Ronaldo Laranjeira

• MD, PhD
• Federal University of São Paulo

Objective: The latest edition of the Open Drug Scenes Survey in Brazilian Cities (LECUCA) investigated social vulnerability, health, and the use of the Psychosocial Care Network by attendees of open drug scenes (ODSs) involving crack cocaine in São Paulo, Fortaleza, and Brasília between 2021/2022. Methods: Since 2016, LECUCA has used Time-Location...

Objective: The latest edition of the Open Drug Scenes Survey in Brazilian Cities (LECUCA) investigated social vulnerability, health, and the use of the Psychosocial Care Network by attendees of open drug scenes (ODSs) involving crack cocaine in São Paulo, Fortaleza, and Brasília between 2021/2022. Methods: Since 2016, LECUCA has used Time-Location...

Purpose: Affected family members(AFMs) of relatives who misuse substances (RMS) play an important role in supporting their relatives to enter substance use treatment. This study investigated the help-seeking behaviours for their relatives by AFMs in Brazil including the characteristics of those who sought help and the risk factors for delaying seek...

Introduction: The Therapeutic Community Model narrows the gap in substance use disorder’s network of assistance in Brazil by offering residential treatment to socially vulnerable populations. Due to a historical lack of evidence-based approaches, the government has established treatment guidelines and has been trying to implement training and monit...

Objectives Although previous studies have investigated the role of religiosity in violence outcomes, there is a lack of studies including this aspect as a mediator for violence in childhood and adulthood. This study aimed to investigate the relationship between religiosity and violence in childhood, as well as the possible mediating role of religio...

Objective: To evaluate the relationship between crack/cocaine use and domestic violence perpetration from the perspective of substance users' families. A secondary retrospective cross-sectional study, with 3162 family members of crack/cocaine users seeking treatment in the Recomeço Família Programme in São Paulo/Brazil was undertaken. Family membe...

Objective: We explored hospitalization patterns and the clinical and individual characteristics of a large cohort of patients who underwent involuntary psychiatric hospitalization in Brazil (n=64,685). Methods: Data were collected from the District Attorney's Office of the State of São Paulo (Ministério Público do Estado de São Paulo) on all inv...

São Paulo’s Crackland is the biggest and oldest open drug use scene in Brazil, yet little is known about the profile of crack cocaine treatment-seeking individuals living in this region. The aim of this cross-sectional study was to describe the demographics and clinical characteristics of treatment-seeking crack users living in the Crackland region...

Abstract Background: Smoked cocaine (i.e., crack use) is a severe health problem in Brazil, with the country being reported as having the largest crack market in the world. The objective of this study was to evaluate the effectiveness of incorporating Contingency Management targeting cocaine abstinence into a public treatment program in Brazil. Met...

Objective: To provide rates of cannabis use and dependence and risk factors, proposing a conditional path model for cannabis addiction, depressive symptoms and alcohol consumption. Methods: A subsample of adult participants from a Brazilian household survey was analyzed to estimate cannabis dependence. Estimation of prevalence rates and associati...

Background Crack-cocaine dependence is a serious public health issue, related to several psychiatric and psychosocial problems. Crack-cocaine users are usually embedded in a context of great social vulnerability, often associated with violence, poverty, family conflict and easy and early access to alcohol, tobacco and other drugs. Methods This cro...

A Comunidade Terapêutica tem sido incluída como na rede de cuidados para a dependência química, faz parte de recentes mudanças na política de saúde mental. Em virtude do hiato entre o surgimento e a normatização/regulamentação desses serviços, este trabalho busca descrever a implementação de um sistema de monitoramento nas Comunidades Terapêuticas...

Objective: To assess the efficacy of cannabidiol (CBD) in the management of crack-cocaine craving and the treatment of frequent withdrawal symptoms. Methods: Thirty-one men with a diagnosis of crack-cocaine dependence were enrolled in a randomized, double-blind, placebo-controlled trial. We applied neuropsychological tests and assessed craving int...

