0,003) and internet addiction (χ² = 16,486a; gl = 1; p = 0,000). Conclusion: The risk of suicide in school adolescents is associated with several factors, that is, it is a multi- factorial phenomenon, so comprehensive prevention strategies with a comprehensive risk management approach are suggested, which allow early identification of suicide risk to prioritize measures. preventive and therapeutic as an integral part of the educational process of adolescents.

Resumo O tabagismo é um problema de Saúde Pública e é controversa a liberação do seu uso no sistema prisional. Sua prevalência nesta população é elevada, inclusive nas prisões femininas. O objetivo deste artigo é estimar a prevalência do tabagismo em mulheres privadas de liberdade e os fatores associados. Estudo de corte transversal, com 259 participantes que responderam um questionário numa prisão no Centro-Oeste do Brasil. A variável dependente foi o tabagismo, e as independentes, as sociodemográficas, histórico de vida, situação jurídica e uso de outras drogas. Realizou-se análises descritiva e bivariada, através de razões de prevalência com o teste Qui-quadrado e, na análise multivariável, a regressão de Poisson. A prevalência de tabagismo foi de 86,87%. No modelo final as variáveis: faixa etária, de 18 a 39 anos (RP 1,33; IC95% 1,10-1,61); uso de álcool (RP 1,26; IC95% 1,00-1,59); uso de maconha (RP 1,16; IC95% 1,03-1,30); e interação entre tempo de prisão e uso de cocaína (RP 1,05; IC95% 1,00-1,11) se mantiveram associadas ao tabagismo. A prevalência de tabagismo foi alta. A faixa etária 18-39 anos, uso de álcool, maconha e interação entre tempo de prisão por 36 meses ou mais e uso de cocaína foram fatores associados ao tabagismo.

Abstract Tobacco use is a Public Health issue, and the release of its use in the prison system is controversial. Its prevalence in this population is high, including in women’s prisons. The objective of this article is to estimate tobacco use prevalence in women deprived of liberty and its associated factors. Cross-sectional study with 259 participants who answered a questionnaire in a prison in the Brazilian Midwest. The dependent variable was tobacco use, and the independent variables were sociodemographic, life history, legal status, and use of other drugs. Descriptive and bivariate analyses were performed, using prevalence ratios through the Chi-square test and Poisson regression in the multivariate analysis. Tobacco use prevalence was 86.87%. In the final model, the variables: age group, from 18-39 years (PR 1.33; 95%CI 1.10-1.61), alcohol use (PR 1.26; 95%CI 1.00-1.59), marijuana use (PR 1.16; 95%CI 1.03-1.30), and interaction between prison time and cocaine use (PR 1.05; 95%CI 1.00-1.11) remained associated with tobacco use. Tobacco use prevalence was high. The age group 18-39 years, alcohol and marijuana use and interaction between imprisonment length of 36 months or more and cocaine use were associated with tobacco use.

RESUMO Objetivo: rastrear o consumo de drogas por gestantes em pré-natal de baixo risco, usuárias da atenção básica de saúde. Método: estudo transversal, desenvolvido em 2016, 2018 e 2020, em município do Paraná - Brasil. Rastreou-se o consumo de drogas de abuso com uso do ASSIST 3.1. Utilizou-se estatística descritiva, não paramétrica e coeficiente de correlação de Spearman. Resultados: entrevistou-se 588 gestantes. Verificou-se uso atual de álcool, tabaco, maconha e cocaína durante a gestação e aumento progressivo no consumo destas substâncias, constatou-se correlações significativas entre o risco relacionado ao consumo das drogas de abuso entre si, nível de escolaridade, renda familiar, cor e religião. Conclusão: o consumo atual de uma das drogas foi correlacionado com as demais, revelando um perfil de usuárias com poliuso de substâncias, jovens, primigestas, casadas, sem residência própria, nível educacional médio, renda familiar de até dois salários mínimo, de cor preta e/ou parda, e católicas.

