INTERRUPTION OF TUBERCULOSIS TREATMENT AMONG USERS OF PSYCHOACTIVE SUBSTANCES: AN ANALYSIS IN THE STATE OF PARANÁ (2022–2024)

Tuberculosis is a major health problem, especially among populations using psychoactive substances (PAS). Present since antiquity, TB continues to pose new challenges for healthcare and remains a global public health issue. This study aims to describe the association between interruption of tuberculosis treatment and psychoactive substance use in a southern Brazilian state. This is a descriptive, cross-sectional, retrospective study. All TB notifications from the Notifiable Diseases Information System (SINAN) between 2022 and 2024 were eligible. Indicators analyzed included age, sex, race/color, education, transmission form, municipality size, associated conditions (including psychoactive substance use), drug susceptibility profile, and case outcomes. Descriptive statistics and simple frequency analysis were performed using SPSS version 22.0. The project was approved by the Research Ethics Committee (CAAE No. 73429023.6.0000.5231). Between 2022 and 2024, 731 cases of TB treatment interruption were reported in Paraná with qualified information on psychoactive substance use. Most individuals lived in large municipalities (15.5%), urban and periurban areas (93%), were male (78.5%), aged 19–59 years (92.9%), white (50.9%), and had up to nine years of schooling (52.4%). Psychoactive substance use was the most prevalent associated condition (46.4%), followed by tobacco use (46.2%) and alcohol use (37.6%). Regarding entry type, new cases predominated (57.5%), followed by re-entry after treatment interruption (24.1%), with predominance of pulmonary TB (87.6%) and rifampicin sensitivity (65%). The results demonstrate a predominance of psychoactive substance use as the main associated condition, significantly linked to TB treatment interruption. The study highlights the burden of TB among a population with complex vulnerabilities and raises questions regarding current healthcare practices. TB combined with psychoactive substance use constitutes a syndemic, perpetuating therapeutic failure. Integrating substance use management into TB treatment is therefore essential to improve clinical outcomes.