Neste capítulo, os autores revisaram a literatura científica disponível sobre o tema, bem como analisaram o mais recente banco de dados do II Levantamento Nacional sobre Álcool e Drogas (LENAD II), conduzido em 2012 pela Universidade Federal de São Paulo (Unifesp), a fim de sintetizar os principais resultados e conceitos atuais sobre a associação e...

Objective To evaluate the associations between relapse and admissions (voluntary and involuntary) in a sample of patients with substance dependence. Methods This is a cross-sectional study undertaken at a private medical therapeutic community specialised in treating addiction, located in a rural area of São Paulo, Brazil. Sociodemographic characte...

Objetivo: Descrever as características do serviço e o perfil dos usuários atendidos no Ambulatório Médico de Especialidades de Psiquiatria Dra. Jandira Masur (AME Psiquiatria), na cidade de São Paulo. Métodos: Foi realizado um estudo transversal com amostra de conveniência de todos os pacientes atendidos desde o início do funcionamento do ambulatór...

Although there is a wide array of evidence showing the beneficial effect of religiosity on violence among adolescents, nationwide studies in the general population are scarce. This study aims to explore whether religiosity is associated or not with diminishing violence in a Brazilian population-based representative sample. This observational cross-...

Background: Crack cocaine is a serious public health issue, with many psychiatric and psychosocial consequences. The crack cocaine user is usually inserted in a context of great social vulnerability, often associated to violence, unstructured family functioning, antisocial peer factors and easy access to the consumption of alcohol, tobacco and illi...

Studies of adolescents receiving inpatient substance use treatment remain limited. We explored the characteristics of adolescents who received substance use treatment as inpatients in a psychiatric hospital in Brazil and factors associated with length of time in this treatment. Methods: A retrospective observational study was performed. Electroni...

This study aimed to evaluate the differences in gambling exposure and onset of gambling problems among male and female gamblers by comparing their demographic and behavioral profiles. This study utilized data from the gambling section of the First Brazilian National Alcohol Survey and Related Behaviors. Interviews were conducted with 3007 participa...

Resumo Objetivo: Descrever as características do serviço e o perfil dos usuários atendidos no Ambulatório Médico de Especialidades de Psiquiatria Dra. Jandira Masur (AME Psiquiatria), na cidade de São Paulo. Métodos: Foi realizado um estudo transversal com amostra de conveniência de todos os pacientes atendidos desde o início do funcionamento do a...

Introduction This study describes the epidemiological scenario of human immunodeficiency virus (HIV) and syphilis at the biggest specialist drug addiction center in Brazil. The great challenge is to find strategies to reduce the impact of inequality and discrimination and develop policies to protect individuals living with – or at risk of – infecti...

The objective of this study is to evaluate the prevalence of self-reported rape and its associations with other forms of violence and mental health outcomes. The Brazilian National Alcohol and Drugs Survey is a probabilistic household survey that collected data from 4,283 Brazilians aged 14 years and older in 2012. The prevalence of rape was 2.3% (...

Purpose: The heterogenic characteristics of affected family members (AFMs) of substance misusing relative (SMR) remain understudied. This study examined the occurrence and correlates of AFMs having more than one relative with substance use problems. Material and methods: A secondary analysis of a cross-sectional study on the characteristics of a...

Objective: To describe the prevalence of substance use and the associations between adverse early life experiences, sexual behaviour and violence in sexual minority (SM) individuals. Methods: The Brazilian National Alcohol and Drugs Survey is a probabilistic household survey performed in 2012, collecting data from 4,067 Brazilians aged 14 years a...

As in many other health disorders, people who misuse substances tend to be assisted by female caregivers. Despite this, little is known about the characteristics of women affected by a substance misusing relative (SMR). Data from 2541 Brazilian female affected family members (AFM) were analyzed. The majority of participants were mothers, age 45 or...