ABSTRACT Objective: to screen drug consumption by pregnant women undergoing low-risk prenatal care and who use Primary Health Care services. Method: a cross-sectional study developed in 2016, 2018 and 2020 in a municipality from Paraná, Brazil. Consumption of drugs of abuse was screened using ASSIST 3.1. Descriptive and non-parametric statistics was used, as well as Spearman’s correlation coefficient. Results: a total of 588 pregnant women were interviewed. Current use of alcohol, tobacco, marijuana and cocaine during pregnancy was verified, as well as a progressive increase in the consumption of these substances; significant correlations were found between the risk related to the consumption of drugs of abuse between them, schooling level, family income, skin color and religion. Conclusion: current consumption of one of the drugs was correlated with the others, revealing a profile of women with substance polyuse, young, primiparous, married, without their own house, medium schooling level, family income of up to two minimum wages, black- and/or brown-skinned, and catholic.

RESUMEN Objetivo: detectar el consumo de drogas en mujeres embarazadas que cursan atención prenatal de bajo riesgo y utilizan los servicios de Atención Primaria de la Salud. Método: estudio transversal desarrollado en los años 2016, 2018 y 2020 en un municipio de Paraná, Brasil. El consumo de drogas se detectó empleando ASSIST 3.1. Se utilizó estadística descriptiva y no paramétrica, además del coeficiente de Spearman. Resultados: se entrevistó a 588 mujeres embarazadas. Se verificó consumo actual de alcohol, tabaco, marihuana y cocaína durante el embarazo y un aumento progresivo en el uso de estas sustancias; se encontraron correlaciones significativas entre el riesgo relacionado con el consumo de drogas de abuso entre sí, nivel de estudios, ingreso familiar, color de piel y religión. Conclusión: se correlacionó el consumo actual de una de las drogas con las demás, revelando un perfil de usuarias con consumo de sustancias múltiples, jóvenes, primíparas, casadas, sin residencia propia, nivel de estudios medio, ingreso familiar de hasta dos salarios mínimos, de raza negra y/o morena, y católicas.

Abstract Tobacco use is a Public Health issue, and the release of its use in the prison system is controversial. Its prevalence in this population is high, including in women’s prisons. The objective of this article is to estimate tobacco use prevalence in women deprived of liberty and its associated factors. Cross-sectional study with 259 participants who answered a questionnaire in a prison in the Brazilian Midwest. The dependent variable was tobacco use, and the independent variables were sociodemographic, life history, legal status, and use of other drugs. Descriptive and bivariate analyses were performed, using prevalence ratios through the Chi-square test and Poisson regression in the multivariate analysis. Tobacco use prevalence was 86.87%. In the final model, the variables: age group, from 18-39 years (PR 1.33; 95%CI 1.10-1.61), alcohol use (PR 1.26; 95%CI 1.00-1.59), marijuana use (PR 1.16; 95%CI 1.03-1.30), and interaction between prison time and cocaine use (PR 1.05; 95%CI 1.00-1.11) remained associated with tobacco use. Tobacco use prevalence was high. The age group 18-39 years, alcohol and marijuana use and interaction between imprisonment length of 36 months or more and cocaine use were associated with tobacco use.

Resumo O tabagismo é um problema de Saúde Pública e é controversa a liberação do seu uso no sistema prisional. Sua prevalência nesta população é elevada, inclusive nas prisões femininas. O objetivo deste artigo é estimar a prevalência do tabagismo em mulheres privadas de liberdade e os fatores associados. Estudo de corte transversal, com 259 participantes que responderam um questionário numa prisão no Centro-Oeste do Brasil. A variável dependente foi o tabagismo, e as independentes, as sociodemográficas, histórico de vida, situação jurídica e uso de outras drogas. Realizou-se análises descritiva e bivariada, através de razões de prevalência com o teste Qui-quadrado e, na análise multivariável, a regressão de Poisson. A prevalência de tabagismo foi de 86,87%. No modelo final as variáveis: faixa etária, de 18 a 39 anos (RP 1,33; IC95% 1,10-1,61); uso de álcool (RP 1,26; IC95% 1,00-1,59); uso de maconha (RP 1,16; IC95% 1,03-1,30); e interação entre tempo de prisão e uso de cocaína (RP 1,05; IC95% 1,00-1,11) se mantiveram associadas ao tabagismo. A prevalência de tabagismo foi alta. A faixa etária 18-39 anos, uso de álcool, maconha e interação entre tempo de prisão por 36 meses ou mais e uso de cocaína foram fatores associados ao tabagismo.

