Pharmacotherapy used for alcohol and cocaine use disorders in a CAPS-AD of Minas Gerais

Authors

  • Anna Carolina de Moura Costa University of Itaúna (UIT), Itaúna-MG, Brazil, 2 Federal University of Minas Gerais (UFMG), Belo Horizonte-MG, Brazil Federal University of São João delRei (UFSJ), Center-West Campus Dona Lindu (CCO), Divinópolis-MG, Brazil https://orcid.org/0000-0001-6813-9007
  • Laura Maciel de Freitas University of Itaúna (UIT)
  • Geny Carolina Gomes Tranin University of Itaúna (UIT), Itaúna-MG, Brazil
  • Thais Lorenna Souza Sales Federal University of São João delRei (UFSJ), Center-West Campus Dona Lindu (CCO), Divinópolis-MG, Brazil https://orcid.org/0000-0002-1571-3850
  • Ana Cristina Nogueira Rodrigues Pestana University of Itaúna (UIT), Itaúna-MG, Brazil
  • Patrícia Nessralla Alpoim Federal University of Minas Gerais (UFMG), Belo Horizonte-MG, Brazil
  • Cristina Sanches Federal University of São João delRei (UFSJ), Center-West Campus Dona Lindu (CCO), Divinópolis-MG, Brazil
  • Farah Maria Drumond Chequer Federal University of São João delRei (UFSJ), Center-West Campus Dona Lindu (CCO), Divinópolis-MG, Brazil https://orcid.org/0000-0003-3514-2132

DOI:

https://doi.org/10.1590/s2175-97902022e19702%20

Keywords:

Cocaine, Alcoholism, Substance-Related Disorders, Benzodiazepines, Disulfiram

Abstract

Substance use disorder is one of the major social and public health problems in the world.
The present study analyzed the pharmacoepidemiological profile of patients treated at the
Psychosocial Treatment Center for Alcohol and Substance Use Disorders (CAPS-AD) for
treatment of alcohol use disorders (AUD), cocaine use disorders (CUD) and concomitant alcohol
and cocaine use disorders (A-CUD) in the city of Betim-MG. The study used quantitative
and descriptive data and was based on the evaluation of medical records of patients attended
from January to December 2016. After analyzing 295 medical records, the majority of study
participants were male (83.7 %) with an average age of 46.26 for AUD, 28.88 for CUD and 34.29
for A-CUD. The most prescribed drugs for AUD were diazepam (54.1 %), thiamine (37 %),
complex B vitamins (29.5 %), and disulfiram (2.7 %); for CUD, diazepam (26.9 %) and haloperidol
(23.1 %). It should be noticed that although contraindicated by the guidelines, chlorpromazine
(42.3 %, 25.3 %, 20.3 %) was prescribed for CUD, AUD, and A-CUD respectively. Knowing
the pharmacoepidemiological profile of CAPS-AD patients is extremely important for making
decisions regarding which medicines to make available to the population.

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References

Amaral RA, Malbergier A, Andrade AG. Management of patients with substance use illnesses in psychiatric emergency department. Rev Bras Psiquiatr. 2010;32(II):S104-S11.

Amato L, Minozzi S, Vecchi S, Davoli M. Benzodiazepines for alcohol withdrawal. Cochrane Database Syst Rev. 2010;(3):1-128.

Amato L, Minozzi S, Davoli M. Eficacy and safety of pharmacological interventions for the treatment of the Alcohol Withdrawal Syndrome. Cochrane Database Syst Rev . 2011;(6):1-29.

American Psychiatric Association. Practice guideline for the treatment of patients with substance use disorders, 2nd edition. In American Psychiatric Association Practice Guidelines for the Treatment of Psychiatric Disorders. Washington, 2018;(2):1-224. [citad 2020 July 20] Available from: Available from: https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9781615371969

» https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9781615371969

Anton RF. Naltrexone for the Management of Alcohol Dependence. N Engl J Med. 2008;359(7):715-721.

Barboza PS, Silva DA. Antidepressant and antipsychotic drugs prescribed at the Psychosocial Care Center (caps) in the municipality of Porciúncula/RJ. Acta Biomed. Bras. 2012;3(1):85-97.

