Saúde mental, transtorno por uso de substâncias e transtorno por uso de opioides: atualizações e estratégias de tratamento
DOI:
https://doi.org/10.11606/issn.1806-6976.smad.2021.187412Palavras-chave:
Transtornos relacionados ao uso de substâncias, Transtornos relacionados ao uso de opióides, Saúde mental, TerapêuticaResumo
Objetivo: descrever as principais estratégias para abordar lacunas na identificação, tratamento e treinamento sobre saúde mental, transtorno do uso de substâncias (TUS) e transtorno do uso de opioides (TUO). Método: trata-se de uma revisão narrativa, a partir de artigos recentes e de publicações de instituições que abordam a temática da saúde mental e
da dependência química reconhecidas internacionalmente. Resultados: a prevalência de uso concomitante de substâncias e transtornos psiquiátricos/de saúde mental tem sido elevada e continua crescente, compondo problemas complexos que implicam em desafios de tratamento multifacetados, incluindo condições médicas, deficiências, falta de moradia, abandono de medicamentos e altas taxas de recaída. O tratamento de TUS’s e TUO’s são questões individualmente complexas. A combinação dos dois transtornos requer uma abordagem de diagnóstico e tratamento dedicada e multifacetada. Conclusão: como a prevalência de TUO’s, TUS’s e COD’s continua a aumentar, enfermeiros e profissionais de saúde devem estar preparados para diagnosticar, tratar e/ou encaminhar os usuários para garantir o cuidado adequado e a recuperação a longo prazo dos indivíduos acometidos.
Downloads
Referências
Substance Abuse and Mental Health Services Administration (US). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55) [Internet]. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2020. [cited 2021 June 10]. Available from: https://www.samhsa.gov/data/
Gordon S. About a Revolution: Toward Integrated Treatment in Drug and Mental Health Courts [Internet]. 2019 [cited 2021 June 10].
Available from: https://scholars.law.unlv.edu/facpub/1179
Mota P. Avoiding a new epidemic during a pandemic: The importance of assessing the risk of substance use disorders in the COVID-19 era. Psychiatry Res. 2020;290:113142. doi: https://doi.org/10.1016/j.psychres.2020.113142
Milano G, Vergani HM, Cattedra S, Carrozzino R, Mattioli F, Robbiano L, et al. Co-Occurring Psychiatric and Substance Use Disorders: Clinical Survey Among a Rural Cohort of Italian Patients. Neuropsychiatr Dis Treat. 2019;15:3453-9. doi: https://doi.org/10.2147/NDT.S222567
American Medical Association (US). Drug overdose epidemic worsened during COVID pandemic [Internet]. Maryland: AMA; 2020. [cited 2021 June 10]. Available from: https://www.ama-assn.org/system/files/2020-11/issue-brief-increases-in-opioid-related-overdose.pdf
Priester MA, Browne T, Iachini A, Clone S, DeHart D, Seay KD. Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review. J Subst Abuse Treat. 2016;61:47-59. doi: https://doi.org/10.1016/j.jsat.2015.09.006
Ritchie H, Roser M. Drug use [Internet]. 2019 [cited 2021 June 10]. Available from: https://ourworldindata.org/drug-use
American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: APA; 2013.
