Llevar el Mensaje: Análisis de la actividad de AA en un contexto hospitalario

                             Folleto-Tesis: aquí                                      Tesis completa: aquí                         

RESUMEN:
El programa de los Doce Pasos de Alcohólicos Anónimos (AA) representa el principal modelo de ayuda-mutua en México. Específicamente el 12º Paso o llevar el mensaje promueve la difusión del programa a través del relato de experiencias personales de recuperación, además de ayudar al mantenimiento de la sobriedad. El contexto hospitalario representa un lugar ideal para el encuentro con alcohólicos internados como consecuencia del consumo crónico del alcohol.

Con base en la teoría de la actividad de Alexei Leontiev y en el modelo del sistema de actividad de Yrjö Engeström analicé la actividad de llevar el mensaje en un hospital de tercer nivel de la Ciudad de México. Realicé una etnografía (notas de campo, entrevistas semi-estructuradas y análisis de textos) para identificar los significados de AA entorno a la recuperación del alcoholismo y para comprender el sentido personal que para los miembros tiene el llevar el mensaje en su recuperación.

La estructura de servicio es la organización de AA que garantiza el acceso al hospital e introducción a los nuevos miembros en la actividad. En los relatos personales se comunican significados como regresar la dádiva, despertar espiritual y puente de comprensión. Esta red de significados y las acciones de servicio establece las condiciones para la transformación de la persona alcohólica. Estos significados son instrumentos que orientan las acciones frente al alcohólico hospitalizado, no obstante, son interpretados de manera individual, estableciendo un sentido personal sobre la actividad. Llevar el mensaje representa una estrategia para aproximarse a pacientes con dependencia al alcohol.

Palabras Clave: Alcohólicos Anónimos, Contexto Hospitalario; Teoría de la Actividad.

Programa para la Reunión Nacional de Consejos Estatales Contra las Adicciones - 2013

http://www.cenadic.salud.gob.mx/PDFS/prog_reunioncecas.pdf

Hispanic and Latino Recovery Population

The National Hispanic and Latino ATTC releases its latest fact sheet entitled:        Support for Hispanic and Latino Recovery Population     Recovery from addiction is person-centered and culturally relevant to an individual's substance free lifestyle. Dona Dmitrovic, MHS ellaborates on how Hispanic and Latinos experience RECOVERY, especially as we celebrate September as the National Recovery Month.      You might access the following link for a downloadable copy of this fact sheet. The fact sheet is available in English and Spanish:   CLICK HERE    Also, if you want to learn more you may register for our nextwebinar:

Webinar Registration When: October 9th, 2013    Time: 1:00 PM EDT/10:00 AM PDT     Presenter: Dona Dmitrovic, MHS Director of Consumer Affairs, Substance Use Disorders at Optum Behavioral Solutions. REGISTER HERE

Chronic Care Management for Dependence on Alcohol and Other Drugs. The AHEAD Randomized Trial

Richard Saitz; Debbie M. Cheng; Michael Winter; Theresa W. Kim; Seville M. Meli; Don Allensworth-Davies; Christine A. Lloyd-Travaglini; Jeffrey H. Samet



JAMA. 2013;310(11):1156-1167. doi:10.1001/jama.2013.277609.              PDF

Importance  People with substance dependence have health consequences, high health care utilization, and frequent comorbidity but often receive poor-quality care. Chronic care management (CCM) has been proposed as an approach to improve care and outcomes.

Objective  To determine whether CCM for alcohol and other drug dependence improves substance use outcomes compared with usual primary care.

Design, Setting, and Participants  The AHEAD study, a randomized trial conducted among 563 people with alcohol and other drug dependence at a Boston, Massachusetts, hospital-based primary care practice. Participants were recruited from September 2006 to September 2008 from a freestanding residential detoxification unit and referrals from an urban teaching hospital and advertisements; 95% completed 12-month follow-up.