Introduction: Brazil is the world’s biggest consumer of crack cocaine, and dependence is a major public health issue. This is the first study to investigate the prevalence of potentially harmful adulterants present in hair samples from Brazilian patients with crack cocaine dependence. Method: We evaluated adulterants in hair samples extracted by c...

Objective: Cocaine use disorders (CUDs) represent a major public health problem in many countries. To better understand the interaction between the environmental modulations and phenotype, the aim of the present study was to investigate the DNA methylation pattern of CUD patients, who had concomitant cocaine and crack dependence, and healthy contr...

Objective: The purpose of this study was to compare the characteristics of treatment-seeking crack cocaine users in Brazil in 1996/1997 and 2012/2013. Methods: We analyzed data from 2 cross-sectional studies conducted 16 years apart. The first study (performed 1996-1997) included 133 crack users. The second study (performed 2012-2013) included 577...

Objective To evaluate the associations between relapse and admissions (voluntary and involuntary) in a sample of patients with substance dependence. Methods This is a cross-sectional study undertaken at a private medical therapeutic community specialised in treating addiction, located in a rural area of São Paulo, Brazil. Sociodemographic charact...

Com base na análise dos dados de corte transversal provenientes do Segundo Levantamento Nacional de Álcool e Drogas realizado em 2012, utilizando-se uma amostra probabilística estratificada por conglomerado representativa da população brasileira, este estudo apresenta as prevalências de estupro e analisa a relação deste evento com o consumo de álco...

Com base na análise dos dados de corte transversal provenientes do Segundo Levantamento Nacional de Álcool e Drogas realizado em 2012, utilizando-se uma amostra probabilística estratificada por conglomerado representativa da população brasileira, este estudo apresenta as prevalências de estupro e analisa a relação deste evento com o consumo de álco...

Objective: To investigate the prevalence rates of suicidal ideation (SI) and suicide attempts (SA) and their association with substance use in a nationally representative sample of Brazilians. Methods: The Second Brazilian National Alcohol and Drug Survey (II BNADS) is a household cross-sectional survey that investigated the consumption of psych...

Background DNA methylation has been increasingly recognized in the etiology of drug dependence. Due to the difficulties in assessing brain tissue in living humans, peripheral cells such as blood and saliva have been explored as alternatives to explore the involvement of DNA methylation in drug dependency. Here, we characterized DNA methylation chan...

Background Abuse and dependence on cocaine and its smoked form, crack, is an important public health problem. To better understand the interaction between genes and the environment, we analyzed methylation changes in the peripheral blood of cocaine/crack dependents. Methods The DNA methylation pattern in the peripheral blood of 23 cocaine and crac...

Introduction: The recovery housing (RH) program was initiated in São Paulo with the objective of providing treatment for substance use disorders and addressing users’ housing and employment problems. The purpose of this study was to describe the model based on its first 11 months of operation, it was launched in June 2016 in Brazil. Method: We car...

Objective: This study compared the rates of binge drinking (BD) and alcohol use disorder (AUD) reported for 2006 with those reported for 2012, exploring their associations with unprotected sex, early pregnancy, and abortion in a representative sample of women in Brazilian households. Methods: This was a descriptive analysis of data from a cross-...

Objectives: We evaluated the psychometric properties of the Brazilian version of a set of measures designed to assess four psychological constructs associated with having a substance misusing relative in the family: the Family Member Impact (FMI), the Symptom Rating Test (SRT), the Coping Questionnaire (COPE) Hopefulness-hopelessness scale (HOPE)....

Background Although many studies suggest that religiosity is a protective factor against drug use, there is little information on its effect on drug consumption patterns of those who do use drugs. Aims We aimed to examine if there is any relationship between religiosity during childhood and adolescence, and drug consumption in adult crack users....

Crack cocaine (crack) dependence is a severe disorder associated with considerable morbidity and mortality, constituting a major public health problem in Brazil. The aim of this study was to improve understanding of the profile of treatment-seeking crack-dependent individuals. We recruited 65 crack-dependent individuals from among those seeking tre...