Centers for Disease Control and Prevention (US). Opioid Overdose. Washington, D.C.: CDC; 2020 [cited 2021 June 18]. Available from: https://www.cdc.gov/drugoverdose/epidemic/index.html#:~:text=The%20first%20wave%20began%20with,increasing%20since%20at%20least%201999.&text=The%20second%20wave%20began%20in,in%20overdose%20deaths%20involving%20heroin
Velez FF, Luderer HF, Gerwien R, Parcher B, Mezzio D, Malone DC. Evaluation of the cost-utility of a prescription digital therapeutic for the treatment of opioid use disorder. Postgrad Med. 2021;133(4):421-7. doi: https://doi.org/10.1080/00325481.2021.1884471
Schulte M, Boumparis N, Huizink AC, Riper H. Technological Interventions for the Treatment of Substance Use Disorders. Ref Mod Neurosci Biobehav Psychol. 2020. doi: https://doi.org/10.1016/B978-0-12-818697-8.00010-8
Stoychev KR. Neuroimaging Studies in Patients With Mental Disorder and Co-occurring Substance Use Disorder: Summary of Findings. Front Psychiatry. 2019;10:702. doi: https://doi.org/10.3389/fpsyt.2019.00702
Substance Abuse and Mental Health Services Administration (US). Women in the mirror: Addressing co-occurring mental health issues and trauma in women with substance use disorders [Internet]. Rockville, MD: SAMHSA; 2015 [cited 2021 June 13]. Available from: https://www.samhsa.gov/sites/default/fles/programs_ campaigns/women_children_families/women-in-mirror.pdf
Substance Abuse and Mental Health Services Administration; Office of the Surgeon General (US). Early Intervention, Treatment, and Management of Substance Use Disorders. In: Substance Abuse and Mental Health Services Administration; Office of the Surgeon General (US). Facing addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health [Internet]. Washington, D.C.: US Department of Health and Human Services; 2016 [cited 2021 June 13]. Chap. 4. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424859/
Jones EB, Staab EM, Wan W, Quinn MT, Schaefer C, Gedeon S, et al. Addiction Treatment Capacity in Health Centers: The Role of Medicaid Reimbursement and Targeted Grant Funding. Psychiatr Serv. 2020;71(7):684-90. doi: https://doi.org/10.1176/appi.ps.201900409
Hadjikou A, Pavlopoulou ID, Pantavou K, Georgiou A, Williams LD, Christaki E, et al. Drug Injection-Related Norms and High-Risk Behaviors of People Who Inject Drugs in Athens, Greece. AIDS Res Hum Retroviruses. 2021;37(2):130-8. doi: http://doi.org/10.1089/aid.2020.0050
Guerrieri M, Giacomini PG, Flora B, Silvani L, Di Girolamo S. Drug-Induced Atrophic Rhinitis. In: Di Girolamo S, editor. Atrophic Rhinitis. Cham: Springer; 2020. doi: https://doi.org/10.1007/978-3-030-51705-2_4
Mukherji P, Azhar Y, Sharma S. Toxicology Screening [Internet]. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020 [cited 2021 June 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499901/
Beck O. Exhaled breath for drugs of abuse testing: evaluation in criminal justice settings. Sci Justice. 2014;54(1):57-60. doi: http://doi.org/10.1016/j.scijus.2013.09.007
Moeller KE, Kissack JC, Atayee RS, Lee KC. Clinical Interpretation of Urine Drug Tests: What Clinicians Need to Know About Urine Drug Screens. Mayo Clin Proc. 2017;92(5):774-96. doi: https://doi.org/10.1016/j.mayocp.2016.12.007
Yang YK, Johnson-Davis KL, Kelly BN, McMillin GA. Demand for Interpretation of a Urine Drug Testing Panel Reflects the Changing Landscape of Clinical Needs; Opportunities for the Laboratory to Provide Added Clinical Value. J Appl Lab Med. 2020;5(5):858-68. doi: https://doi.org/10.1093/jalm/jfaa119
Xue W, Tan X, Khaing Oo MK, Kulkarni G, Ilgen MA, Fan X. Rapid and sensitive detection of drugs of abuse in sweat by multiplexed capillary based immuno-biosensors. Analyst. 2020;145(4):1346-54. doi: https://doi.org/10.1039/c9an02498k
OraSure. Oral fluid test [Internet]. 2015. [cited 2021 June 17]. Available from: http://www.orasure.com/products-substance/products-substance-abuse-intercept-FAQ.asp
Kimmel SD, Bazzi AR, Barocas JA. Integrating harm reduction and clinical care: Lessons from Covid-19 respite and recuperation facilities. J Subst Abuse Treat. 2020;118:108103. doi: https://doi.org/10.1016/j.jsat.2020.108103
Hyshka E, Morris H, Anderson-Baron J, Nixon L, Dong K, Salvalaggio G. Patient perspectives on a harm reduction-oriented addiction medicine consultation team implemented in a large acute care hospital. Drug Alcohol Depend. 2019;204:107523. doi: https://doi.org/10.1016/j.drugalcdep.2019.06.025
Adams JM, Volkow ND. Ethical Imperatives to Overcome Stigma Against People With Substance Use Disorders. AMA J Ethics. 2020;22(1):E702-8. doi: https://doi.org/10.1001/amajethics.2020.702
National Institute of Drug Abuse (NIDA) (US). Why is there comorbidity between substance use disorders and mental illnesses? [Internet]. 2020 [cited 2021 June 13]. Available from: https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/why-there-comorbidity-between-substance-use-disorders-mental-illnesses
Wakeman SE. Facing Addiction. Psychiatr Ann. 2019;49(2):47-54. doi: https://doi.org/10.3928/00485713-20190108-01
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality (US). Treatment Episode Data Set (TEDS): 2017. Admissions to and discharges from publicly funded substance use treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2019.
