Parental protective and risk factors regarding cannabis use in adolescence: A national sample from the Chilean school population.

Background: Research has increased our understanding of the parental factors associated with the initiation and development of cannabis use disorder in adolescents, but few studies about this have been performed in middle- or low-income countries.Objective: First, to examine whether perceived past parental drug use, parental monitoring, and attitude toward adolescent cannabis use are associated with general and problematic cannabis use in Chilean adolescents. Second, to explore whether perceived past parental drug use weakens the associations of protective factors with general and problematic adolescent cannabis use.Methods: Regression analyses were performed on cross-sectional data from a multistage probabilistic sample stratified by clusters (municipalities, school and grade) of 43,060 students (47% male, mean age 15.5 years) from grades 8 to 12, which was collected from the Chilean National School Survey on Drug Use (2013).Results: Perceived past parental drug use increased the likelihood of adolescent cannabis use in general, but not its problematic use. Parental monitoring of adolescents' whereabouts and parental opposition to adolescent cannabis use decreased the likelihood of adolescent cannabis use in general, as well as problematic use. Perceived past parental drug use only interacted with parental monitoring of school activities.Conclusions: In line with research from the United States, the Netherlands and Spain, parental monitoring of adolescents' whereabouts and a strong parental opposition to cannabis use appear to be protective factors, irrespective of past parental use. However, the effectiveness of monitoring adolescents' school activities seems to decrease when parents are perceived as having used drugs in the past.

Marijuana Use and Dependence in Chilean Adolescents and Its Association with Family and Peer Marijuana Use.

PURPOSE: The purpose of the study is to examine (1) whether family and peer marijuana use are independently related to adolescent marijuana use in Chile, (2) whether family and peer marijuana use are associated with adolescent marijuana dependence in adolescents using marijuana, and (3) whether the adolescent's age moderates the association between family or peer use and adolescent marijuana use and/or dependence. METHOD: This study used data from the National Survey on Drug Use in the General Population in Chile (a cross-sectional observational study), which was conducted in 2008 and 2010 in 4413 adolescents aged 12-19. Adolescents answered questions about their past-year marijuana use and dependence (ICD-10 criteria) and the marijuana use of their family and peers. Logistic regressions were performed while controlling for confounders. RESULTS: Adolescents who had a family member who used marijuana were five times more likely to use the drug. Adolescents with a close friend who used marijuana were eight times more likely to use marijuana. When adolescents were using marijuana, they were three times more likely to be dependent if they had a family member who used the drug. However, no significant relationship was found between peer use and dependence. No statistically significant interactions were found between family or peer use and age. CONCLUSION: Family and peer marijuana use was independently associated with adolescent's past-year marijuana use; however, only family marijuana use was statistically associated with adolescent's marijuana dependence.

[Alcohol use and self-reported violent events in Chile]. / Consumo de alcohol y autoinforme de eventos violentos en Chile.

The objective is to examine the association between binge drinking and frequency of alcohol consumption during the last month with self-reported episodes of violence committed by people under the influence of alcohol or other drugs. We carried out a cross-sectional study that uses data from the National Survey on Drug Use on the General Population of Chile of 2010. A sample of 16,000 subjects, from 12 to 64 years of age (mean 35.8 years), representing a population of 9,536,602 individuals (49.5% men and 50.5% women) was used. The dependent variables were: being a victim of assault, aggression or sexual violence. The independent variables were: binge drinking (six or more drinks on one occasion at least once in the month) and the monthly frequency of alcohol consumption. The adjusted prevalence ratio (PR) for men reporting binge drinking (vs. negative reporting) was of 1.85 (95% CI: 1.28 to 2.66) for assault, 2.0 for aggression (1.40 to 2.66), and 1.35 for sexual violence (0.43 to 4.23). Among women, the PR was 2.08 (0.97 to 4.50), 1.61 (0.78 to 3.35) and 1.37 times (0.48 to 3.91), respectively. Regarding the frequency of alcohol use, for each day a month of alcohol consumption the PR increases significantly for aggression among men and for the three victimization variables among women. Men and women who reported frequent alcohol consumption and/or binge drinking had significantly a higher prevalence of episodes of aggression, assault or sexual violence; compared to those who did not report these consumption patterns.

Polydrug Use and Co-occurring Substance Use Disorders in a Respondent Driven Sampling of Cocaine Base Paste Users in Santiago, Chile.

We characterized substance use patterns and co-occurring substance use disorders among active cocaine base paste (CBP) users in Santiago, Chile using data from respondent-driven sampling (RDS) in three areas of Metropolitan Santiago. Recruitment began with nine seeds, reaching 398 active CBP users (18% women; mean age 37.7 years), defined as persons consuming CBP at least twice per week in the last three months. Population proportions and uncertainty were estimated accounting for individuals' social network and homophily. The median CBP age of initiation was 21 years, and the median number of years using CBP was 7 for women and 15 for men. The median days of use in the past month was 25 days, with a median of 56 doses per week. The proportion of monthly income spent on CBP was 65%. The prevalence of substance use disorders (SUDs) were: 98% for CBP, 67% for alcohol, 60% for marijuana, and 41% for cocaine hydrochloride. Heavy polydrug use patterns and co-occurring SUDs are frequent among active CBP users in the metropolitan area of Santiago. Traditional surveillance strategies may have underestimated polysubstance use and co-occurring SUDs in active CBP users. RDS proved to be a feasible methodology that could be effectively used for substance use surveillance among hard-to-reach populations.

School collective occupation movements and substance use among adolescents: A school-level panel design.

