At-risk drinking and current cannabis use among medical students: a multivariable analysis of the role of personality traits

Objective: To explore the role of personality traits in at-risk drinking and current cannabis use among medical students. Methods: This cross-sectional study evaluated 707 medical students from two universities. Multiple logistic regression models for at-risk drinking and current cannabis use were constructed including sociodemographic, psychiatric, and personality variables. Results: At-risk drinking and current cannabis use were reported by 19.3% and 14.9% of participants, respectively. Models including Big Five measures showed associations of at-risk drinking with higher extraversion (p < 0.00001, adjusted odds ratio [AOR] = 1.9) and lower conscientiousness (p = 0.00001, AOR = 0.5); cannabis use was also associated with lower conscientiousness (p = 0.003, AOR = 0.6), besides higher openness to experience (p = 0.002, AOR = 1.9). Models including measures of the Behavioral Inhibition and Activation Systems scales (BIS/BAS) showed associations of at-risk drinking with lower BIS (p = 0.002, AOR = 0.9) and higher BAS fun-seeking (p = 0.0005, AOR = 1.2); cannabis use was also associated with higher BAS fun-seeking (p = 0.008, AOR = 1.2). Personality variables had modest effects on model fit. Conclusion: Specific personality traits were independently associated with at-risk drinking and current cannabis use, albeit with modest effect sizes.

Prevalencia de vida y factores asociados al consumo de marihuana en estudiantes escolarizados de Pamplona-Colombia, durante el primer período de 2015: estudio Emtamplona / Marijuana consumption among Colombian adolescents

Background: Marijuana consumption is a public health problem. Aim: To determine the life time prevalence of marijuana use among Colombian adolescents and the factors associated with its consumption. Material and Methods: Secondary analysis of data from a study aimed to determine the prevalence of smoking. A self-administered and anonymous questionnaire was answered by 814 adolescents aged 14 ± 2 years (439 women). Results: Ten percent of respondents consumed marijuana at least once in their life. A logistic regression analysis showed that professing a non-christian religion, being smoker and having an age over 12 years, was associated with marijuana consumption. Conclusions: There is a high frequency of marijuana use among these adolescents.

The use of drugs and medical students: a literature review

SUMMARY INTRODUCTION The consumption and abuse of alcohol and other drugs are increasingly present in the lives of university students and may already be considered a public health problem because of the direct impacts on the physical and mental health of these individuals. The requirements of the medical program play a vital role in the increasing rate of drug users. OBJECTIVES To carry out a systematic review of the literature on the use of drugs, licit or not, in Brazilian medical students. METHODS A descriptive-exploratory study, in which the SciELO and MEDLINE databases were used. A total of 99 articles were found, of which 16 were selected for this review. RESULTS Alcohol and tobacco were the most frequently used licit drugs among medical students. The most consumed illicit drugs were marijuana, solvents, "lança-perfume" (ether spray), and anxiolytics. The male genre presented a tendency of consuming more significant amounts of all kinds of drugs, with the exception of tranquilizers. It was found an increasing prevalence of drug consumption in medical students, as the program progressed, which may result from the intrinsic stress from medical school activities. Students who do not use psychoactive drugs are more likely to live with their parents, to disapprove drugs consumption, to practice religious beliefs and to be employed. Conclusion The prevalence of licit and illicit drug use among medical students is high, even though they understand the injuries it may cause.

RESUMO INTRODUÇÃO O consumo e o abuso de álcool e outras drogas estão cada vez mais presentes na vida dos estudantes universitários, e podem ser considerados problemas de saúde pública pelos potenciais prejuízos acarretados na saúde física e mental. No curso de medicina, as exigências acadêmicas e o estresse têm papel fundamental no aumento do uso de drogas entre os estudantes. OBJETIVO Realizar uma revisão sistemática da literatura sobre o uso de drogas, lícitas e ilícitas, em estudantes de medicina brasileiros. MÉTODOS Estudo de revisão de literatura, cuja fonte bibliográfica foram os portais de periódicos SciELO e Medline. No total, 99 artigos foram encontrados, dos quais 16 foram selecionados para esta revisão. RESULTADOS O álcool e o tabaco foram as drogas mais consumidas por estudantes de medicina. Dentre as drogas ilícitas, as mais frequentemente utilizadas incluem maconha, solventes, lança-perfume e ansiolíticos. O sexo masculino apresentou maior proporção de consumo de todos os tipos de drogas, com exceção de tranquilizantes. Foi encontrado um aumento da prevalência de consumo de drogas ao longo do curso de medicina, o que pode ser resultante do estresse próprio das atividades do curso. Estudantes que fazem menos uso de substâncias psicoativas tendem a viver com os pais, não possuir vínculos próximos com usuários de drogas, desaprovar o consumo de drogas, possuir e praticar crenças religiosas e trabalhar. CONCLUSÃO A prevalência de consumo de drogas lícitas e ilícitas entre estudantes de medicina é alta, mesmo eles tendo conhecimento sobre os malefícios que o uso pode causar.

Cannabinoides: un obstáculo cognitivo para conducir con seguridad / Cannabinoids: a cognitive obstacle to drive safely

Las altas pérdidas económicas y humanas que traen consigo los accidentes de tránsito, además de sus implicaciones sociales y políticas, hacen evidente la necesidad de una comprensión clara de todos los factores que modifican su incidencia y severidad, entre los cuales se enuncia el consumo de psicotrópicos como el cannabis. Tras dos décadas de reducciones sustanciales en la magnitud del problema de la ingesta de alcohol y accidentes de tránsito, el uso extendido de cannabis en todo el mundo es lo que la hace, después del alcohol, la sustancia psicotrópica más frecuentemente hallada en la sangre de los conductores implicados en este tipo de accidentes; la presencia de cannabis se asocia con el doble de riesgo de ser herido fatalmente en el tráfico. Contrario a la creencia general, la marihuana no debe ser considerada una droga benigna; su consumo se asocia con trastornos cardiovasculares, pulmonares, reproductivos, inmunológicos y sobretodo sobre el sistema locomotor y cognitivo; concentraciones de tetrahidrocannabinol en sangre de 2 a 5 ng/mL, se asocian con deterioro sustancial en las habilidades necesarias para operar un vehículo motorizado. Por esta razón, se requieren aún más investigaciones que establezcan nexos claros de causalidad, y que permitan generar a largo plazo políticas públicas de responsabilidad vial que divulguen las devastadoras repercusiones humanas, sociales y económicas que genera el hecho de consumir cannabis y operar un vehículo motorizado en la vía.

