title: Characteristics of clients using a community-based drug treatment service ('CAPS-AD') in Brazil: An exploratory study.
abstract: Substance use is common in Brazil. In order to improve availability of substance misuse care services, over 400 Psycho-Social Care Centres for Alcohol and Drugs (CAPS-AD) - providing community-based care - have been established following mental health care reform (2001). Information on CAPS-AD clients and outcomes is limited. The present study examined select characteristics of local CAPS-AD clients.
  
  
  
  N=143 adult CAPS-AD clients in Ceilândia (suburb of Brasília, Federal District) participated in a 1-week 'snapshot' assessment of service users (February 2015). Following consent, descriptive data were collected by a brief, anonymous interviewer-administered questionnaire that included socio-demographic, drug use, treatment history and needs/barriers information.
  
  
  
  Participants were predominantly male; middle-aged; unemployed; married; with middle-school education; primary problem drugs indicated were alcohol and cocaine/crack; half had prior treatment histories and indicated that treatment was externally motivated; 60% reported ways to improve treatment and possible reasons for treatment discontinuation; in multi-variate analyses, the latter was associated with employment and education status (both p<.05).
  
  
  
  CAPS-AD services appear to have increased low-barrier substance misuse treatment availability in Brazil, as well as attract individuals new to the treatment system. Various potential barriers to continuing in treatment should be addressed and more research on CAPS-AD clients and outcomes is needed.
authors.affiliation: Center of Drugs and Associated Vulnerabilities, Faculty of Ceilândia, University of Brasilia, Brazil; Science and Health Technology Program, Faculty of Ceilândia, University of Brasilia, Brazil. Electronic address: andrea.gallassi@gmail.com.
authors.forename: Andrea Donatti
authors.initials: AD
authors.lastname: Gallassi
authors.affiliation: Department of Statistics, University of Brasilia, Brazil.
authors.forename: Eduardo Yoshio
authors.initials: EY
authors.lastname: Nakano
authors.affiliation: Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Gabriela Arantes
authors.initials: GA
authors.lastname: Wagner
authors.affiliation: Center of Drugs and Associated Vulnerabilities, Faculty of Ceilândia, University of Brasilia, Brazil.
authors.forename: Maria de Nazareth Rodrigues Malcher
authors.initials: Mde N
authors.lastname: de Oliveira Silva
authors.affiliation: Social & Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D057229:Alcoholics / Q000523:psychology*; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D001291:Attitude of Health Personnel; D001938:Brazil / Q000453:epidemiology; D000074101:Cocaine Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D003153:Community Health Services; D055030:Drug Users / Q000523:psychology*; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020380:Needs Assessment; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D014478:Unemployment / Q000523:psychology; D055815:Young Adult
keywords: Barriers; Brazil; Community-based treatment; Retention; Substance misuse