Characteristics of clients using a community-based drug treatment service (‘CAPS-AD’) in Brazil: An exploratory study

• ‘CAPS-AD’ is a novel vehicle of community-based treatment for alcohol and drugs in Brazil.
• We assessed a ‘snapshot sample’ of CAPS-AD clients in Brasilia (capital of Brazil).
• Most clients were male, middle-aged, unemployed, with alcohol or crack-cocaine problems.
• Half engaged in their first-ever treatment episode, suggesting effective reach by the CAPS-AD.
• Concerns about care structures, logistics and staff attitudes may compromise client retention.

BackgroundSubstance 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.MethodsN = 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.ResultsParticipants 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).ConclusionCAPS-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.