Background: Contingency management (CM) has recently shown efficacy in promoting abstinence and retention in treatment among crack cocaine users in Brazil. However, partially because of unawareness and resistance among health care providers, CM has not been widely employed. The objective of this study was to conduct a secondary analysis in order t...

Although contingency management (CM) is effective in promoting abstinence and treatment retention among crack cocaine users who meet the criteria for cocaine dependence, less is known about its off-target effects. In this secondary analysis, we evaluated the impact of CM on depressive and anxiety symptoms in a sample of cocaine-dependent individual...

Abortion is a very sensitive issue with relevance to public health; however few clinical or population-based studies have examined induced abortion among drug users. The study aims to evaluate the prevalence of induced abortion and sex-related conditions in an inpatient drug user sample. A cross-sectional design study was conducted in an inpati...

Purpose: There is a virtual absence of previous research about the experiences of people affected by the presence of a substance misuser in the family in Brazil. Materials and methods: A diverse sample of 3158 (80.6% female) affected family members (AFMs) was recruited in the largest cities in all five Brazilian regions. A Brazilian Portuguese tran...

Objective To investigate the association of alcohol and cocaine use with urban violence (both as victim and as perpetrator) in a representative sample of the Brazilian population. Method The Second Brazilian Alcohol and Drugs Survey (II BNADS) interviewed 4607 individuals aged 14 years and older from the Brazilian household population including an...

Background Crack-cocaine addiction is an important public health problem worldwide. Although there is not a consensus, preliminary evidence has suggested that cognitive impairments in patients with crack-cocaine dependence persist during abstinence, affecting different neuropsychological domains. However, few studies have prospectively evaluated th...

Background and objectives: Retaining substance using women in antenatal care remains a major challenge. This study explored factors associated with attrition rate among women with substance use problems attending a supportive care service during pregnancy and soon after the birth of the infant. Methods: Records of 166 women's antenatal consultat...

Objective: The aim of this study was to estimate nationally representative prevalence rates of amphetamine-type stimulant (ATS) use and to identify consumption-associated factors, proposing a conditional model of direct and indirect consumption paths. Method: Using data from the Second Brazilian National Alcohol and Drugs Survey, this cross-sectio...

Objective: To perform a construct validation of the List of Threatening Events Questionnaire (LTE-Q), as well as convergence validation by identifying its association with drug use in a sample of the Brazilian population. Methods: This is a secondary analysis of the Second Brazilian National Alcohol and Drugs Survey (II BNADS), which used a cross-...

In recent years, several studies have been focused on the comorbidity of psychiatric disorders with alcohol and other substance dependence. In this context, the Brazilian Association of Studies on Alcohol and Other Drugs initiated a project to establish Brazilian Guidelines. The aim of this study was to review diagnostic and therapeutic criteria fo...

Introduction and aims: The aims of this study were to determine the prevalence of witnessing parental violence (WPV) during childhood and of current intimate partner violence (IPV) victimisation and aggression in a Brazilian sample, in order to verify pathways between WPV and involvement in IPV as an adult. Design and methods: The mediating role...

Título: Álcool, Cocaína e Crack: Evidências Epidemiológicas, de Tratamento e Prevenção Embasando a Política de Drogas Autores: Clarice Madruga, Phd1, 2, André Miguel, MSc1, 2, Zila M. Sanchez, PhD3, Ronaldo Laranjeira, PhD1, 2,3. Afiliações: 1:Departamento de Psiquiatria e Psicologia Médica, Universidade Federal de São Paulo – Escola Paulista de Me...

Abstract The aim of this study was to evaluate the potential relationship between self-reported sexual dysfunction, sexual behavior, and severity of addiction of drug users. A cross-sectional design study was conducted at an inpatient addiction treatment unit in Sao Paulo, Brazil, with a sample of 508 male drug users. Sociodemographic data, sexual...

