| dc.description.abstract | Cocaine abusive use and addiction are a serious public health issue. It is estimated that 0,4% of the
world population, between 15 and 64 years old, has made use of cocaine in 2016. Global data on
illicit drug use indicates Brazil as one of the emerging nations where the use of stimulants, such as,
cocaine, snorted or smoked, is increasing. This work aims to describe and analyse the data from
the estimates of the Global Burden of Disease Study (GBD 2017) of cocaine use disorders in Brazil
and its Federal Units (UF) between 2000 and 2017. Estimates of GBD 2017 were used: agestandardized prevalence rate (ASPR) of addiction, age-standardized mortality rate (ASMR), and
age-standardized rate of life years lost due to death or disability [DALY = YLL (years of life lost
for premature death) + YLD (years lived with disability)], by sex and age group. It has also
investigated the ratio between observed versus expected DALY (O/E), based on the SocioDemographic Index (SDI). Statistic models were used to produce the estimates. For all the metrics,
Uncertainty Intervals of 95% (II95%) were used. For estimates of mortality rate, the GBD 2017
study used an algorithm for the redistribution of garbage codes, where International Classification
of Diseases (ICD-10) codes of accidental poisoning (X40-X44 and X49) were redistributed to
disorders for illicit drug use. The main preposition of this algorithm is the dominance of some
substance when considering the intermediate causes of death by accidental poisoning, applying the
following order: opioids; cocaine; amphetamines, psychoactive, and psychedelic drugs in the same
level of fatality; then alcohol, and, finally, marijuana. The results show that Brazil has the sixth
highest rate of DALY (43.45 / 100 thousand in hab. II95%: 30,19 - 60,37) of cocaine use disorders
worldwide, affecting mainly men and young adults. There were not substantial differences in the
burden of these disorders among the UFs. Between 2000 and 2017, there was positive variation in
prevalence in absolute numbers (53%), as well as positive variation in the Age-Standardised
Prevalence Rate (ASPR), with the rate of dependence of disorders due to cocaine use 2.33 times
higher among men than among women. There was a statistically significant increase in MR in all
UFs, ranging from 85% in the Federal District to 211% in Rio Grande do Norte. States with higher
SID presented the lowest rates in the DALY O / E and the opposite took place in the states with
low SID. Mortality and burden attributed to cocaine use are considered to be avoidable. In this
sense, the statistic significant increase of MR of the disorders caused by cocaine use and the high
rate of DALY of these disorders reinforce the need of new strategies in the public policies to face
drug use in Brazil. | |
