South America Alexandre Kieslich da Silva Addiction Psychiatrist

Countries in the Region The 4 th Capacity Building Program of Green Crescents, 3

Countries in the Region PRODUCTION 5/22 countries with the highest transit and production of

Countries in the Region Social problems: • poverty • social exclusion • corruption •

Countries in the Region Alcohol and Tobacco are legal in all South American countries

Addiction in Brazil million LENAD II, 2012 The 4 th Capacity Building Program of

Alcohol Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December

Alcohol Addiction Alcohol use in Uruguay Lifetime Last year Last month The 4 th

Alcohol Addiction Barber shop Hairdresser

Tobacco Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December

Cannabis Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December

Cannabis Addiction The largest production is concentrated in Paraguay and Colombia. Paraguay is the

Cannabis Addiction Uruguay • Legalized marijuana in 2013 • Regulation the cultivation, production, dispensing

Cannabis Addiction Uruguay • Authorities in Uruguay recorded 66 % increase in homicides during

Cocaine Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December

Cocaine Addiction South America is the world’s largest producer of coca leaf and cocaine

Cocaine Addiction Cocaine base paste (“Crack”) Cocaine base paste is a derivative of coca

Cocaine Addiction Cracolândia (“Crackland”) São Paulo, downtown Almost 20 years Almost 2. 000 people

Other Drugs The 4 th Capacity Building Program of Green Crescents, 3 -6 December

Conclusion Many challenges! The 4 th Capacity Building Program of Green Crescents, 3 -6

Thank you for Listening Brazilian Green Crescent Alexandre Kieslich da Silva Addiction Psychiatrist Master

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South America Alexandre Kieslich da Silva Addiction Psychiatrist Master in Psychiatry at the Federal University of Rio Grande do Sul/ Brazil Professor of the Medical School at the University of Taquari Valley/Brazil The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Countries in the Region The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Countries in the Region PRODUCTION 5/22 countries with the highest transit and production of illegal drugs The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Countries in the Region Social problems: • poverty • social exclusion • corruption • political class irresponsibility • organized crime (i. e. , drug cartels in Colombia) The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Countries in the Region Alcohol and Tobacco are legal in all South American countries Other substances are illegal to produce and sell Use is generaly not criminalized Production, distribution and sale of psychotropics are regulated New: cannabis in Uruguay The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Countries in the Region The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Addiction in Brazil million LENAD II, 2012 The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Alcohol Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Alcohol Addiction Alcohol use in Uruguay Lifetime Last year Last month The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Alcohol Addiction Barber shop Hairdresser

Alcohol Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Tobacco Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cannabis Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cannabis Addiction The largest production is concentrated in Paraguay and Colombia. Paraguay is the first supplier of this drug, with more than 50% of the production in the region A large part of the production is used for the consumption The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cannabis Addiction Uruguay • Legalized marijuana in 2013 • Regulation the cultivation, production, dispensing and use of cannabis for recreational purposes • Institute for the Regulation and Control of Cannabis – Pharmacies – Cannabis clubs – Individual cultivation The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cannabis Addiction Uruguay • Authorities in Uruguay recorded 66 % increase in homicides during the first half of 2018 • The impact will only become evident in the coming years! The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cannabis Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cocaine Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cocaine Addiction South America is the world’s largest producer of coca leaf and cocaine The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cocaine Addiction The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cocaine Addiction Cocaine base paste (“Crack”) Cocaine base paste is a derivative of coca leaf Traditionally in Colombia and Peru Gradually has spread to other countries Higher toxicity with a greater potential for dependence than cocaine • Severe psychological and physical disorders (around 60% of addiction) • • The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Cocaine Addiction Cracolândia (“Crackland”) São Paulo, downtown Almost 20 years Almost 2. 000 people Main traffic group Youth, unemployed, broken family, psychiatric comorbidities, use of other drugs The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Other Drugs The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Conclusion Many challenges! The 4 th Capacity Building Program of Green Crescents, 3 -6 December 2019, Istanbul, Turkey

Thank you for Listening Brazilian Green Crescent Alexandre Kieslich da Silva Addiction Psychiatrist Master in Psychiatry at the Federal University of Rio Grande do Sul. Professor of the Medical School at the University of Taquari Valley akieslich@gmail. com