Crack cocaine dependence has become a severe public health problem in Brazil, and current psychosocial approaches to this problem have shown little or no effectiveness. Although contingency management is among the most effective behavioral treatments for substance use disorders, it has never been applied in the treatment of crack cocaine–dependent...

INTRODUÇÃO: A dependência de crack é hoje um problema de alta relevância para a saúde pública no Brasil. Estima-se que mais de um milhão de brasileiros tenham fumado crack em 2012, fazendo do Brasil possivelmente um dos maiores mercados para o consumo desta droga do mundo. Evidências robustas provindas de diversos estudos randomizados controlados e...

Objective:: To compare intimate partner violence (IPV) prevalence rates in 2006 and 2012 in a nationally representative household sample in Brazil. The associations between IPV and substance use were also investigated. Methods:: IPV was assessed using the Conflict Tactic Scale-R in two waves (2006/2012) of the Brazilian Alcohol and Drugs Survey....

The aim of this study was to investigate the link between violence, crime, and sexual behavior among patients with substance-related disorder admitted to a specialized inpatient care unit. This was a cross-sectional study using a questionnaire on socio-demographic characteristics, drug of choice (DOC), questions about sexual behavior, and instrumen...

The trend of stimulant use, especially crack cocaine, carries worrisome ramifications in Brazil, whose population of 200. million includes a young, booming, new middle class, as well as a large, economically disadvantaged and uneducated tier of society; both are equally vulnerable to drug abuse and addiction. The geographically continental-sized pr...

Aims: The aim of this study is to evaluate whether there is a difference in the identified prevalence between the assessment of symptoms of sexual dysfunction in female drug users using a standardized scale and by means of a nonstandardized set of questions about sexual dysfunctions. Method: A cross-sectional study was conducted with two groups...

Open air drug scenes represent very substantial challenges to health and law enforcement professionals around the world, especially in LAMI countries. Crack-cocaine users have gathered for 25 years in Cracolândia (São Paulo, Brazil), one of the world's largest open drug scenes. Several initiatives have provided treatment, employment and accommodati...

Relatório Científico Final Edital MCT/CNPq Nº41/2010

Aim: The aim of the present study was to evaluate violence, crime and sexual behaviour among patients with substance-related disorder admitted to a specialized inpatient care unit. Methods: This was a cross-sectional study using a questionnaire about socio-demographic data and drug of choice (DOC), questions about sexual behaviour, and instruments...

Brazil has the biggest crack cocaine market in the world. In the 27 Brazilian state capitols and in the Federal District, 370 thousand individuals are crack cocaine users and the majority of them use this drug in open air drug scenes. São Paulo City Metropolitan Area (20 million people) has the oldest and largest crack cocaine drug scene - ”cracolâ...

Background: It is known that Brazil holds some of the highest rates of urban violence in the world, this may not be unrelated to the combination of an extremely unregulated alcohol market as well as a growing crack/cocaine issue. The misuse of those substances carry worrisome ramifications in Brazil, whose population of 200 million includes a youn...

Contingency management (CM) and the community reinforcement approach (CRA) are among the most effective psychosocial treatments for substance use disorders (SUD). This article briefly discusses these interventions and their outcomes, giving special emphasis to the underlying models of human behavior. We describe a theoretical perspective based on o...

A presença de fenacetina e de levamisol como adulterantes do crack vem sendo detectada por pesquisadores europeus e dos Estados Unidos. Ambas as substâncias são considerados compostos baratos e farmacologicamente são capazes de aumentar a meia-vida da cocaína, aumentando assim a potência da mesma. Dessa forma, são adicionados à cocaína, visando aum...

Objective: To describe mortality by suicide among physicians in the state of Sa˜o Paulo, Brazil, between 2000 and 2009. Methods: Secondary analysis of government mortality data. The variable of interest was ‘‘underlying cause of death’’, specifically deaths classified by the ICD-10 as intentional self-harm (X60 to X84). Results: The analyses examin...

