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Edit orial
RESEARCH ON TH E DRUGS PH EN OM EN ON FROM TH E PERSPECTI VE OF M ULTI CEN TER
STUDI ES I N LATI N AMERI CA AN D THE CARI BBEAN
Maria da Gloria Miot t o Wright1 Louis Glik sm an2 Ak w at u Khent i3 Ant onia Regina Fer r eir a Fur egat o4
T
he drugs phenom enon is one of t he great est challenges count ries are confront ed wit h in t he 21st century. I t is well known that drugs use and abuse influence and negatively affect the health of people, fam ilies and com m unit ies, as well as nat ional and int ernat ional developm ent , social st abilit y and securit y( 1- 2).The globalizat ion process can direct or indirect ly facilit at e drugs t rade, as well as t he developm ent of m oney laundry m echanism s, cont ribut ing t o increased drugs consum pt ion in different populat ion groups. That m akes t he dr ugs phenom enon a global pr oblem . Many count r ies have em phasized t he associat ion bet w een drugs and t errorism and have direct or indirect ly reinforced drugs cont rol laws. I n t he cont ext of t he black m arket , drugs are considered a lucrat ive source of m oney; at t he sam e t im e, t his m arket can be associat ed wit h arm s t rade and violence against civilians and governm ent s all over t he world( 3).
Nat ional policies highlight t he im por t ance of r educing dr ugs consum pt ion, t ak ing int o account , for exam ple, t he risk of acquiring HI V/ AI DS am ong inj ect ion drugs user, or great er accident risks, or t he chronic dam age t hat can be associat ed wit h drugs use( 3). Psychoact ive subst ance consum pt ion affect s users’ body and m ind. These effect s range from alt erat ions in physiological funct ions t o m odified t im e and space percept ions, as well as alt erat ions in st at es of awareness about t he consum ers’ environm ent . I t can be affirm ed t hat drugs abuse and addict ion result from a com binat ion of t hree fact ors: a product ( alcohol and ot her drugs) , a person with his history and individual vulnerabilities and a social, cultural, political and econom ic context. I n particular, it is fundam ental to integrate the im portance of social determ inants of health and developm ent into the analysis of and answers given to substance consum ption, including the strong inequities that exist in the region. Likewise, it should be considered that m any people present com orbidities due to addiction and m ental health problem s at t he sam e t im e. I n view of t he above, a com prehensive approach is needed, which does not rem ain lim it ed t o an em phasis on t he subst ance alone.
Hence, the drugs phenom enon is an old problem in a new context. Countries face difficulties to control product ion and t rade and reduce dem and. That m akes drugs use and abuse int o a param ount t hem e on t he nat ional and int ernat ional agenda, due t o t he dam age t hey cause in count ries’ social, econom ic and polit ical aspect s.
The current global cont ext dem ands specialized professionals, who are capable of analyzing problem s and pr esent ing solut ions and/ or st r at egies w it h nat ional and int er nat ional per spect iv es, based on scient ific dat a. Most OAS m em ber s st at es do not hav e specialized pr ofessional st aff at t heir disposal, w it h scient ific k n ow ledge an d su f f icien t r esear ch ex per ien ce on dr u gs an d r elat ed pr oblem s t o w or k in n at ion al dr u gs com m issions, research cent ers or academ ic professional t raining program s.
I n gener al, count r ies hav e neit her est ablished long- t er m pr ogr am s or planning t o r esear ch on t he drugs phenom enon, nor have they m anaged to incorporate research results into national drugs control policies. To solv e t his pr oblem , how ev er, som e developing count r ies hav e linked up w it h developed ones t o out line strategies for scientific advances in research on the drugs phenom enon. I n that context, CI CAD ( I nter- Am erican Drug Abuse Cont rol Com m ission) has developed st rat egies t o st rengt hen inst it ut ional capacit ies and hum an resources relat ed t o drugs dem and reduct ion, securit y and m oney laundering in it s m em ber- st at es.
