Cuba implemented policies mandating social distancing on March 11, 2020, which were still in place at the time of this study. During such periods of isolation, people with psychoactive substance-related disorders and other addictions may be tempted to reduce tension, stress, uncertainty and possible distress by increasing the use of substances or practices they have abused. This can mean relapses and setbacks for patients undergoing treatment. A multidisciplinary team of health professionals specializing in addiction at the Center for Academic Development in Drug Addiction, in Havana, Cuba, cares for people with these disorders and followed their evolution during the initial period of COVID-19 social isolation. With the aim of characterizing strategies employed by patients undergoing treatment for substance abuse and addictions, we conducted a qualitative study from April 2020 through May 2020, using a convenience sample of 37 patients (all students) who had been progressing towards recovery from addictive behaviors when face-to-face encounters were suspended due to COVID-19 restrictions. Contact was maintained through information and communication technologies. The research used telepsychology and focused on understanding patient life experiences. Patients were interviewed using a semi-structured survey, which was then transcribed and coded thematically using a grounded-theory approach. We found that patients’ ability to cope successfully with challenges presented by COVID-19 were influenced by: 1) the individual’s own methods for maintaining self-control (commitment to studies, projects, and work with therapists) that aided them in their goals concerning abstinence; 2) difficulties faced in addressing speci.c events and situations (doubts, uncertainties, disagreements, isolation and time use); 3) perpetuation and revivification of myths related to substances and addictive activities (exacerbation of supposed benefits of tobacco, alcohol, marijuana, overuse of social networks); and 4) tendencies toward irrationality and lack of emotional control (fear, sadness, anger, constant worry and self-imposed demands). Our findings suggest that despite the potential negative psychological impact of preventive social isolation during the COVID-19 pandemic, individual coping mechanisms developed by these patients, aiming at improved self-control, allowed most to avoid setbacks that could have affected their recovery. Nevertheless, patients faced challenges to their recovery that were compounded by difficulties in specific situations, myths related to substances and addictive activities, and tendencies toward irrationality or lack of emotional control.
KEYWORDS COVID-19, substance-related disorders, drug users, alcoholism, tobacco use disorder, psychophysiologic disorders, psychological adaptation, interview, qualitative research, psychological resilience, medical informatics, Cuba
To encourage development of negative attitudes toward alcohol use and thus prevent early onset of alcohol use, an intersectoral intervention was conducted from 2014 to 2015 among Cuban adolescents in 14 schools in Havana. The intervention included 312 students (189 girls and 123 boys) aged 14 to 15 years in 10th grade of high school or vocational school. Workshops were conducted using participatory techniques and group dynamics. Qualitative methods were applied, including narrative, desiderative and projective techniques. Indicators included attitudes, motivation, interests and perception of risk. Following the intervention, 82.7% (258/312) of participants reported healthy cultural and recreational interests and 61.9% (193/312) reinforced negative attitudes toward drinking. Such interventions can help prevent early onset of alcohol use in school settings. Given the positive results, the intervention is slated to be reproduced in other Cuban provinces.
KEYWORDS Adolescents, prevention, alcoholism, attitudes, Cuba
INTRODUCCIÓN El consumo de cigarrillos y de alcohol por estudiantes de ciencias de la salud (más allá de lo permitido por las normas sociales) constituye un comportamiento que contradice la función social que ellos desempeñarán como promotores de la salud en sus profesiones.
OBJETIVO Identificar la prevalencia del consumo de alcohol y tabaco en estudiantes de ciencias de la salud en México y Cuba para apoyar intervenciones educativas que promuevan estilos de vida saludables y el desarrollo de competencias profesionales que ayuden a reducir el impacto perjudicial de estas drogas legales en ambos países.
MÉTODOS Se realizó un estudio descriptivo transversal utilizando técnicas cuantitativas y cualitativas. Se recogieron datos proporcionados voluntariamente por estudiantes de ciencias de la salud en ambos países mediante una encuesta anónima autoaplicada, seguida de una entrevista en profundidad.
RESULTADOS La prevalencia de consumo de tabaco fue del 56.4% entre los estudiantes mexicanos y de 37% entre los cubanos. Fue mayor entre los hombres en ambos casos, pero también se observaron niveles sustanciales en las mujeres. En ambos grupos la mayoría estuvo expuesta regularmente al humo de tabaco ambiental.
La prevalencia de consumo de alcohol fue de 76.9% entre los estudiantes mexicanos y de 74.1% entre los estudiantes cubanos. En condiciones de riesgo clasificaron 44.4% entre los estudiantes mexicanos y 3.7% entre los cubanos.
CONCLUSIONES La elevada prevalencia de consumo de tabaco y alcohol en estos estudiantes de ciencias de la salud es motivo de preocupación y tiene consecuencias no solo en su salud individual, sino también sobre su eficacia profesional para disminuir el impacto de estas drogas en ambos países.
PALABRAS CLAVE Hábito de fumar, tabaco, dependencia de la nicotina, dependencia del alcohol, trastornos relacionados con el consumo de sustancias, desórdenes relacionados con el alcohol, adicción, comportamiento de riesgo, estudiantes de las ocupaciones de la salud, México, Cuba
INTRODUCTION Smoking and alcohol use (beyond social norms) by health sciences students are behaviors contradictory to the social function they will perform as health promoters in their eventual professions.
OBJECTIVES Identify prevalence of tobacco and alcohol use in health sciences students in Mexico and Cuba, in order to support educational interventions to promote healthy lifestyles and development of professional competencies to help reduce the harmful impact of these legal drugs in both countries.
METHODS A descriptive cross-sectional study was conducted using quantitative and qualitative techniques. Data were collected from health sciences students on a voluntary basis in both countries using the same anonymous self-administered questionnaire, followed by an in-depth interview.
RESULTS Prevalence of tobacco use was 56.4% among Mexican students and 37% among Cuban. It was higher among men in both cases, but substantial levels were observed in women as well. The majority of both groups were regularly exposed to environmental tobacco smoke. Prevalence of alcohol use was 76.9% in Mexican students, among whom 44.4% were classified as at-risk users. Prevalence of alcohol use in Cuban students was 74.1%, with 3.7% classified as at risk.
CONCLUSIONS The high prevalence of tobacco and alcohol use in these health sciences students is cause for concern, with consequences not only for their individual health, but also for their professional effectiveness in helping reduce these drugs’ impact in both countries.
KEYWORDS Smoking, tobacco, nicotine dependence, alcohol dependence, substance-related disorders, alcohol-related disorders, addiction, risk behavior, health occupations students, Mexico, Cuba
