EFFICACY EVALUATION OF BRIEF INTERVENTION IN HIGHER EDUCATION STUDENTS WITH PREDISPOSITION TO CHEMICAL DEPENDENCY IDENTIFIED BY ASSIST

ANA PAULA CALATRAVA JARA MARTINES ECHEVERRIA, GUSTAVO ROBERTO VILLAS BOAS, ANA PAULA STEFANELLO DA SILVEIRA

Resumo


Introduction: Studies show that drug use by people considered dependent began
in the young phase of life, and that this contact often occurs in academic centers. In
view of the seriousness of this disease, it is essential to seek anticipatory measures.
Material and Methods: Thus, in order to evaluate the efficacy of a preventive
method, 150 university students were submitted to the ASSIST questionnaire (risk
identification instrument by scores). The preventive method used was Brief
Intervention (IB), which is a motivational interview aimed at reducing the
indiscriminate use of drugs. The respondents were placed in a group: the IBs who
received Brief Intervention sequentially and the CONTs who received them after 30
days. The ASSIST was reapplied to both and the scores compared statistically.
Results: In the end, the IB group showed a significant decrease in their ASSIST
score regarding drug use in relation to the CONT group. The study also verified that
men are more predisposed to use, and that the most commonly used drugs are
alcohol and tobacco, respectively. Discussion and Conclusion: The determining
factors for the early use of drugs are: transition between the young and adult
phases; social inclusion; aesthetic idealisms; and accelerated pace of activities.
Already the peculiarities between the sexes, occur as a consequence to
neurocognitive and neurochemical physiological processes. The wide dissemination
by the media and the familiar cultural influence, justifies the predominant use of
alcohol and tobacco. As for prevention, the measures of the Brief Intervention
contribute to its effectiveness, being these: Feedback; Responsibility; Counseling;
Options menu; and Auto Efficacy. These measures assist the acceptance process
and encourage the importance of consent for continued treatment. Therefore, IB
proves to be a safe and efficient method to reduce the risky and abusive use of
drugs by young people.
INTRODUCTION
The use of psychotropic substances has become increasingly common in people's
lives and this practice has started earlier and earlier, which is a worrying risk factor,
due to the probability of developing addiction. Due to the complexity and severity of
the problem of installed addiction, the WHO ASSIST questionnaire, which is an
effective tool in identifying use and abuse with regard to psychoactive drugs, has
been incorporated by WHO through the addition of the score for each substance.
Thus, it is possible to adopt measures aimed at preventing addiction. The preferred
method is the Brief Intervention (IB), which consists of the application of an oral /
verbal explanatory of the risks involved in the use of psychotropic substances
aiming at the behavioral and discursive change of the individual, so that it has the
capacity to diminish or extinguish its use. Thus, the study aimed to evaluate the
efficacy of brief intervention in university students with predisposition to
dependence.
MATERIAL AND METHODS
The research was conducted at the University Center of Grande Dourados, where
150 individuals were interviewed using ASSIST. Participants with scores for alcohol
from 11 to 26 and for other drugs from 4 to 26 were randomly divided into
experimental groups: IB (received the Brief Intervention); and CONT (they waited 30
days to receive the Short Intervention). After 30 days, the ASSIST was reapplied and
the data compared statistically between baseline interview and return for both
groups.
RESULTS
The study pointed out that the use of psychotropic substances is common to college
life, with alcohol being the most used drug in the life of all individuals interviewed
(100%, n = 150/150). Tobacco was the second most used drug among the
participants (66%, n = 99/150), followed by marijuana (12.6%, n = 19/150),
hypnotics / sedatives (7.3%, n = 11/150) and there was no use of injectable drugs.
The study also elucidated that most college students who have ever made the risky
use belong to the male sex.
Figure 1. Comparison between
the means of the total score
obtained by the ASSIST
instrument in the baseline and
return interview for the IB and
CONT groups. Mean ± SD of the
total scores obtained by the
ASSIST instrument on the two
interview occasions in users of
groups IB (Basal, n = 75, Return,
n = 75) and CONT (Basal, n = 75; and abusive use of drugs in an institution of
higher education in Dourados (MS). * differs from the baseline interview (two-way
ANOVA followed by the Newman-Keuls test, p?0.05).
The multiple comparison (two-way ANOVA) for the variable total ASSIST score,
considering as factors the groups (CONT and IB) and the interviews (baseline and
return), detected a statistically significant reduction in the return score when
compared to the baseline, (FCONT (1,148) = 57.01, p <0.01; FIB (1,148) = 57.01, p
<0.01).
DISCUSSION AND CONCLUSION
The use of drugs in the young phase of life is a result of the atypical circumstances
in this transitory phase between adolescence and adulthood, and can be used as a
stimulus to cross situations of high complexity. The greater use of the man in
relation to the woman is attributed to the particularities of the impulsive behavior in
relation to the use, this due to the divergence between the sexes and its
peculiarities by virtue of neurocognitive and neurochemical processes of the human
organism. Through the scientific literature can be found that, women have more
intense brain activation than men in some specific regions. Thus, the compensatory
mesolimbic regions are activated more markedly in the female organism than in the
male organism. The consumption of alcohol and tobacco products is legal and
widely publicized through media advertising and other information vehicles, which
contributes to the increase in its prevalence of use. In addition to the fact that, most
of the times people do not view these drugs as aggravating to health, since this is a
practice that can be passed by the relatives themselves as a common habit. Thus,
many young people begin with the use of drugs considered lighter as alcohol, which
instigates the curiosity to try new substances like the tobacco. Knowing that this
practice can lead to various complications for life (social, family, work, among
others), dependence can be considered a public health issue and needs a cautious
look in order to alleviate problems that may be due to this disease. Harm reduction
is an effective health promotion tactic that provides common sense or selfawareness
tips on disease prevention for practitioners of sporadic and continuous
use. This search for health promotion occurs through the democratization of
information aiming to reduce the damages associated with the use of drugs. The
characteristics of Brief Intervention contribute to its effectiveness and is suggested
as a viable approach for reducing the risk of dependence on users. The principles
embodied in IB promote a more delicate approach with a non-possessive reception
and a good reflective listening that is aimed at creating a bond of trust and
empathy through individual experiences, seeking to clarify them in order not to
carry out therapeutic impositions. This early intervention extends the preventive
competence allowing to transcend a vision returned to moderate and serious
chemical dependents. Thus, the adoption of Brief Intervention may serve as a
preventive tool for harm and health problems for individuals with early detection of
drug abuse, and as a motivational source for adherence to treatment for patients
identified with chemical dependency.


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