1Ph.D., Senior Specialist , Coordinator, Educational Developm ent Program , Dem and Reduction Section, I nter-Am erican Drug Abuse Cont rol Com m ission,
CI CAD, Organization of Am erican States, OAS, United States, e- m ail: gwright@oas.org. 2Ph.D., Director, Public Policy Research, Prevention and Health, Centre
for Addict ion and Ment al Healt h, CAMH; Academ ic Coordinat or, I RCBP, CI CAD- CAMH. 3M.Sc., Direct or, Workshop on I nt ernat ional Healt h, Division of Policy,
Education and Health Prom otion, Centre for Addiction and Mental Health, CAMH; Local Coordinator, Program I RCBP, CI CAD- CAMH. 4Mem ber of the Editorial
Board of the Latin Am erican Journal of Nursing, Full Professor of the University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Developm ent , Brazil, e- m ail: furegat o@eerp.usp.br.
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Since 1998, CI CAD has organized t he Associat ion Program wit h Lat in Am erican Universit ies, aim ed at int r oducing t he dr ugs t hem e int o under gr aduat e and gr aduat e cour se cur r icula, w it h a v iew t o dev eloping research and com m unit y service act ivit ies in nursing, public healt h, educat ion and m edicine. Nowadays, CI CAD collabor at es w it h m or e t han 174 colleges in Lat in Am er ica and t he Car ibbean. Regional and int er nat ional t r aining pr ogr am s on int er nat ional healt h, t he dr ugs phenom enon, r esear ch and leader ship const it ut e new st r at egies for hum an r esour ce t r aining in t he r egion, so as t o addr ess t he dr ugs phenom enon in a global cont ex t .
As fr om 2003, CI CAD cr eat ed t he “ I nt er nat ional Resear ch Pr ogr am for Pr ofessionals in Healt h and Relat ed Areas t o St udy t he Drugs Phenom enon in Lat in Am erica ( English acronym I RCBP) ”, first associat ed wit h t he Universit y of Albert a, Canada ( 2003- 2004) , and soon aft erwards wit h t he Cent er for Addict ions and Ment al Healt h- CAMH, in Toront o, Canada* ( from 2006 unt il t oday) . The Program obj ect ives are: ( i) t o prepare professional st aff in healt h and relat ed areas wit h scient ific and t echnical com pet encies ( at t it udes, knowledge and skills) in research so as to perm it scientific advances in the drugs phenom enon - especially related to drugs dem and reduct ion; ( ii) t o perm it t he developm ent of m ult icent er research t o st udy t he different aspect s of t he drugs phenom enon, especially in t he field of drugs dem and reduct ion in Lat in Am erica and t he Caribbean; ( iii) t o su p p or t , w it h scien t if ic ev id en ce, p u b lic p olicy d ev elop m en t , d ecision m ak in g , p r og r am an d p r oj ect m anagem ent and assessm ent and ( iv) t o perm it exchanges bet ween regional and Canadian researchers in t he field of t he drugs phenom enon( 4).
The Program has been preparing 51 professionals, 31 of whom have graduated, while 20 are finishing their m ulticenter research and preparing scientific papers about the research results for publication in specialized j ournals. As for the distribution by nationality, the Program has received participants from 16 countries ( Argentina, 1; Brazil, 13; Chile, 5; Colom bia, 7; Cost a Rica, 1; Ecuador, 2; El Salvador, 1; Guat em ala, 3; Honduras, 2; Jam aica, 4; Mexico, 2; Nicaragua, 3; Peru, 3; Panam a, 1; Paraguay, 1; Uruguay, 1) . The following academ ic areas are represent ed in t he Program : Medicine, Nursing, Public Healt h, Social Work/ Service, Educat ion and Law( 4). This kind of program offers a series of advantages for the developm ent of m ulticenter research: ( i) the cent ral research t hem e is im port ant t o different count ries and t he region; ( ii) it perm it s collaborat ion am ong researchers during design, elaborat ion, publicat ion and dissem inat ion; ( iii) favors cooperat ion am ong count ries and part icipant organizat ions; ( iv) facilit at es t he m obilizat ion/ exchange of resources and responsibilit ies; ( v) pr om ot es t he est ablishm ent of r esear ch net w or k s; ( v i) per m it s t he dev elopm ent of gr aduat e t heses and dissert at ions ( Mast er’s and Ph.D.) for in- dept h analysis of specific aspect s in t he result s( 5- 6).
