Evaluación de un Sistema de Gestión de Riesgos para prevenir el deterioro cognitivo en consumidores crónicos de cocaína

The study evaluated the feasibility and impact of a Risk Management System (RMS) to prevent cognitive decline in chronic cocaine users in Ambato. The objective was to design and implement a RMS adapted to the local context and evaluate its effectiveness in reducing risk factors and improving cognitive function. A sample of 80 participants with a mean age of 32.5 years was recruited. A system was implemented that included cognitive-behavioral therapy, N-acetylcysteine ​​supplementation, and lifestyle counseling. Neuropsychological assessments and biomarker measurements were conducted over a 24-month period. Qualitative interviews were also conducted to explore participants' experiences. Significant improvements were observed in neuropsychological tests. Levels of biomarkers of oxidative stress and inflammation decreased, supporting the effectiveness of the interventions. However, 22% of participants reported difficulty maintaining adherence to N-acetylcysteine ​​supplementation due to mild side effects. Interviews highlighted improvements in mental clarity and emotional regulation, but also challenges with adherence. The evaluated system proved to be a viable tool for preventing cognitive decline in chronic cocaine users, with improvements in cognitive functions and biomarkers. However, barriers to adherence to NAC supplementation were identified, suggesting the need to adjust intervention strategies. The findings provide evidence for the design of public policies and health strategies tailored to the local context.