Interventions  Participants were randomized to receive CCM (n=282) or no CCM (n=281). Chronic care management included longitudinal care coordinated with a primary care clinician; motivational enhancement therapy; relapse prevention counseling; and on-site medical, addiction, and psychiatric treatment, social work assistance, and referrals (including mutual help). The no CCM (control) group received a primary care appointment and a list of treatment resources including a telephone number to arrange counseling.

Main Outcomes and Measures  The primary outcome was self-reported abstinence from opioids, stimulants, or heavy drinking. Biomarkers were secondary outcomes.

Results  There was no significant difference in abstinence from opioids, stimulants, or heavy drinking between the CCM (44%) and control (42%) groups (adjusted odds ratio, 0.84; 95% CI, 0.65-1.10; P=.21). No significant differences were found for secondary outcomes of addiction severity, health-related quality of life, or drug problems. No subgroup effects were found except among those with alcohol dependence, in whom CCM was associated with fewer alcohol problems (mean score, 10 vs 13; incidence rate ratio, 0.85; 95% CI, 0.72-1.00; P=.048).

Conclusions and Relevance  Among persons with alcohol and other drug dependence, CCM compared with a primary care appointment but no CCM did not increase self-reported abstinence over 12 months. Whether more intensive or longer-duration CCM is effective requires further investigation.

Problem solving styles among people who use alcohol and other drugs in South Africa

Katherine Sorsdahl, 

Dan J. Stein, 

Henri Carrara, 

Bronwyn Myers

Addictive Behaviors

Available online 13 September 2013

http://www.sciencedirect.com/science/article/pii/S0306460313002700

The present study examines the relationship between problem-solving styles, socio-demographic variables and risk of alcohol and other drug (AOD)-related problems among a South African population. The Social Problem-Solving Inventory–Revised, Center for Epidemiologic Studies Depression Scale (CES-D) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were administered to a convenience sample of 1000 respondents. According to the ASSIST, 32% and 49% of respondents met criteria for moderate to high risk of alcohol use and illicit drug use respectively. After adjusting for the effects of other variables in the model, respondents who were of “Coloured” ancestry (PR = 1.20, 95% CI 1.0-1.4), male (PR = 1.19, 95% CI 1.04-1.37), older (PR = 1.01, 95% CI 1.00-1.02), who adopted an avoidance style of coping with problems (PR = 1.03, 95% CI 1.01-1.05) and who met criteria for depression (PR = 1.42, 95% CI 1.12-1.79) were more likely to be classified as having risky AOD use. This suggests that interventions to improve problem solving and provide people with cognitive strategies to cope better with their problems may hold promise for reducing risky AOD use.

Energy drinks and alcohol: research supported by industry may be downplaying harms

1. Peter Miller, associate professor, School of Psychology, 

1. Deakin University, Geelong, Victoria, 3220, Australia

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f5345 (Published 12 September 2013)

http://www.bmj.com/content/347/bmj.f5345

Concern is growing about the harms that may arise from heavy drinkers mixing alcohol with so called energy drinks to enable them to drink for longer and achieve higher levels of intoxication. On Friday and Saturday evenings, about 40% of people on Australian city streets are heavily intoxicated (breath alcohol concentrations (BAC) greater than 0.087 mg alcohol/100 ml) and nearly a quarter of these drinkers will have consumed more than two energy drinks.1 Data are lacking on energy drink use by alcohol drinkers in other countries but in samples, 73% of US college students2 and 85% of Italian college students3 reported consuming energy drinks mixed with alcohol in the past month.

Epidemiological studies show that drinkers who consume energy drinks are more likely to record a higher breath alcohol concentration than those who do not.4 They are also more likely to report drinking more alcohol5; engaging in aggressive acts1; being injured1 6; symptoms of alcohol dependence7; having driven while drunk or been a passenger in a car with an alcohol impaired driver1; and having taken sexual advantage of, or having been taken advantage of, by another person.