The high economic and human losses that bring traffic accidents, as well as their social and political implications, make evident the need of a clear understanding of all the factors that influence its incidence and severity, between which states the use of psychotropic drugs as cannabis. After two decades of substantial reductions in the magnitude of the problem of alcohol consumption and traffic accidents, the widespread use of cannabis in the world is what makes it, after alcohol, the psychoactive substance most commonly found in the blood of drivers involved in such accidents; the presence of cannabis is associated with twice the risk of being fatally injured in traffic. Contrary to popular belief, marijuana should not be considered a benign drug, its use is associated with cardiovascular, pulmonary, reproductive, immunological, and especially with locomotor and cognitive disorders; blood tetrahydrocannabinol concentrations of 2-5 ng/mL are associated with substantial deterioration in the skills needed to operate a motor vehicle. Therefore, further investigations are required to establish clear causal links, to favor the generation of long-term public policy of vial responsibility, to divulge the devastating human, social and economic impacts that are generated because of the act of consuming cannabis while operating a motor vehicle on the track.

Illegal drugs in Grenada: arrests and drug treatment from 2001-2009 / Drogas ilegales en Granada: arrestos por frogas y tratamiento de la drogadicción de 2001-2009

OBJECTIVE: Illegal drug use and abuse has increased in the Caribbean since the 1990s. In Grenada, statistical indicators such as admission rates to treatment facilities and drug arrests have provided evidence for the increased rates of illegal drug use and abuse. This study reviewed these statistical indicators and explored drug treatment options in Grenada from 2001 to 2009. METHODS: A search of statistical records from the Drug Control Secretariat and the Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) was performed. Literature review of relevant articles from search engines was used to support findings. Additionally, semistructured interviews of key stakeholders from government and health agencies involved in drug prevention in Grenada were conducted to obtain information on recent developments surrounding drug arrests and treatments in Grenada. RESULTS: From 2001 to 2009, there were a 118% and a 23% increase in the arrest rate for males and females, respectively. There was also an increase in demand for drug treatment at the sole drug treatment facility. CONCLUSION: Preventive measures in schools and several forms of media programmes have raised awareness. However, drug use/abuse/activities still persist at a significant rate. Programmes that target improvement oftreatment facilities and increased inter-agency collaboration may be successful in enhancing drug arrests and treatments.

OBJETIVO: El uso y abuso de drogas ilegales ha aumentado en el Caribe desde la década de 1990. En Granada, los indicadores estadísticos tales como las tasas de ingreso a los centros de tratamiento de la drogadicción y los arrestos por drogas, han proporcionado evidencia del aumento de las tasas del uso y abuso de drogas ilegales. Este estudio examinó estos indicadores estadísticos, y exploró las opciones de tratamiento en Granada desde 2001 hasta 2009. MÉTODOS: Se realizó una búsqueda de registros estadísticos de la Secretaría de Control de Drogas, y la Red de Información de Drogas/Observatorio Nacional de Drogas de Granada (GRENDIN/NOD). Se utilizó una revisión de la literatura de los artículos pertinentes mediante los sistemas de búsqueda en internet para fundamentar los resultados. Además, se llevaron a cabo entrevistas semiestructuradas de grupos claves de interés (stakeholders) del gobierno y las agencias de salud involucradas en la prevención de drogas en Granada, a fin de obtener información sobre los últimos acontecimientos en relación con los tratamientos de drogadicción y arrestos por drogas en Granada. RESULTADOS: De 2001 a 2009, se produjeron aumentos de 118% y 23% en la tasa de arrestos de hombres y mujeres, respectivamente. También hubo un aumento en la demanda de tratamiento por drogas en el único centro de tratamiento de la drogadicción. CONCLUSIÓN: Las medidas preventivas en las escuelas y varias formas de los programas de los medios masivos de comunicación han traído consigo una toma de conciencia. Sin embargo, el uso, abuso, y las actividades en relación con las drogas todavía persisten en una tasa significativa. Los programas dirigidos a la mejora de los centros para el tratamiento de la drogadicción y una mayor colaboración interinstitucional pueden contribuir a mejorar con éxito el problema de los arrestos por drogas y los tratamientos de drogadicción.

Consumo de marihuana en estudiantes de una universidad colombiana / Marijuana consumption in students of a Colombian university

Objetivo Describir el patrón de comportamiento asociado al consumo de marihuana en estudiantes de la Universidad del Tolima-Colombia, identificando: características sociodemográficas, conocimiento, frecuencia, actitudes, prácticas y su apreciación sobre efectos en la salud producto del consumo. Métodos. Estudio descriptivo transversal, cuantitativo realizado en la Universidad del Tolima, 2009. La muestra fue de 700 estudiantes con edades entre 15 y 25 años, pertenecientes a las diferentes facultades. La encuesta se adaptó a partir de la Encuesta Nacional de Adicciones del Instituto Nacional de Epidemiología de México, (2002) y se sometió a pruebas de validez de constructo, confiabilidad y análisis de consistencia interna, con un alfa de Cronbach, con valor de 0.79. Resultados La edad de mayor consumo se centra en el grupo de 18 a 21 años, consumen más los hombres, los cuales se ubican en los estratos 2 y 3.Los que viven con los dos padres o con uno, consume más que los que viven solos o con amigos. Son significativos los consumos en programas como Topografía, Arquitectura, Educación Física, Enfermería y Medicina. Conclusiones A pesar de conocer los efectos nocivos para la salud, su influencia en cambios negativos de actitud y malos resultados académicos, el consumo de marihuana prevalece en la Universidad del Tolima, motivado entre otros, por la fácil adquisición dentro delclaustro.A mayor pobreza mayor riesgo de consumo. El tipo de información suministrada y la fuente, son vitales al momento de hacer prevención.