This supplem ent of the Latin Am erican Journal of Nursing ( RLAE) sum m arizes the articles of participants who graduated from the Program in 2006- 2007 and 2007- 2008. The them e of the m ulticenter research participants developed in 2006- 2007 w as: “ I llicit dr ugs use in 7 Lat in Am er ican count r ies: a cr it ical per spect ive on t he fam ily and close cont act s”, and, in 2007- 2008: “ St andards perceived by college st udent s about drugs use by t heir peers: a m ult icent er st udy in 5 Lat in Am erican count ries”.
This Journal present s art icles on t he general result s found in t he count ries involved in each of t he m ult icent er st udies, followed by art icles wit h specific result s from sit es where inform at ion was collect ed for different part icipant count ries. The print version of t his supplem ent cont ains 22 art icles, issued in Spanish, while English and Port uguese versions are available on- line at ht t p: / / www.scielo.br.rlae.
Thus, once again, t he Lat in Am erican Journal of Nursing ( RLAE) cont ribut es t oget her wit h CI CAD/ OAS and CAMH t o put in pract ice a specialized hum an resource t raining policy for research and act ivit ies on drugs dem and reduct ion in Lat in Am erica and t he Caribbean.
* CAMH ( www.cam h.net) is a WHO/ PAHO Collaborating Centre affiliated with the University of Toronto. I t develops the following m ain areas: clinical services, research, educat ion, public policies and healt h prom ot ion. I t s I nt ernat ional Healt h Office collaborat es wit h m ult iple count ries in t he search for and im plem ent ation of effect ive and sust ainable answers, in view of act ual needs in Ment al Healt h and Addict ions. An im port ant part of CAMH’s internat ional work is focused on Lat in Am erica and t he Caribbean, wit h st rong em phasis on skills developm ent in int erprofessional healt h t eam s, researchers, leaders and decision- m akers, am ong ot hers.
Research on the drugs phenomenon… Wright MGM, Gliksm an L, Khenti A, Furegato ARF.
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REFEREN CES
1 . Men des I AC, Mar ziale MHP. Dev elopin g com pet en cies for dr u g dem an d r edu ct ion . Rev Lat in o- am En fer m agem 2 0 0 8 ; 1 6 ( sp e) : 5 0 5 - 6 .
2. Reinaldo MAS, Pillon SC. Alcohol effect s on fam ily relat ions: a case st udy. Rev Lat ino- am Enferm agem 2008; 16( spe) : 529-3 4 .
3. CI CAD- MEM ( 2005- 2006) . I nfor m e Hem isfér ico del Mecanism o de Ev aluación Mult ilat er al. Washingt on, DC.; 2006. 4. CI CAD- CAMH ( 2006- 2009) . I nform es finales del “ Program a I nt ernacional en I nvest igación para Profesionales de la Salud y Áreas Relacionadas para Est udiar el Fenóm eno de las Drogas en Am érica Lat ina y Caribe”. Washingt on, DC ( USA) ; Toront o ( CAN) ; 2 0 0 9 .
5. Bangdiwala SI , Sousa de Paula C, Ram iro LS, Muñoz S. Coordinat ion of I nt ernat ional Mult icent er St udies: Governance and Adm inist r at iv e St r uct ur e. Salud Publica de Mex ico 2003; 45( 1) : 58- 66.
6. Caufield C, Gilbert J, Radunz V, Olson J. Nurses and Mult icent ric Research on t he Drug Phenom enon in t he Am ericas: Benefit s and Challenges. Tex t o Cont ex t o Enfer m 2006; 15( 4) : 685- 8.
Rev Latino- am Enferm agem 2009 novem bro- dezem bro; 17( Esp.) : 755- 7 www.eerp.usp.br/ rlae
Research on the drugs phenom enon…