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Programa Nacional Integral contra las Adicciones (PRONADIC)

Academia Mexicana de Cirugía, A. C.

Sesión Conjunta con la Comisión Nacional Contra las Adicciones

Martes 10 de Septiembre del 2013.

Auditorio de la Academia Mexicana de Cirugía.

Tema General: "El Programa Nacional Integral contra las Adicciones".

Coordinador: Dr. Fernando Cano Valle. Comisionado Nacional Contra las Adicciones.

1. Bienvenida y Presentación.
Acad. Dr. Alejandro Reyes Fuentes. Presidente de la Academia Mexicana de Cirugía.

2. Introducción.
Ponente: Dr. Fernando Cano Valle. Comisionado Nacional Contra las Adicciones






3. Panorama general de las adicciones en México y el mundo: un problema de salud pública y de salud personal con implicaciones familiares y del entorno.
Ponente: Dr. Víctor Manuel Guisa Cruz. Coordinador de Asesores.

4. El Observatorio Mexicano del tabaco, alcohol y drogas: información para la toma de decisiones.
Ponente: Mtro. Raúl Martín Del Campo. Director General del CENADIC.

5. Fundamentos conceptuales, estructurales y metodológicos de la respuesta sectorial organizada para contender contra las adicciones.
Ponente: Dr. Leoncio Lara Sáenz. Director General de Coordinación y Cooperación en Adicciones.







6.  El Programa Nacional Integral contra las Adicciones: propósitos, objetivos, estrategias y líneas de acción.
Ponente: Dr. José de Jesús Villalpando Casas. Director General de Programas en Adicciones.






7. Implementación intersectorial del PRONADIC a nivel federal, estatal y local: infraestructura y recursos humanos.
Ponente: Lic. Martín Mosqueda Ventura. Director de Coordinación de los Programas Nacionales en Adicciones.

8. Nuevas áreas de desarrollo del PRONADIC.
Dr. José de Jesús Villalpando Casas. Director General de Programas en Adicciones.
Mtra. María José Martínez Ruiz. Directora de la Oficina Nacional para el Control del Consumo de Alcohol y Drogas Ilícitas.






9.  El enfoque médico integral para la prevención del consumo y el abuso de sustancias adictivas, su diagnóstico y tratamiento.
Ponente: Dr. Mario González Zavala. Subdirector de área.

10. Preguntas y Comentarios.

5a Reunión Ordinaria - CONADIC

http://www.almomento.mx/se-analizan-propuestas-para-la-atencion-integral-de-las-adicciones/

Se analizan propuestas para la atención integral de las adicciones

CIUDAD DE MÉXICO, 12 de septiembre (Al Momento Noticias).- La Secretaria de Salud, Mercedes Juan, en su calidad de presidenta del Consejo Nacional contra las Adicciones, presidió la 5ª Reunión Ordinaria de este organismo, donde se analizaron las propuestas de acción en materia de prevención, atención, tratamiento y reinserción social, de las personas que tienen adicciones.

Acompañada por el Comisionado Nacional contra las Adicciones, Fernando Cano Valle, consejeros estatales y representantes de las diferentes organizaciones de la sociedad civil que integran este Consejo, la titular de Salud enfatizó que el tema de las adicciones es una de las tareas más importantes de salud, por lo que es parte fundamental de los ejes rectores que integran el Plan Nacional de Desarrollo.

Asimismo, precisó que se trabajará coordinadamente con la Secretaría de Gobernación a través de la Comisión Intersectorial para la Prevención Social  de la Violencia y la Delincuencia, donde se integra el CONADIC como pieza clave para su combate.

más...

Durante la quinta Reunión Ordinaria del Consejo Nacional Contra las Adicciones se analizaron las propuestas de acción en materia de prevención, atención, tratamiento y reinserción social, de las personas que tienen adicciones.

Fernando Cano Valle, titular de CONADIC, presentó algunas de las acciones que conformarán el Programa Nacional contra las Adicciones, que tiene como objetivo proporcionar servicios eficaces, oportunos y de calidad a todas las personas con algún tipo de adicción.