Objective Describe pattern of behavior associated with the consumption of marijuana in students of the University of Tolima, Colombia, identifying their sociodemographic characteristics, knowledge, frequency of consumption, attitudes, practices and assessments of health effects resulting from consumption. Methods Transverse Descriptive study realized in the University of Tolima in 2009. The sample was of 700 students aged between 15 and 25 years, belonging to the different faculties. The survey was adapted from the National School of Addictions of the National Institute of Epidemiology of Mexico, (2002) and it underwent to tests of construct validity , reliability and analysis of internal consistency (sends inland), with Cronbach's alfa, with value of 0.79. Results The age of highest consumption focuses on the 18 to 21 age group, Men belonging to strata the 2 and 3 show the higher consumption. Those who live with one or both parents consume more than those who live alone or with friends. The consumptions are significant in programs as Topography, Architecture, Physical Education, Nursing and Medicine. Conclusions In spite of knowing the harmful effects to health, its influence in negative changes of attitude and poor academic results, the consumption of marijuana prevails in the University of Tolima, motivated, among others, for the easy acquisition of marijuana inside the campus. The higher poverty increases consumption. The type of information provided and the source are vital at the time of formulating prevention strategies.

Norma subjetiva, intención y consumo de marihuana en jóvenes universitarios de México / Subjective norm, intention and consumption of marijuana in college students of México

Este artículo tuvo como propósito conocer la relación de la norma subjetiva con la intención y el consumo de marihuana en un grupo de jóvenes universitarios del Norte de México. El diseño del estudio fue descriptivo-correlacional, los datos fueron obtenidos a través de la aplicación de un instrumento sobre la Norma Subjetiva para el consumo de marihuana y analizados en el programa SPSS 18. Participaron 558 jóvenes de nueve facultades de una universidad pública. Los resultados mostraron que 15.1 por ciento ha consumido marihuana alguna vez en la vida. La prevalencia del consumo de marihuana fue mayor en hombres (χ2 =42.5, p<.001), en mayores de 20 años de edad (χ2 =11.64, p<.001) y en los estudiantes de ingenierías y ciencias agropecuarias (χ2=9.54, p<.023). La norma subjetiva se relacionó positivamente con la intención de consumo (rs=.224; p<.001). La norma subjetiva fue más alta en jóvenes que muestran intención de consumo que aquellos que no tienen intención (X= 15.85 y X=6.99; U=20561.5, p<.001), de la misma forma la norma subjetiva fue más alta en los jóvenes que han consumido marihuana que en aquellos que nunca han consumido (X =220.94 y X =7.05; U=28713.5, p<.001). Los resultados presentados aportan al conocimiento de la disciplina de enfermería y áreas a fines, principalmente en la línea de generación de conocimientos de prevención de adicciones y en un futuro podrán servir como base para la justificación de diseños de programas preventivos.

This article was aimed to determine the relationship between subjective norm with intention and marijuana consumption in a group of college students in northern Mexico. The study design was descriptive, co relational; data collection was obtained through the application of a Subjective Norm Instrument for marijuana consumption and analyzed with SPSS 18. Study participants were 558 students from nine faculties of a public university. Results showed that 15.1percent had used marijuana at some time in their life. The prevalence of marijuana consumption was higher in men (χ2=42.5, p<.001), older than 20 years of age (χ2=11.64, p<.001) and students in engineering and agricultural sciences (χ2=9.54, p<.023). The subjective norm is positively related with intention (rs=.224, p<.001). The subjective norm was higher in young people who displayed intention for consumption than those who have no intention (X=15.85 and X=6.99, U=20561.5, p<.001); in the same way, subjective norm was higher in young people that have used marijuana than those who have never used it (X=220.94 and X =7.05, U=28713.5, p<.001). The results are a contribution to the discipline of nursing knowledge and related areas, especially in the line of knowledge generation about addiction prevention, and in the future may serve as a basis for the rationale design of preventive programs.

Consumo de sustancias y síntomas depresivos en escolares de liceos municipales de Santiago / Association between drug consumption and depression among high school students

Background: The presence of emotional problems may trigger drug abuse. Aim: To determine the association between illicit drug use and severity of depression symptoms among students of public secondary schools in Santiago, Chile. Material and Methods: A probabilistic sample of2,597 adolescents aged between 12 and 18 years (45% women), attending first year in public high-schools in Santiago, answered self-report questionnaires about consumption, during the last 30 days ,of alcohol, tobacco and marihuana, and the Beck Depression Inventory - II. Logistic regression models were used to study the association between drug use and severity of depression symptoms, adjusting by sex. Results: Tobacco and marihuana use was reported by 38 and 13% of students, respectively. Frequency of consumption was significantly higher among women. Mild, moderate or severe depressive symptoms were found among 16%, 14% and 9% of students, respectively. Depressive symptoms were more common among women. There was a significant association between drug use and severity of depression among participants of both genders. Conclusions: The association between depressive symptoms and drug use should be considered on the design of treatment guidelines for these health problems in Chile.

Prevalencia de consumo de drogas en estudiantes universitarios que cursan primer y cuarto año / Prevalence of tabacco, alcohol and marijuana consumption among university students

Background: University students are especially vulnerable towards substance abuse Aim: To describe and compare drug consumption in students of a Chilean university who attended first and fourth year of studies, according to gender and faculty. Material and Methods: A representative, stratified and proportional sample of305 students was randomly chosen by faculty, career, grade and gender during2009. The consumption of alcohol, tobacco and illicit drugs was evaluated using an anonymous survey. Results: Students from health care faculties had the lower prevalence of consumption of tobacco, alcohol, tobacco-alcohol and marijuana, during the first and fourth year. Education area and social sciences faculties had the highest prevalence of consumption. Fourth year students had higher rates of consumption than their first year counterparts. Females had significantly lower rates of alcohol and marijuana consumption. Conclusions: Alcohol, tobacco and marijuana consumption was higher among students from education and social sciences faculties and those attending the fourth year of studies.