Kelly PJ, Baker AL, Deane FP, Callister R, Collins CE, Oldmeadow C, et al. Study protocol: A stepped wedge cluster randomised controlled trial of a healthy lifestyle intervention for people attending residential substance abuse treatment. BMC Public Health. 2015;465(2015). doi: https://doi.org/10.1186/s12889-015-1729-y
DiClemente CC, Corno CM, Graydon MM, Wiprovnick AE, Knoblach DJ. Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness. Psychol Addict Behav. 2017;31(8):862-87. doi: https://doi.org/10.1037/adb0000318
- Solari CD, Shivji A, de Sousa T, Watt R, Silverbush M, Khadduri J, et al. The 2016 annual homeless assessment report (AHAR) to Congress. Part 2: Estimates of homelessness in the United States [Internet]. Washington, D.C.: United States Department of Housing and Urban Development; 2017. [cited 2021 June 13]. Available from: http://works.bepress.com/dennis_culhane/214/
Tsai J, Cao X. Association between suicide attempts and homelessness in a population-based sample of US veterans and non-veterans. J Epidemiol Community Health. 2019;73(4):346-52. doi: https://doi.org/10.1136/jech-2018-211065
Fazel S, Yoon IA, Hayes AJ. Substance use disorders in prisoners: an updated systematic review and meta-regression analysis in recently incarcerated men and women. Addiction. 2017;112(10):1725-39. doi: https://doi.org/10.1111/add.13877
Al-Rousan T, Rubenstein L, Sieleni B, Deol H, Wallace RB. Inside the nation's largest mental health institution: a prevalence study in a state prison system. BMC Public Health. 2017;17(1):342. doi: https://doi.org/10.1186/s12889-017-4257-0
Evans E, Padwa H, Li L, Lin V, Hser YI. Heterogeneity of Mental Health Service Utilization and High Mental Health Service Use Among Women Eight Years After Initiating Substance Use Disorder Treatment. J Subst Abuse Treat. 2015;59:10-9. doi: https://doi.org/10.1016/j.jsat.2015.06.021
Maura J, Weisman de Mamani A. Mental Health Disparities, Treatment Engagement, and Attrition Among Racial/Ethnic Minorities with Severe Mental Illness: A Review. J Clin Psychol Med Settings. 2017;24(3-4):187-210. doi: https://doi.org/10.1007/s10880-017-9510-2
Mauro PM, Canham SL, Martins SS, Spira AP. Substance-use coping and self-rated health among US middle-aged and older adults. Addict Behav. 2015;42:96-100. doi: https://doi.org/10.1016/j.addbeh.2014.10.03
Bush DM, Lipari RN. Substance Use and Substance Use Disorder by Industry [Internet]. In: The CBHSQ Report. Rockville, MD; Substance Abuse and Mental Health Services Administration; 2013. [cited 2021 June 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK343542/
Jordan TR, Khubchandani J, Wiblishauser M. The Impact of Perceived Stress and Coping Adequacy on the Health of Nurses: A Pilot Investigation. Nurs Res Pract. 2016;2016:5843256. doi: https://doi.org/10.1155/2016/5843256
Kunyk D. Substance use disorders among registered nurses: prevalence, risks and perceptions in a disciplinary jurisdiction. J Nurs Manag. 2015;23(1):54-64. doi: https://doi.org/10.1111/jonm.12081
Winkler A. Treating Physicians for Addiction. Am J Psychiatry Res J. 2017;12(4):6-7. doi: https://doi.org/10.1176/appi.ajp-rj.2017.1204037.120403
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2021 SMAD Revista Eletrônica Saúde Mental Álcool e Drogas (Edição em Português)
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