BACKGROUND: Recently, social movements across the world have demanded reforms to education systems and other institutions. Although such movements have affected large numbers of people across multiple countries, we know little about the impacts they have had on population health. We focus on one example: the massive strikes and collective occupation of secondary schools across Chile, which occurred contemporaneously with a large increase in marijuana use among students in this age group. We aimed to evaluate the causal effects that the 2011 Chilean school strikes had on adolescent substance use, including the initiation of marijuana use and the use of alcohol and marijuana. METHODS: School-level, aggregated panel design using data from the National Drug Surveys among Secondary Students from 2005 to 2015 for students in grades 9-12. We used a fixed-effects difference-in-difference model to estimate the effect of school occupations on prevalence of self-reported indicators of drug use. RESULTS: Reported marijuana use doubled between 2009 and 2013 among Chilean adolescents. After controlling for secular trends in outcomes and for school characteristics, there was no evidence of increased marijuana initiation, alcohol and marijuana use, or of an increase in heavy use among adolescents being directly attributable to school strikes and occupations in 2011. CONCLUSIONS: The 2011 Occupy school movement in Chile had no detectable causal effect on substance use among Chilean adolescents. The increase in marijuana use from 2009 to 2013 seems to be part of broader social changes occurring among the school-age population.

The effects of using answer sheets on reported drug use and data quality in a classroom survey: A cluster-randomized study.

BACKGROUND: We compare self-reported prevalence of drug use and indicators of data quality from two different response modes (with and without an independent answer sheet for recording responses) in a survey conducted in 2015 among secondary school students. METHODS: Stratified cluster-randomized study conducted among students in grades 8-12 from public, private and subsidized schools in Chile (N=2317 students in 122 classes). Measurements included were: percentage reporting substance use (tobacco, alcohol, marijuana, cocaine, ecstasy); number of inconsistent responses; number of item nonresponses; percentage of extreme reports of drug use; percentage reporting using the nonexistent drug, relevón; and completion times. RESULTS: Compared with those who responded directly in the questionnaire booklet, students who used a separate answer sheet took 17.6 more minutes (95% confidence interval [CI]: 14.4-20.8) to complete the survey and had on average 1.5 more inconsistent responses (95%CI: 0.91-2.14). The prevalence and variance of drug use was higher among those who used an answer sheet for all substances except tobacco; the prevalence ratio (PR) of reported substance use for low-prevalence substances during the past year were: cocaine PR=2.5 (95%CI: 1.6-4.1); ecstasy PR=5.0 (95%CI: 2.4-10.5); relevón PR=4.8 (95%CI: 2.5-9.3). CONCLUSIONS: Using an answer sheet for a self-administered paper-and-pencil survey of drug use among students result in lower quality data and higher reports of drug use. International comparison of adolescent drug use from school-based surveys should be done with caution. The relative ranking of a country could be misleading if different mode of recording answers are used.

Consumo de alcohol y autoinforme de eventos violentos en Chile / Alcohol use and self-reported violent events in Chile

Se estudió la asociación entre el consumo intenso y la frecuencia mensual de alcohol con el autoinforme de episodios de violencia cometido por personas bajo los efectos del alcohol u otras drogas. Se realizó un estudio transversal en el que se analizaron los datos del Estudio Nacional de Drogas en Población General de Chile del año 2010. La muestra encuestada fue de 16.000 sujetos de 12 a 64 años de edad (media de 35,8 años), que representan a una población de 9.536.602 personas (49,5% de hombres y 50,5% de mujeres). Las variables dependientes fueron: haber sido víctima de asalto, agresión o violencia sexual. Las variables independientes fueron: el consumo intenso (seis o más consumiciones en una ocasión al menos una vez en el mes) y la frecuencia mensual de consumo de alcohol. La razón de prevalencia (RP) ajustada en hombres que informan consumo intenso (vs. informes negativos) fue de 1,85 (IC95%: 1,28 a 2,66) para asalto, 2,0 (1,40 a 2,73) para agresión y 1,35 (0,43 a 4,23) para violencia sexual. En mujeres, las RP fueron 2,08 (0,97 a 4,50), 1,61 (0,78 a 3,35) y 1,37 (0,48 a 3,91), respectivamente. En relación a la frecuencia de uso de alcohol, por cada día de consumo al mes la RP aumenta significativamente para agresión en hombres y para las tres variables de victimización en mujeres. Los hombres y mujeres que informaron un consumo frecuente y/o intenso de alcohol presentaron prevalencias significativamente mayores de episodios de agresión, asalto o violencia sexual, respecto a aquellos que no informaron estos patrones de consumo

The objective is to examine the association between binge drinking and frequency of alcohol consumption during the last month with self-reported episodes of violence committed by people under the influence of alcohol or other drugs. We carried out a cross-sectional study that uses data from the National Survey on Drug Use on the General Population of Chile of 2010. A sample of 16,000 subjects, from 12 to 64 years of age (mean 35.8 years), representing a population of 9,536,602 individuals (49.5% men and 50.5% women) was used. The dependent variables were: being a victim of assault, aggression or sexual violence. The independent variables were: binge drinking (six or more drinks on one occasion at least once in the month) and the monthly frequency of alcohol consumption. The adjusted prevalence ratio (PR) for men reporting binge drinking (vs. negative reporting) was of 1.85 (95% CI: 1.28 to 2.66) for assault, 2.0 for aggression (1.40 to 2.66), and 1.35 for sexual violence (0.43 to 4.23). Among women, the PR was 2.08 (0.97 to 4.50), 1.61 (0.78 to 3.35) and 1.37 times (0.48 to 3.91), respectively. Regarding the frequency of alcohol use, for each day a month of alcohol consumption the PR increases significantly for aggression among men and for the three victimization variables among women. Men and women who reported frequent alcohol consumption and/or binge drinking had significantly a higher prevalence of episodes of aggression, assault or sexual violence; compared to those who did not report these consumption patterns