Bastos FIPM, Vasconcellos MTL, Boni RB, Reis NB, Coutinho CFS. III National Survey on the use of drugs by the Brazilian population. Rio de Janeiro: Instituto de Comunicação e Informação Científica e Tecnologia em Saúde/Fundação Oswaldo Cruz (ICICT/FIOCRUZ), 2017;528.

Bogenschutz MP, Bhatt S, Bohan J, Foster B, Romo P, Wilcox CE et al. Coadministration of Disulfiram and Lorazepam in the Treatment of Alcohol Dependence and Co-occurring Anxiety Disorder: An Open-label Pilot Study. Am J Drug Alcohol Abuse. 2016;42(5):490-499.

Boger B, Federhen C, Brand M, Szpak R, Patriota B, Morishita L, Gomes EL. Drugs of special control most used in psychosocial care center in a city of Paraná. Visão Acad. 2017;18(4):84-97.

Brazil. Ministry of Health. Secretariat of Health Care. Department of Strategic Programmatic Actions. Mental health in SUS: the centers of psychosocial attention. Ministry of Health. 2004;1:86.

Brazil. Ministry of Health. Secretariat of Health Care. Department of Specialized and Thematic Attention. Psychosocial Care Centers and Reception Units as places of psychosocial care in the territories: guidelines for elaboration of construction projects, reform and expansion of CAPS and UA. Brasilia (DF), 2015a. [citad 2020 July 21]. Available from: Available from: http://bvsms.saude.gov.br/bvs/publicacoes/centros_atencao_psicossocial_unidades_acolhimento.pdf

» http://bvsms.saude.gov.br/bvs/publicacoes/centros_atencao_psicossocial_unidades_acolhimento.pdf

Brazil. Ministry of Health. Technical Note No. 100/2012 (updated 11/23/2015). Active Ingredient: naltrexone. 2015b [citad 2020 July 21]. Available from: Available from: https://www.saude.gov.br/images/pdf/2016/janeiro/07/naltrexona--atualizada-em-23-11-2015-.pdf

» https://www.saude.gov.br/images/pdf/2016/janeiro/07/naltrexona--atualizada-em-23-11-2015-.pdf

Brower KJ. Insomnia, alcoholism and relapse. Sleep Med Rev. 2003;7(6):523-39.

Campana AAM, Zaleski M, Ramos SP, Dualibi SM, Stein AT. Alcohol Abuse and Dependence. Project Guidelines. Brazilian Medical Association, Federal Council of Medicine. Associação Bras Psiquiatr. (ABP). 2012;1-36.

Carelli A, Frighetto M, Santin NC. Medicines used by patients served by the Psychosocial Attention Center (CAPSI) in the city of Videira/SC and related factors. Anuário Pesq Extensão Unoesc Videira. 2016;(1):1-14.

Castro Neto AG, Silva DCN, Figueiroa MS. Main mental disorders in crack-cocaine users treated at Psychosocial Care Centers for Alcohol and Drugs in the city of Recife, Brazil. Trends Psychiatry Psychother. 2016;38(4):227-233.

Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) Series 49. HHS Publication No. (SAMSHA) 09-4380. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2009.

Conceição MIG, Cardona, HH, Assis JT, Mohr RR, Sydbrack, MFO, Strike C. Crack Cocaine Users Seeking Treatment in Brasília. Psicol: Teor Pesq. 2017;32,1-8.

Fairbanks J, Umbreit A, Kolla BP, Karpyak VM; Schneekloth TD, Loukianova LL et al. Evidenced-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls. Mayo Clin Proc. 2020;95(9):1964-1977

Firmino KF, Abreu MHNG, Perini E, Magalhães SMS. Use of benzodiazepines in local public health services in Coronel Fabriciano in the State of Minas Gerais. Cienc Saude Colet. 2012;17(1):157-166.

Foppe KS, Hammond-Weinberger DR, Subedi B. Estimation of the consumption of illicit drugs during special events in two communities inWestern Kentucky, USA using sewage epidemiology. Sci Total Environ. 2018;633:249-256.