ABSTRACT Paraguay was traditionally listed as one of the largest marijuana producers worldwide. In recent years, with the discovery of several cocaine laboratories, international seizures of said substance and the hegemonic presence of the First Command of the Capital (PCC), it was affirmed that the small South American nation would be immersed in a deep and marked process of transformation of their illegalities. The methodology used was qualitative, with a country focus, under the time period stipulated between the years 2016 and 2020. Among the main results we can highlight that the growth of this activity had as a context low investment, precarious control, and abundant suspicions of complicity by the political / government class. In another sense, a dislocated production is reflected, in conjunction with the countries of the region. It is recommended to analyze the production associating above all with the tax level that this product could generate.

RESUMEN Tradicionalmente Paraguay fue catalogado como uno de los mayores productores de marihuana a nivel mundial. En los últimos años, con el descubrimiento de varios laboratorios de cocaína, in- cautaciones internacionales de dicha sustancia y la presencia hegemónica del Primer Comando de la Capital (PCC), se afirmó que la pequeña nación sudamericana se encontraría inmersa en un profundo y marcado proceso de transformación de sus ilegalidades. La metodología utilizada fue cualitativa, con un enfoque país, bajo el espacio temporal estipulado entre los años 2016 y 2020. Entre los principales resultados podemos destacar que el crecimiento de esta actividad tuvo como contexto una baja inversión, precario control, y abundantes sospechas de complicidad por parte de la clase política/gubernamental. En otro sentido, se refleja una producción dislocada, en conjunto con los países de la región. Se recomienda analizar la producción asociando sobre todo al nivel impositivo que este producto podría generar, que, si bien es un tema controversial, el trabajo plantea situar desde otro punto de vista la lucha contra el narcotráfico.

Resumo Verificar as diferenças do julgamento moral em relação às pessoas que abusam de drogas de acordo com a escolaridade dos participantes. Parte brasileira de um estudo multicêntrico. N=180 indivíduos de uma comunidade em Brasília, DF, Brasil. Dados descritivos foram coletados por questionário que incluía dados sóciodemográfico, escolaridade e o histórico de uso de drogas. Os participantes eram predominantemente mulheres, de meia idade, casados, empregados, religiosos e com ensino médio; participantes com escolaridade superior consideraram abusadores de álcool, maconha, cocaína e crack importantes como qualquer outra pessoa; a maioria com menor nível educacional conhecia alguém que usava drogas, mas nenhuma associação foi encontrada quanto ao uso de drogas e a escolaridade; no modelo de regressão logística não ajustada, associações positivas foram encontradas entre o ensino superior e “quem usa drogas são tão importantes quanto qualquer outra pessoa” para todas as drogas estudadas; Depois de ajustado, a associação permaneceu apenas para a maconha (para todos os dados p <0,05). A escolaridade pode ajudar a reduzir o estigma associado aos usuários de drogas; políticas públicas podem minimizar os danos sociais causados por tais visões estigmatizadas.

Abstract The aim of the present study is to verify the differences of the moral judgment toward the people who abuse drugs according to the schooling of the participants. This is the Brazilian part of a multicentric study. N=180 individuals in a community in Brasília, DF, Brazil; following consent, descriptive data were collected by anonymous interviewer-administered questionnaire that included socio-demographic, educational level and the history of drug use. Participants were predominantly females, middle-aged, married, employed, religious, with high school education; higher schooling considered alcohol abusers, marijuana, cocaine and crack are important as anyone else; the majority with lower education level knew someone who used drugs, but no association was found regarding drug use and schooling; in the unadjusted logistic regression model, positive associations were found between higher schooling and ‘who use drugs are as important as anyone else’ for all drugs studied; after adjusted, the association remained only for marijuana (all p<0.05). The negative attitude surrounding drugs issue can be an important obstacle. The results suggest that education can help to reduce the stigma associated; public policies would be important to minimizing social harm caused by stigmatized visions of drug users.