Factores psicosociales asociados al consumo de sustancias en estudiantes de una universidad pública / Public university students' psychosocial factors associated with legal and illegal substance consumption

Objetivo Determinar prevalencia y factores psicosociales asociados al consumo de sustancias legales e ilegales en estudiantes de una universidad pública. Método Estudio de tipo transversal realizado con 1359 estudiantes, seleccionados aleatoriamente. El instrumento de recolección incluyó el VESPA, CAGE, y las escalas de WHO, Rosemberg, Francis y APGAR. Se realizó análisis univariado y bivariado a través de razones de disparidad, con intervalos de confianza del 95 por ciento y error del 5 por ciento; análisis multivariado por medio de regresión logística, utilizando el programa Statistical Package Socials Sciencies (SPSS). Resultados Se encontró asociación entre el consumo abusivo de alcohol con el consumo de cigarrillos (OR=4,6), marihuana (OR=4,6) y cocaína (OR=2,2). El tener familias disfuncionales se asoció con el consumo de cigarrillo (OR=1,2), cocaína (OR=1,95) y consumo abusivo de alcohol (OR=1,94). Conclusiones El consumo abusivo de alcohol y la disfuncionalidad familiar son factores influyentes para el consumo de sustancias psicoactivas, en estudiantes universitarios.

Objective Determining the prevalence and psychosocial factors associated with public university students' legal and illegal substance consumption. Method This was across-sectional study of 1,359 randomly selected students. The harvesting instrument included the CAGE questionnaire and VESPA,WHO, Rosenberg, Francis and APGAR scales. The Statistical Package for the Social Sciences (SPSS) was used for univariate and bivariate analysis using disparity ratios (95 percent confidence intervals and 5 percent error) whilst logistic regression was used for multivariate analysis. Results An association was found between abusive alcohol consumption and smoking cigarettes (OR=4.6), marijuana (OR=4.6) and using cocaine (OR=2.2); having a dysfunctional family was associated with smoking cigarettes (OR=1.2), using cocaine (OR=1.95) and abusive alcohol consumption (OR=1.94). Conclusions Abusive alcohol consumption and having a dysfunctional family were influential factors regarding psychoactive substance consumption in public university students.

Prevalência do consumo de álcool, tabaco e entorpecentes por estudantes de medicina da Universidade Federal de Minas Gerais / Prevalence of alcohol, tobacco and psychotropic drug consumption by medical students of the "Universidade Federal de Minas Gerais"

OBJETIVO: Verificar a prevalência do consumo de álcool, tabaco e entorpecentes por estudantes da Faculdade de Medicina da Universidade Federal de Minas Gerais e determinar fatores relacionados a esse consumo. MÉTODOS: Este trabalho foi realizado com estudantes de todos os anos do curso de Medicina, convidados a participar, de forma anônima, respondendo a um questionário autoaplicável, que foi previamente avaliado e adequado à realidade brasileira. Esse questionário foi estruturado com base no World Health Organization's Guidelines for Student Substance Use Survey e consistiu de 25 perguntas relacionadas ao uso de drogas. A comparação das médias foi por teste T de Student e as proporções foram avaliadas usando o teste Qui quadrado. RESULTADOS: Contato com bebidas alcoólicas ocorreu em 85,2 por cento e com tabaco em 16,3 por cento dos entrevistados. Dentre as drogas entorpecentes, a maconha foi consumida por 16,5 por cento, LSD por 6,9 por cento, ansiolíticos por 12 por cento, estimulantes por 7,5 por cento e solventes por 16,8 por cento dos estudantes. Foi raro o consumo de cocaína, crack, opioides, xaropes ou anabolizantes. CONCLUSÃO: A droga mais consumida foi o álcool. Seu uso relacionou-se com o consumo de outras substâncias, sendo que a adesão a drogas ocorreu mais em estudantes solteiros, do sexo masculino, que moram longe da família e não dependem de si para seu sustento ou o de sua família.

OBJECTIVE: The purpose of this study was to assess the prevalence of alcohol, tobacco and psychotropic drug consumption by students of the Medical School of the Federal University of Minas Gerais, Brazil, and to verify aspects related to those addictions. METHODS: This study was carried out with students of all years of the medical course invited to participate anonymously, by answering a self-applied questionnaire which was previously evaluated and adapted to Brazilian reality. It was based upon the World Health Organization's Guidelines for Student Substance Use Survey and included 25 questions about drug addiction. Student's t test and chi-square test were applied to assess differences between the mean and proportions of data. RESULTS: Alcohol and tobacco were the more frequently used by the students, 85.2 percent and 16.3 percent respectively. Among psychotropic drugs, marijuana was reported by 16.5 percent of students, LSD by 6.9 percent, sedatives by 12 percent, amphetamines by 7.5 percent and inhalant substances by 16.8 percent. Cocaine, crack, opiates, anticholinergics and anabolics consumption were rarely mentioned. CONCLUSION: Alcohol was the drug most used and was related to other drug addictions. Drugs were most frequently used by single, male students, who live alone and do not support themselves.

Consumo de sustancias ilícitas y psicotrópicos entre los estudiantes de medicina de la Pontificia Universidad Católica de Chile / Illicit and psychotropic drug use among medical students at the Pontificia Universidad Católica de Chile

Background: Illicit drug abuse is a public health problem, generally starting in adolescence. Medical students are not an exception. Aim: To assess the consumption of illicit drugs among medical students of the Pontificia Universidad Católica de Chile. Material and Methods: A questionnaire used by the National Council for the Control of Substance Abuse (CONACE) to evaluate substance use and the Goldberg Health Questionnaire (GHQ-12), were applied to medical students. The questionnaires were self administered under supervision. Results: The survey was completed by 569 of 775 students (74%). “Ever used” reached 33% for marijuana, 1.1% for cocaine, 2.1% for amphetamines without prescription, 6.9% for not prescribed benzodiazepines and 5.8% for not prescribed antidepressants. The use of these substances was only associated for ever used marijuana and level of career (p <0.01), with the highest rate in the seventh final year (51.4%). Benzodiazepine use was also associated with the level of career (p <0.01) withless than 6% prevalence from first to fourth and the highest in seventh year (32.4%). Non prescribed antidepessant use was significantly higher among women. Tobacco and alcohol use were associated with consumption of marijuana (p <0.0001) and benzodiazepines (p <0.0001). Conclusions: Our medical students have low marijuana consumption rates, only above Turkey. Cocaine and amphetamines use is low, benzodiazepine consumption is higher among final year students. Antidepressant use is higher among women.