Grossi FT, Oliveira, RM. Clinical Protocols. Crack User's Clinical Management. Hospital Foundation of the State of Minas Gerais (FHEMIG). 2013. [citad 19 Mar 09] Available from: Available from: http://www.fhemig.mg.gov.br/index.php/docman/Protocolos_Clinicos-1/181-041-manejo-clinico-do-usuario-de-crack-07082014/file

» http://www.fhemig.mg.gov.br/index.php/docman/Protocolos_Clinicos-1/181-041-manejo-clinico-do-usuario-de-crack-07082014/file

Guimarães RA, Souza MM, Caetano CAA, Teles SA, Matos MA. Use of illicit drugs by adolescents and young adults of an urban settlement in Brazil. Rev Assoc Med Bras. 2018;64(2):114-118.

Hardey S, Thomas S, Stein S, Kelley R, Ackermann K. American Addiction Centres. Dangers of Combining Benzos and Alcohol. New York, 2020a. [citad 2020 May 07] Available from: Available from: https://americanaddictioncenters.org/benzodiazepine/and-alcohol

» https://americanaddictioncenters.org/benzodiazepine/and-alcohol

Hardey S, Thomas S, Stein S, Kelley R, Ackermann K. American Addiction Centres. Mixing Benzodiazepine and Alcohol. New York, 2020b. [citad 2020 May 07] Available from: Available from: https://www.alcohol.org/mixing-with/benzodiazepine/

» https://www.alcohol.org/mixing-with/benzodiazepine/

Hillemacher T, Frieling H. Pharmacotherapeutic options for co-morbid depression and alcohol dependence. Expert Opin Pharmacother. 2019;20(5):547-569.

Indave BI, Minozzi S, Pani PP, Amato L. Antipsychotic medications for cocaine dependence. Cochrane Database Syst Rev . 2016;3:1-69.

Jorgensen CH, Pedersen B, Tonnesen H. The Efficacy of Disulfiram for the Treatment of Alcohol Use Disorder. Alcohol Clin Exp Res. 2011;35:(10):1749-1758.

Kantorski LP, Jardim VMR, Porto AR, Schek G, Cortes JM, Oliveira MM. The supply and consumption of psychiatric drugs in care centers Psychosocial in the South Brazilian Region. Rev Esc Enferm USP. 2011;45(6):1481-1487.

Kranzler HR, Soyka M. Diagnosis and pharmacotherapy of alcohol use disorder: a review. JAMA. 2018;320(8):815-824.

Laranjeira R, Madruga CS, Pinsky I, Caetano R, Mitsuhiro SS. II National Survey of Alcohol and Drugs (LENAD) [bibliography]. São Paulo: Instituto Nacional de Ciência e Tecnologia para políticas públicas sobre álcool e outras substâncias (INPAD), UNIFESP; 2014.

Leite LOB, Salgado PRR, Rosa SPS, Gonçalves SAA, Medeiros AP, Dias JMF et al. The main drugs prescribed in psychosocial support centers - CAPs. INTESA - Informativo Técnico doSemiárido (Pombal-PB). 2016;10(2):76 - 91.

Manhapra A, Chakraborty A, Arias AJ. Topiramate Pharmacotherapy for Alcohol Use Disorder and Other Addictions: A Narrative Review. J Addict Med. 2019;13(1):7-22.

Marques ACPR, Ribeiro M, Laranjeira R, Andrada NC. Abuse and dependence: crack. Rev Assoc Med Bras . 2012;58(2):141-153.

Martin PR, Singleton CK, Hiller-Sturmhöfel S. The Role of Thiamine Deficiency in Alcoholic Brain Disease. Alcohol Res Health. 2003;27(2):134-142.

McHugh RK, Votaw VR, Taghian NR, Griffin ML, Weiss RD., Benzodiazepine misuse in adults with alcohol use disorder: Prevalence, motives and patterns of use, J. Subst. Abuse Treat. 2020, 26p. [citad 2020 Jul 14] Avaible from: [citad 2020 Jul 14] Avaible from: https://doi.org/10.1016/j.jsat.2020.108061

» https://doi.org/10.1016/j.jsat.2020.108061

Oliveira VC, Capistrano FC, Ferreira ACZ, Kalinke LP, Felix JVC, Maftum MA. Sociodemographic and clinical profile of people assisted in a CAPS AD in the South of Brazil. Rev Baiana Enferm. 2017;31(1):e16350.