Objetivo: Descrever a mortalidade por suicídio entre os médicos no Estado de São Paulo, Brasil, entre 2000 e 2009. Métodos: Análise secundária dos dados de mortalidade do governo. A variável de interesse era “causa básica de morte”, especificamente óbitos classificados pela CID–10 como auto-mutilação intencional (X60 a X84). Resultados: As análises...

To examine the association between increases in income and self-reported alcohol consumption, binge drinking, and alcohol problems in 2006 and 2012 in Brazil. Participants were interviewed as part of 2 multistage representative cluster samples of the Brazilian household population between November 2005 and April 2006 and between November 2011 and M...

The aim of this study was to evaluate the potential relationship between self-reported sexual dysfunction, sexual behavior, and severity of addiction of drug users. A cross-sectional design study was conducted at an inpatient addiction treatment unit in Sao Paulo, Brazil, with a sample of 508 male drug users. Sociodemographic data, sexual behavior,...

The aim of this study was to evaluate the potential relationship between self-reported sexual dysfunction, sexual behavior, and severity of addiction of drug users. A cross-sectional design study was conducted at an inpatient addiction treatment unit in Sao Paulo, Brazil, with a sample of 508 male drug users. Sociodemographic data, sexual behavior,...

The consumption of psychoactive substances in Brazil is worrying, as occurs worldwide. Dependence on alcohol and drugs is considered a chronic disease, your goal is not to "cure ", but abstinence, which requires prolonged monitoring. The efficacy of treatments for addiction depends on the time patients spend in treatment until discharge and abandon...

Este estudo buscou analisar, em uma amostra representativa da população brasileira, as prevalências de aceitação de políticas relacionadas ao acesso, promoção, prevenção e tratamento dos problemas relacionados ao uso do álcool, bem como sua anuência para possíveis mudanças. Investigou, ainda, o perfil dos indivíduos não favoráveis às políticas por...

Este estudo buscou analisar, em uma amostra representativa da população brasileira, as prevalências de aceitação de políticas relacionadas ao acesso, promoção, prevenção e tratamento dos problemas relacionados ao uso do álcool, bem como sua anuência para possíveis mudanças. Investigou, ainda, o perfil dos indivíduos não favoráveis às políticas por...

Este estudio pretende evaluar los comportamientos sexuales de riesgo en pacientes dependientes de sustancias no inyectables admitidos en hospitalizacion especializada brasilena. Se realizo un estudio transversal con informacion sociodemografica, informacion sobre el comportamiento sexual, droga de eleccion y se les aplico el Short Alcohol Dependenc...

Although addiction develops in a considerable number of regular cocaine users, molecular risk factors for cocaine dependence are still unknown. It was proposed that establishing drug use and memory formation might share molecular and anatomical pathways. Alpha-Ca(2+)/calmodulin-dependent protein kinase-II (αCaMKII) is a key mediator of learning and...

Introduction: Brazil has been targeted by beverage companies due to its fast growing economy. Yet, it has only recently started to develop comprehensive population studies about alcohol consumption. The understanding of the trends in alcohol consumption is essential to implement new policies and to establish public health initiatives. Methods: Thi...

Background The associations between depressive symptoms and alcohol-related disorders, drinking patterns and other characteristics of alcohol use are important public health issues worldwide. This study aims to study these associations in an upper middle-income country, Brazil, and search for related socio-demographic correlations in men and women....

Introduction: Despite of Brazil’s remarkable economic development during the last decade, traffic accidents are still one of the main causes of death, with around 35,000 people. In 2007 policy makers had already shown interest in tackling this issue by reviewing the law code thus leading to more severe penalties. Objectives: We compared the rates o...

Introduction A study of 1383 drug users was undertaken in Brazil focusing on crack cocaine users. Detailed interviews were undertaken about their personal life history and psychoactive substance use and hair samples were taken to corroborate the interview data. The main objective of this paper is to evaluate hair drug testing as a biomarker capable...