Efectos del consumo de marihuana en funciones cognitivas en jóvenes adolescentes / Effects of consumption of marihuana on cognitive functions in young students

El presente estudio explora el efecto de la marihuana en una población de jóvenes adolescentes escolares, que sólo consumen esta droga ilícita y no otra, y que jamás han consultado a un especialista por problemas de adicción. Los resultados muestran el efecto del consumo habitual de marihuana en funciones cognitivas involucradas en el aprendizaje. Una vez identificados los sujetos, se realizan evaluaciones individuales de estudiantes consumidores y no consumidores de educación media de establecimientos de dependencia municipal, particular subvencionada y particular pagada del Area Metropolitana (Santiago de Chile). Se evidencian efectos nocivos sobre la memoria inmediata, atención-concentración y estrategias de ejecución en los consumidores, con diferencias estadísticamente significativas respecto al grupo control. Se constata mayor consumo relativo en colegios pertenecientes a sectores marginales y escasa o inexistente percepción de daño asociado al consumo de la droga, especialmente entre los consumidores habituales. Las niñas tienden a igualar los niveles de consumo de los varones.

This study evaluates the effects of marihuana in a population of 14 to 17 year old secondary school students, who consume exclusively this illegal drug, and who have never consulted a specialist for addiction problems. The results show the effects of habitual consumption of marihuana on cognitive functions involved in the learning process. Once the subjects have been identified, individual evaluations are performed on students who consume and who do not consume marihuana in public, subsidized public, and private schools of Santiago, Chile. Harmful effects are detected on immediate memory, attention-concentration and execution strategies in consumers, with statistically significant differences in comparison to the control group. Higher consumption is found in schools in poorer districts. There is impaired perception of harm associated with the consumption of the drug especially among habitual consumers. Girls tend to consume the same amount as boys.

Caracterização da cultura de crack na cidade de São Paulo: padrão de uso controlado / Characterization of the crack cocaine culture in the city of São Paulo: a controlled pattern of use / Caracterización de la cultura de crack en la ciudad de Sao Paulo: el padrón del uso controlado

OBJETIVO: Caracterizar a situação do uso de crack na cidade de São Paulo, assim como o perfil sociodemográfico de seu usuário. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo etnográfico com amostra intencional de usuários (n=45) e ex-usuários de crack (n=17). Os participantes foram recrutados pela técnica de amostragem em cadeias e responderam a uma entrevista semi-estruturada, direcionada por questionário, durante os anos de 2004 e 2005. O conjunto de cada questão e suas respectivas respostas originou relatórios específicos que foram interpretados individualmente. ANÁLISE DOS RESULTADOS: O perfil predominante do usuário de crack foi ser homem, jovem, solteiro, de baixa classe socioeconômica, baixo nível de escolaridade e sem vínculos empregatícios formais. O padrão de uso mais freqüentemente citado foi o compulsivo, caracterizado pelo uso múltiplo de drogas e desenvolvimento de atividades ilícitas em troca de crack ou dinheiro. Entretanto, identificou-se o uso controlado que consiste no uso não-diário de crack, mediado por fatores individuais, desenvolvidos intuitivamente pelo usuário e semelhantes, em natureza, às estratégias adotadas por ex-usuários para o alcance do estado de abstinência. CONCLUSÕES: A cultura do uso de crack tem sofrido mudanças quanto ao padrão de uso. Embora a maioria dos usuários o faça de forma compulsiva, observou-se a existência do uso controlado, que merece maior detalhamento, principalmente quanto às estratégias adotadas para seu alcance.

OBJECTIVE: To characterize the situation regarding crack cocaine use in the city of São Paulo, along with the sociodemographic profile of its users.

OBJETIVO: Caracterizar la situación del uso de crack en la ciudad de Sao Paulo, así como el perfil sociodemográfico del usuario.

Marijuana Smoking among Secondary School Students in Zaria; Nigeria: Factors Responsible and Effects on Academic Performance

Background: The use of Marijuana is on the increase worldwide especially among adolescents and youths. Marijuana smoking has gained a foothold in our environment because of peer group influence; accessibility and availability. Its medico-social effects could ruin the life and future of our youths. This study was undertaken to determine the prevalence and the factors that influence secondary school students in Zaria LGA to smoke and the effects on academic performance. Methods: A cross-sectional descriptive study was employed to generate data among secondary school students. A multi-stage sampling technique was used. Data was collected with the use of a structured; pre tested self-administered questionnaire. c2 test was used to test for significance of association between categorical variables. Results: Of the 350 respondents; 262 (74.9) were males; while 88 (25.1) were females. The study shows that 33 of the students smoke marijuana giving a prevalence of 9.4. There were more smokers in the age group 15-19 years (54.6). Other factors that influence marijuana smoking include family background; peer pressure and attendance of social functions. There was better academic performance (51.1) among non smokers as compared to smokers (27.2); and this was found to be statistically significant (x2 = 11.73;df = 5;P .05) There was also statistically significant association between age and marijuana smoking (x2 ) were males; while 88 (25.1) were females. The study shows that 33 of the students smoke marijuana giving a prevalence of 9.4. There were more smokers in the age group 15-19 years (54.6). Other factors that influence marijuana smoking include family background; peer pressure and attendance of social functions. There was better academic performance (51.1) among non smokers as compared to smokers (27.2); and this was found to be statistically significant (x2 = 11.73;df = 5;P .05) There was also statistically significant association between age and marijuana smoking (x2