Abstract The consumption of psychoactive substances in Colombia has increased, both legal and illegal, especially in university students, if we review the national studies on consumption developed by the Colombian Drug Observatory (2016), we can conclude that not only does consumption increase, but the age of onset decreases, which also constitutes greater needs for care in specialized services for substance abuse. Research questions arise: what are the substances consumed by young university students in Colombia? What risk and protective factors are prioritized in university contexts for the prevention of substance abuse? The objectives of this research were: to identify which drugs are being consumed by young people and how the foundations of prevention programs are established. Methodologically, to carry out the present narrative review, a search was carried out in PubMed, Lilacs, Scielo, Dialnet databases. A chain search was also performed and other studies were located using bibliographic reference lists of the studies retrieved in the primary search. This is a narrative review was carried out under criteria of international standards. The critical evaluation of the articles consisted of the complete reading of the study, its evaluation and filling of the data collection instrument. Those studies published in duplicate or found in more than one database were considered only once. Once all the sources were integrated, it was decided to organize the evidence found by cities, consumption substances, risk perception, risk and protection factors. The results show an emphasis on the consumption of alcohol and tobacco. Marijuana as an illegal substance is the most consumed and considered the initiation channel for other substances. After these, relatively significant use of inhalants, cocaine and LSD is shown. It is evident that the consumption of psychoactive substances presents a behavior similar to that reported by epidemiological studies, the prevalence of consumption is higher for legal substances, as well as the age of onset is lower for these. In conclusion, the following stand out as risk factors: the life cycle and ease of access; and as a protective factor: satisfaction with the career and a positive vision of the future. With this panorama, the Ministry of National Education of Colombia (MEN) (2008) proposes as a strategy to reduce academic dropout, the creation of psychological support programs for students that are focused on the identification and monitoring of people at risk of consumption of psychoactive substances. It is necessary to build campaigns within the framework of social advertising in two scenarios: one, communications conceptualized by professionals towards public awareness training; and two, prevention campaigns to focus on areas and foci of influence, sectored and atomized to specific problems, specific substances and target adopting public. Likewise, the preventive practices that must be incorporated must aim at three areas: recognition of the negative consequences of drug abuse; clear, systematic and efficient communication; and to the promotion of sound decision-making by young people.The promotion of mental health in national health systems and professional health organizations need prevention campaigns with the participation of communities. Within the limitations of this study, this article is the product of the narrative review carried out for Colombia, as it is described geographically, only characterization of three of the regions is obtained and with a strong emphasis on studies of the capital city (Bogotá ), the other two regions that are not described are areas with an active presence of illicit crops that generate a permanent relationship of the communities with the substances, and even with indigenous groups with consumption associated with their cultural identity, aspects that are not reflected by not have information on these areas.

Resumen El consumo de sustancias psicoactivas en Colombia ha aumentado especialmente en universitarios. Los objetivos de esta investigación fueron: identificar cuáles son las drogas que están consumiendo los jóvenes y cuáles son los fundamentos de los programas de prevención. Metodológicamente se realizó una revisión narrativa de publicaciones científicas bajo criterios de estándares internacionales. Los resultados muestran énfasis en el consumo de alcohol y tabaco. La marihuana, como sustancia ilegal, es la más consumida y es considerada como el canal de iniciación para el consumo de otras sustancias. En conclusión, se destacan como factores de riesgo: el ciclo vital y la facilidad de acceso; y como factores protectores: la satisfacción con la carrera y la visión positiva de futuro. Asimismo, las prácticas preventivas deben apuntar hacia tres esferas: reconocimiento de las consecuencias negativas que trae el abuso de drogas, comunicación clara, sistemática y eficiente, y fomento de la toma de decisiones acertadas de los jóvenes.