Padilha PD, Toledo CEM, Rosada CTM. Analysis of the disénsation of psychotropic drugs on the Municipal Public Health Network of Campo Mourão/PR. Uningá Rev. 2014;20(2):06-14.

Pani PP, Trogu E, Vecchi S, Amato L. Antidepressants for cocaine dependence and problematic cocaine use. Cochrane Database Syst Rev . 2011;12:1-137.

Pennington DL, Bielenberg J, Lasher B, Herbst E, Abrams G, Tatjana Novakovic-Agopian T et al. A Randomized Pilot Trial of Topiramate for Alcohol Use Disorder in Veterans with Traumatic Brain Injury: Effects on Alcohol Use, Cognition, and Post-Concussive Symptoms. Drug Alcohol Depend. 2020;1;214:108149 (in press).

Pettinati HM, O’Brien CP, Rabinowitz AR, Wortman SM, Oslin DW, Kampman KM et al. The Status of Naltrexone in the Treatment of Alcohol Dependence. Specific Effects on Heavy Drinking. J Clin Psychopharmacol. 2006;26(6):610-625.

Pulcherio G, Stolf AR, Pettenon M, Fensterseifer DP, Kessler F. Crack - from stone to treatment. Rev Científica AMRIGS. 2010;54(3):337-343.

Romano M, Ribeiro M, Marques ACPR. Cocaine Abuse and Dependence. Project Guidelines. Brazilian Medical Association, Federal Council of Medicine. Associação Bras. Psiquiatr. (ABP) 2002;31.

Silva SN, Lima M G. Pharmaceutical Assistance in Mental Health: a diagnosis of Psychosocial Care Centers. Cienc Saude Colet . 2017;22(6):2025-2036.

Singulane BAR, Silva NB, Sartes LMA. History and factors associated with crime and violence among crack dependents. Psico-USF. 2016;21(2):395-407.

Stoner SA, Arenella PB, Hendershot CS. Randomized Controlled Trial of a Mobile Phone Intervention for Improving Adherence to Naltrexone for Alcohol Use Disorders. PLoS ONE. 2015;10(4):e0124613.

Thomaz KCV, Corgozinho MLMV, Saldanha PV, Paiva AMR. Alcoholism and Thiamine Deficiency associated with Wernicke-Korsakoff's Syndrome. Uningá Rev . 2014;20(3):94-100.

United Nations Office on Drugs and Crime. UNODC. World Drug Report. Booklet 2. Viena: United Nations publication; 2019. 80 p. [citad 2019 Jul 14] Available from: Available from: https://wdr.unodc.org/wdr2019/

» https://wdr.unodc.org/wdr2019/

U.S. Department of Veterans Affairs. Clinical Practice Guideline for the Management of Substance Use Disorders. 2015;(3) [Internet]. Washington, D.C. [citad 2020 Jul 19]. Available from: Available from: https://www.healthquality.va.gov/guidelines/mh/sud/

» https://www.healthquality.va.gov/guidelines/mh/sud/

Walker JR, Korte JE. McRae-Clarck AL, Hartwell KJ. Adherence Across FDA-Approved Medications for Alcohol Use Disorder in a Veterans Administration Population. J Stud Alcohol Drugs. 2019;80(5):572-577.

Williams SH. Medications for Treating Alcohol Dependence American. Am Fam Physician. 2005;72(9)1775-1780.

World Health Organization. WHO. Management of alcohol withdrawal. 2012;1:1-15. [citad 2020 July 19]. Available from: Available from: https://www.who.int/mental_health/mhgap/evidence/resource/alcohol_q2.pdf

» https://www.who.int/mental_health/mhgap/evidence/resource/alcohol_q2.pdf

Zanetti LL, Stumm EMF, Bosse FG, Oliveira R, Bandeira VAC, Colet CF. Pharmacological and non-pharmacological treatment of a Psychosocial Care Center users. Sci Med. 2017;27(4):1-10.

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Published

2022-11-23

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Original Article

How to Cite

Pharmacotherapy used for alcohol and cocaine use disorders in a CAPS-AD of Minas Gerais. (2022). Brazilian Journal of Pharmaceutical Sciences, 58. https://doi.org/10.1590/s2175-97902022e19702