Consumo precoz de tabaco y alcohol como factores modificadores del riesgo de uso de marihuana / Early tobacco and alcohol consumption as modifying risk factors on marijuana use

OBJETIVO: Evaluar la relación entre consumo precoz de tabaco y alcohol y el riesgo de consumir marihuana en escolares. MÉTODOS: Estudio transversal con datos del IV Estudio Nacional de Consumo de Drogas en Población Escolar, año 2001. Se analizó 54,001 escolares de ocho a 20 años de edad. Como variables predictoras se consideró el autoreporte de consumo de tabaco y alcohol, la edad de inicio de consumo de tabaco y/o alcohol, y la intensidad de uso del tabaco. Como variable resultado se utilizó el autoreporte de uso de marihuana y la edad de inicio de consumo de ésta. Para el análisis de los datos se utilizó regresión de Poisson y regresión de Weibull. RESULTADOS: Los escolares presentaron alta prevalencia de consumo de tabaco, alcohol y marihuana (77 por ciento, 79 por ciento y 23 por ciento respectivamente). El consumo de tabaco en presencia de consumo de alcohol fue un factor de riesgo de uso de marihuana (RP=10.4; IC 95 por ciento: 8.9;12.2). El inicio tardío de consumo de tabaco (HR=0.85; IC 95 por ciento: 0.84;0.86) y alcohol (HR=0.90; IC 95 por ciento: 0.89;0.91) resultó ser un factor protector del uso de marihuana. La probabilidad de consumo de marihuana fue mayor en quienes fumaban todos o casi todos los días en relación a quienes fumaban sólo los fines de semana (RP=3.11; IC 95 por ciento: 2.96;3.26 vs. RP=1.70; IC 95 por ciento: 1.58;1.83). CONCLUSIONES: El riesgo de consumo de marihuana se asoció significativamente con la edad de inicio de consumo de tabaco, la frecuencia de consumo de tabaco y el consumo simultáneo de alcohol. Las estrategias de prevención deberían orientarse a evitar el consumo precoz de tabaco en escolares.

OBJECTIVE: To assess the relationship between early tobacco and alcohol use and the risk of marijuana consumption among schoolchildren. METHODS: A cross-sectional study comprising data from the Fourth National Study on Drug Use in the Chilean School Population (2001). There were studied 54,001 schoolchildren aged between eight and 20 years. Predictors were self-reported tobacco and alcohol use (ever users), age at initiation of tobacco and/or alcohol use, and intensity of tobacco use. The study outcome was self-reported marijuana use (ever users versus never users) and age at initiation of marijuana use. Poisson regression and Weibull regression were used for data analysis. RESULTS: Lifetime prevalence of tobacco use was high: 77 percent, alcohol 79 percent, and marijuana 23 percent. Tobacco consumption increased the likelihood of marijuana use (PR=10.4; 95 percent CI: 8.9;12.2). Later initiation of tobacco (HR=0.85; 95 percent CI: 0.84;0.86) and alcohol (HR=0.90; 95 percent CI: 0.89;0.91) decreased the risk of marijuana use. Marijuana use was higher in heavy smokers compared to light smokers (PR=3.11; 95 percent CI: 2.96;3.26 versus PR=1.70; 95 percent CI: 1.58;1.83). CONCLUSIONS: Tobacco use is strongly associated with marijuana use, which is significantly associated with the age at initiation of tobacco use, intensity of tobacco use and concurrent use of alcohol. Prevention strategies should target prevention of adolescent early tobacco use.

OBJETIVO: Avaliar a relação entre consumo precoce de tabaco e álcool e o risco de consumir maconha por escolares. MÉTODOS: Estudo transversal com dados do IV Estudio Nacional de Consumo de Drogas en Población Escolar, ano 2001 no Chile. Analisaram-se 54.001 escolares de oito a 20 anos de idade. As variáveis preditoras consideradas foram: consumo de tabaco e álcool, a idade de início de consumo de tabaco e/ou álcool e a intensidade de uso de tabaco. Uso de maconha e idade de início do consumo foram as variáveis de desfecho. Para a análise dos dados se utilizou regressão de Poisson e regressão de Weibull. RESULTADOS: Os escolares apresentaram alta prevalência de consumo de tabaco, álcool maconha (77 por cento, 79 por cento e 23 por cento, respectivamente). O consumo de tabaco na presença de consumo de álcool foi um fator de risco de uso de maconha (RP=10,4; IC 95 por cento: 8,9;12,2). O início tardio de consumo de tabaco (HR=0,85; IC 95 por cento: 0,84;0,86) e álcool (HR=0,90; IC 95 por cento: 0,89;0,91) resultou ser um fator protetor do uso de maconha. A probabilidade de consumo de maconha foi maior naqueles que fumavam diariamente ou quase, em relação àqueles que fumavam somente aos fins de semana (RP=3,11; IC 95 por cento: 2,96;3,26 vs. RP=1,70; IC 95 por cento: 1,58;1,83). CONCLUSÕES: O risco de consumo de maconha se associou significativamente à idade de início de consumo de tabaco, à freqüência de consumo de tabaco e ao consumo simultâneo de álcool. As estratégias de prevenção deveriam proteger os escolares do consumo precoce de tabaco.

