Illicit drug use in seven Latin American countries: critical perspectives of families and familiars

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Abstract

This cross-sectional multi-centre study explored how family members and friends of illicit drug users perceived protective and risk factors, treatment facilities and policies and laws regarding illicit drug use. Family members and friends of illicit drug users were recruited in 10 urban health care outpatient units in 7 Latin American countries (Brazil, Colombia, Costa Rica, Ecuador, Guatemala, Honduras and Mexico) to complete a questionnaire. The majority of the respondents chose psycho-social factors over genetic or biological explanations as causes of drug problems. Respondents felt that families and governments were responsible for preventing drug problems. Church/religious institutions were most often mentioned in the context of accessible treatment. When asked about access to treatment facilities, the majority said that there were not enough. Shame about drug use, cost, and limited treatment options were most often cited as barriers to treatment.

Translated abstract

Este estudo multicêntrico corte temporal explorou a perspectiva de familiares e pessoas próximas a usuários de drogas ilícitas sobre fatores de risco e proteção, serviços de tratamento, políticas e leis relacionadas ao uso de drogas ilícitas. Os familiares e pessoas próximas a usuários de drogas ilícitas foram recrutados em dez unidades de saúde, localizadas em grandes centros urbanos de sete países da América Latina (Brasil, Colômbia, Costa Rica, Equador, Guatemala, Honduras e México), para responderem um questionário. A maioria dos participantes escolheu fatores psicossociais e não fatores genéticos ou biológicos para explicar a causa dos problemas do uso de drogas. Responderam que familiares e governantes são os principais responsáveis pela prevenção dos problemas das drogas. As igrejas e outras instituições religiosas foram mencionadas com frequência dentro do contexto de acesso ao tratamento. A maioria dos entrevistados apontou que o acesso aos serviços que oferecem tratamentos aos usuários de drogas não é suficiente. Vergonha sobre o uso de drogas, custo e opções insuficientes de tratamento foram citados com mais frequência como as principais barreiras para o tratamento.

Translated abstract

Este estudio transversal multicéntrico exploró como los familiares y personas cercanas de usuarios de drogas ilícitas perciben los factores de protección y los de riesgo, las facilidades de tratamiento, las iniciativas de prevención y la legislación relativa a las drogas ilícitas. Los familiares y personas cercanas de los usuarios de drogas ilícitas fueron reclutados en 10 unidades urbanas de atención de salud en ambulatorios, en 7 países de América Latina (Brasil, Colombia, Costa Rica, Ecuador, Guatemala, Honduras y México) para responder a una encuesta. Con respecto a las causas de los problemas de las drogas, la mayoría de los encuestados destacó los factores psicosociales como siendo más importantes que los factores genéticos o biológicos. Los encuestados consideraron que las familias y los gobiernos son quienes tienen más responsabilidad en la prevención de los problemas de drogas. La iglesia y las instituciones religiosas fueron mencionadas con mayor frecuencia en el contexto del acceso al tratamiento. Cuando se les preguntó sobre el acceso a las facilidades de tratamiento, la mayoría manifestó que éstas no eran suficientes. Como barreras para el tratamiento, citaron entre las más frecuentes, la vergüenza por el uso de las drogas, la falta de opciones para su tratamiento y el costo del mismo.

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Most cited references 6

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Is there a case for extended interventions for alcohol and drug use disorders?

Tristan McKay (2005)

To determine whether there is evidence to support the implementation of extended interventions (i.e. longer than 6 months) for individuals with alcohol or other drug use disorders. Literature on extended behavioral and pharmacotherapy interventions was reviewed, along with findings from studies of extended monitoring and monitoring paired with adjunctive counseling. Studies were identified through database searches, citations in prior reviews and examinations of recent volumes of relevant journals. Key terms were defined, and a theoretical rationale was presented for extended treatment. Several adaptive treatment studies that made use of stepped care or continuation protocols were also described. The primary outcomes that were considered were alcohol and drug use during the intervention and post-intervention follow-ups. Other outcomes were examined when they were included in the articles reviewed. Most of the studies in the review provided support for the effectiveness of extended interventions for alcohol and drug abusers, whether the extended care was delivered through face-to-face contact or via the telephone. These findings held across all types of interventions that were examined (e.g. behavioral treatment, pharmacotherapy and monitoring). However, only a few studies directly compared extended and standard length version of the same intervention. New developments in addiction treatment with implications for extended care models were also described and discussed. The findings of the review indicate that maintaining therapeutic contact for extended periods of time with individuals with alcohol and other drug disorders appears to promote better long-term outcomes than 'treatment as usual', although more studies are needed that compare extended and standard versions of interventions. Achieving good compliance and successful disease management with extended interventions will probably require adaptive protocols in which the intensity of treatment can be adjusted up or down in response to changes in symptoms and functioning over time. Future directions in research on extended interventions were discussed.