Reiteró que los principios del CONADIC se fundamentan en la dignidad e integridad de las personas con adicciones, con el máximo respeto a sus derechos humanos y que continuará el estudio de los daños a la salud que ocasiona la mariguana, para que con base a la evidencia científica se elaboren las políticas públicas en la materia.

http://siempre889.com/actualidad/14694/

Brief intervention and decrease of alcohol consumption among women: a systematic review

Carla Ferreira Gebara, Fernanda Monteiro Bhona, Telmo Mota Ronzani, Lelio Moura Lourenço and Ana Regina Noto

http://www.substanceabusepolicy.com/content/8/1/31/abstract

Abstract (provisional)

Problems related to alcohol consumption are priority public health issues worldwide and may compromise women's health. The early detection of risky alcohol consumption combined with a brief intervention (BI) has shown promising results in prevention for different populations. The aim of this study was to examine data from recent scientific publications on the use of BI toward reducing alcohol consumption among women through a systematic review. Electronic searches were conducted using Web of Science, PubMed(Medline) and PsycInfo databases. In all databases, the term "brief intervention" was associated with the words "alcohol" and "women", and studies published between the years 2006 and 2011 were selected. Out of the 133 publications found, the 36 scientific articles whose central theme was performing and/or evaluating the effectiveness of BI were included. The full texts were reviewed by content analysis technique. This review identified promising results of BI for women, especially pregnant women and female college students, in different forms of application (face-to-face, by computer or telephone) despite a substantial heterogeneity in the clinical trials analyzed. In primary care, which is a setting involving quite different characteristics, the results among women were rather unclear. In general, the results indicated a decrease in alcohol consumption among women following BI, both in the number of days of consumption and the number of doses, suggesting that the impact on the woman's reproductive health and the lower social acceptance of female consumption can be aspects favorable for the effectiveness of BI in this population.

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Characterizing Gender Differences in Treatment Seekers

1. Ben Lewis^*, 
2. Sara Jo Nixon

Alcoholism: Clinical and Experimental Research

Article first published online: 9 AUG 2013

http://onlinelibrary.wiley.com/doi/10.1111/acer.12228/abstract

Background

Available evidence suggests women may be more vulnerable to the effects of chronic alcohol consumption than men. The few investigations of gender differences in treatment-seeking populations have often involved study samples restricted by selection criteria (e.g., age, education). The current study examined gender differences in a heterogeneous sample of individuals seeking treatment for a substance use disorder. We examined alcohol drinking levels, age at drinking milestones (e.g., first drink, first intoxication), and progression from milestones to alcohol problems or treatment. Additionally, family history, spousal alcoholism, and nicotine use were analyzed.

Methods

Participants included men (n = 274) and women (n = 257) in substance abuse treatment facilities. Participants completed inventories quantifying affect, intellectual ability, and drinking consequences. A family tree for substance use and personal histories for alcohol and nicotine use, including chronicity, frequency, and regularity, were collected.

Results

Telescoping was not observed when progression from drinking milestones to alcoholism or alcohol problems was compared between men and women. In contrast, when considered as progression to treatment, marked telescoping effects were detected, with women entering treatment more rapidly by approximately 4 years. Familial differences included a greater proportion of women reporting alcoholic parents (73% women; 61% men) and alcoholic spouses (58% women; 38% men). Smoking behaviors were similar between genders; however, men reporting higher levels of alcohol consumption reported greater intensity of chronic smoking. Smoking and drinking behaviors were correlated among men, but not women. Rates of pretreatment drug problems were equivalent between genders.

Conclusions

When contrasted with the available literature, our data were only partially supportive of gender-contingent telescoping. While women did not experience alcohol problems or alcoholism earlier than men, they progressed to treatment more quickly. These results highlight the importance of carefully considering the sample and specific outcome variables when interpreting gender differences.