Caracterização do consumo de maconha entre escolares do ensino médio de São José do Rio Preto, SP, Brasil, 2003 / Marijuana consumption among high school students in São José do Rio Preto, State of São Paulo, Brazil, 2003

OBJETIVO: Caracterizar o consumo de maconha entre escolares do ensino médio do município de São José do Rio Preto - SP. MÉTODO: Utilizou-se um estudo de corte transversal em escolas públicas do ensino médio com uma amostragem de conglomerados. Foram aplicados 1.041 questionários autopreenchíveis de maneira coletiva nas classes, mantidos sem identificação. As variáveis selecionadas foram cruzadas e para a associação foi realizado o teste do qui-quadrado com nível de significância de 5 por cento. RESULTADOS: As prevalências do consumo de maconha foram: uso na vida, 12,1 por cento; no ano, 7,4 por cento; no mês, 4,1 por cento; e na semana, 2,9 por cento. O consumo de maconha na vida foi mais prevalente no sexo masculino, período escolar noturno, estado civil casado, não ter ou não praticar religião e não morar com pai e/ou mãe. Relacionamento bom com os pais e os pais viverem juntos com bom relacionamento estavam associados a menor consumo de maconha. Dentre as atividades de lazer, aqueles que experimentaram maconha referiram mais sair sem destino certo, ir dançar, freqüentar bares e ficar com namorado(a), e menos assistir televisão, sair com a família e ir ao cinema. Ingerir bebida alcoólica toda semana e usar tabaco estiveram associados a um maior índice de experiência com maconha. Experimentar maconha relacionou-se com maiores índices de experiência com anfetamínicos, alucinógenos, cocaína e crack. CONCLUSÃO: O consumo de maconha está relacionado a muitas variáveis. Família e religiosidade estão associadas a menor consumo de maconha, enquanto desajuste familiar e uso de álcool e tabaco estão associados a maiores índices de consumo da droga.

OBJECTIVE: This research aimed to study marijuana consumption among high school students in São José do Rio Preto, SP, Southeastern Brazil. METHOD: A cross-sectional survey was carried out in São José do Rio Preto. A self-completion questionnaire was given to a proportional sample of 1,041 teenagers enrolled in the 9th, 10th and 11th grades of public schools. RESULTS: The prevalence of marijuana consumption was: throughout life: 12.1 percent, in the past year: 7.4 percent, in the past month: 4.1 percent, and in the past week: 2.9 percent. Marijuana consumption was more prevalent in male, nighttime students, married individuals, those who work, those who do not have a religion or do not practice it, and who does not live with a father and/or mother. Excellent or good relationship with parents and parents living together with a good relationship were associated with less prevalent marijuana consumption. Students that experimented marijuana referred activities like wandering, going dancing, attending bars, and staying with boyfriend / girlfriend more frequently as leisure activities, and referred watching TV, going out with family and going to the movies less frequently than the population in general. Weekly alcohol consumption and tobacco use were associated with higher marijuana experience indices. Marijuana experience is associated with greater amphetamine, hallucinogen, cocaine, and crack experience indices. CONCLUSION: Marijuana consumption is associated with many variables. Family and religiosity may be protective factors against the marijuana experience, while family disharmony, tobacco and weekly alcohol use were associated with higher marijuana consumption indices.

The prevalence of marijuana smoking in young adults with sickle cell disease: a longitudinal study / Prevalencia del hábito de fumar marihuana en los adultos jóvenes con enfermedad de células falciforme un estudio longitudinal

BACKGROUND: The active ingredients of marijuana may have beneficial properties in the treatment of chronic pain and inflammation and is being used by sufferers of chronic pain and arthritis in some settings. Anecdotally, marijuana is believed by some sickle cell disease (SCD) patients to improve their health. This study aimed to determine the prevalence of marijuana smoking in the Jamaica Sickle Cell Cohort Study (JSCCS) in the years 2000 and 2004. The perception that marijuana use ameliorated the complications of SCD was also investigated. METHODS: All patients in the JSCCS were invited to attend an annual review, and during the 2000 and 2004 reviews, participants with homozygous sickle cell (SS) disease and sickle cell haemoglobin-C (SC) disease were asked whether they smoked marijuana, and if they smoked, whether it was used for medicinal purposes related to SCD. The authors compared smoking prevalence by gender, disease, and year of review. The association of smoking with a measure of pain frequency was also examined. RESULTS: The prevalence of marijuana smoking was higher among men and among SC participants. The proportion of either gender reporting smoking of marijuana increased in 2004 compared to 2000, and this use was not related to a simple measure of clinical severity of SCD. CONCLUSIONS: Marijuana smoking is common in adults with SCD but its usage is unrelated to clinical severity of the disease.

ANTECEDENTES: Los ingredientes de la marihuana pueden tener propiedades beneficiosas para el tratamiento del dolor e inflamación crónicos, y en algunos lugares esta planta está siendo usada por enfermos que sufren de dolor y artritis de manera crónica. De forma anecdótica, se dice que algunos pacientes de la enfermedad de células falciformes (ECF) creen que la marihuana les mejora la salud. Este estudio se propuso determinar la prevalencia del hábito de fumar marihuana en el Estudio de Cohorte Jamaicano de Células Falciformes (ECJCF) en los años 2000 y 2004. Los autores también examinaron la creencia de que el uso de la marihuana guarda relación con la percepción de que la misma mejora los casos con complicaciones por ECF. MÉTODOS: A todos los pacientes en el ECJCF, se les invita a asistir a un examen anual, y durante los exámenes de los años 2000 y 2004, a los participantes con enfermedad de célula falciforme homocigótica (SS) y con la enfermad de célula falciforme hemoglobina C (SC), se les preguntó si fumaban marihuana, y si la usaban con fines medicinales en relación con la ECF. Los autores compararon la prevalencia por género, enfermedad, y año de examen. Asimismo, examinaron la asociación del hábito de fumar marihuana con una medida de frecuencia de dolor. RESULTADOS: La prevalencia del hábito de fumar marihuana fue más alta entre los hombres y entre los participantes SC. La proporción de ambos géneros que reportó hábito de fumar, aumentó en el año 2004 en comparación con el año 2000, y el uso de la marihuana no estuvo relacionado con una simple medida debida a la gravedad de la ECF. CONCLUSIONES: El hábito de fumar marihuana es común en adultos con ECF, pero su uso no guarda relación con la gravedad de la enfermedad.

High risk health behaviours among adult Jamaicans / Conductas de Alto Riesgo para la Salud entre los Adultos Jamaicanos

The purpose of this study was to assess the prevalence of high risk health behaviours among adult Jamaicans aged 15-49 years in 2000, and to compare the results with the 1993 survey. A nationally representative sample of 2013 persons aged 15-74 years was surveyed in 2000 using cluster sampling in the Jamaica Healthy Lifestyle Survey (Wilks et al, unpublished). Interviewer administered questionnaires and anthropometrical measurements were done. Data for a sub-sample of adults aged 15-49 years were analyzed The sub-sample included 1401 persons (473 men and 928 women). Significantly more men (18.6) than women (4.3) reported never having had a blood pressure check (p = 0.0001). Approximately one-third of the women reported that they had never had a Pap smear (36.0) or a breast examination (31.2). Current cigarette smoking was reported in 28.6 of men and 7.7 of women (OR 3.73 CI 2.71, 5.15), while 49.0 of men and 15.0 of women ever smoked marijuana (OR 3.28 CI 2.56, 4.20). Significantly more men (28.0) than women (11.7) reported ever having a sexually transmitted disease (OR 2.93 CI 2.16, 3.97); having more than one sexual partner in the past year (49.1 vs 11.4, OR 4.31 CI 3.22, 5.76) and usually using a condom during sexual intercourse (55.3 vs 40.5, OR 1.3 CI 1.11, 1.68). Between 1993 and 2000, significant trends include: more persons reported having a blood pressure check, a reduction in multiple sexual partners, increased condom use at last sex (women), reduced crack/cocaine use (males) and increased marijuana smoking. Although there were some significant positive lifestyle trends between 1993 and 2000, high risk behaviours remain common among Jamaican adults. Comprehensive health promotion programmes are needed to address these risk behaviours

El propósito de este estudio fue evaluar la prevalencia de conductas de alto riesgo para la salud entre adultos jamaicanos comprendidos en las edades de 15 a 49 en el año 2000, y comparar los resultados con la investigación realizada en 1993. Una muestra nacional representativa de 2013 personas comprendidas en las edades de 15 a 74 años, fue sometida a investigación en el 2000, usando el muestreo por cluster del Jamaica Healthy Lifestyle Survey (Wilks et al, inédito). Se realizaron entrevistas en forma de cuestionarios, así como mediciones antropométricas. Se analizaron los datos de una sub-muestra de adultos entre edades de 15 a 49 años. La submuestra incluyó 1401 personas (473 hombres y 928 mujeres). Un número de hombres significativamente mayor (18.6%) que el de las mujeres (4.3%) reportaron no haber tenido nunca un chequeo de la presión (p = 0.0001). Aproximadamente un tercio de las mujeres reportó no haberse hecho nunca la prueba citológica (36.0%) o el examen de mamas (31.2%). El hábito actual de fumar cigarrillos fue reportado en el 28.6% de los hombres y el 7.7% de las mujeres (OR 3.73 CI 2.71, 5.15), mientras que el 49.0% de los hombres y el 15% de las mujeres nunca fumó marihuana (OR 3.28 CI 2.56, 4.20). Significativamente más hombres (28.0%) que mujeres (11.7%) reportaron no haber tenido nunca enfermedades de transmisión sexual (OR 2.93 CI 2.16, 3.97); haber tenido más de una pareja sexual en el año anterior (49.1% vs 11.4%, OR 4.31 CI 3.22, 5.76), y usar comúnmente condón durante el acto sexual (55.3% vs 40.5%, OR 1.3 CI 1.11, 1.68). Entre 1993 y 2000, las tendencias significativas incluyen lo siguiente: más personas reportaron el chequeo de la presión sanguínea, una reducción en las parejas sexuales múltiples, el aumento del uso de condones en el último acto sexual (mujeres), la reducción en el uso de crack/cocaína (hombres), y aumento en el consumo de marihuana para fumar. Aunque hubo algunas tendencias positivas significativas en cuanto al estilo de vida entre 1993 y el 2000, los comportamientos de alto riesgo siguieron siendo comunes entre los adultos jamaicanos. Se necesitan programas generales de la promoción de la salud para abordar estas conductas de alto riesgo.

Prevalência do consumo de drogas na FEBEM, Porto Alegre / Drug use prevalence at FEBEM, Porto Alegre

OBJETIVO: Identificar a prevalência do uso de drogas entre crianças e adolescentes institucionalizados e avaliar o uso associado das substâncias lícitas, álcool e tabaco, com drogas ilícitas; e verificar qual a droga de uso inicial para o consumo das substâncias psicoativas ilícitas. MÉTODOS: Realizou-se um estudo transversal na Fundação Estadual do Bem-Estar do Menor do Rio Grande do Sul, na cidade de Porto Alegre. Um questionário elaborado pela Organização Mundial da Saúde, anônimo, sobre o uso de drogas e sua quantificação, auto-aplicado em salas de aula, foi respondido pela população de crianças e adolescentes alfabetizados que cumpriam medidas socioeducativas ou medidas protetivas. A análise visou descrever o uso de drogas entre os dois subgrupos levando em conta gêneros e idades de início de uso. RESULTADOS: Os resultados foram obtidos a partir de 382 indivíduos. As substâncias mais experimentadas foram: álcool (81,3 por cento), tabaco (76,8 por cento), maconha (69,2 por cento), cocaína (54,6 por cento), solventes (49,2 por cento), ansiolíticos (13,4 por cento), alucinógenos (8,4 por cento), anorexígenos (6,5 por cento) e barbitúricos (2,4 por cento). Em torno de 80 por cento afirmaram ter usado experimentalmente alguma droga ilícita. As meninas usaram principalmente medicamentos e os meninos drogas ilícitas, álcool e tabaco. As crianças albergadas por atos infracionais mostraram uso significativamente mais freqüente de álcool, maconha, cocaína e solventes. A idade de início do álcool e tabaco ocorreu antes dos 12 anos; maconha e solventes, antes dos 13, e cocaína, antes de completar 14, em média. Verificou-se alta freqüência de uso concomitante de drogas lícitas e ilícitas por esta população. CONCLUSÕES: A prevalência de experimentação e uso de drogas entre crianças e adolescentes institucionalizados é alta e precoce. As drogas lícitas foram usadas mais precocemente que as ilícitas. Indivíduos do sexo masculino e albergados por atos infracionais apresentam maior probabilidade de já terem utilizado drogas ilícitas.