Effectiveness evaluation of the school-based drug prevention program #Tamojunto in Brazil: 21-month follow-up of a randomized controlled trial.

INTRODUCTION: A school-based randomized controlled trial was conducted in 2014/2015 with students in 7th and 8th grades in 72 public schools in 6 Brazilian cities. A total of 5028 students were linked (75, 7%) in at least one of the two waves of follow-up (9 months and 21 months later). The principal research question was whether this 12-lesson program delays the initiation of alcohol, tobacco, inhalants and binge drinking among early adolescents when compared to usual care, that is, no prevention program in Brazilian schools, after 21 months of follow up. METHODS: Cox regression models were adjusted to evaluate the incidence of drug use. Generalized linear latent mixed models (GLLAMM) were used to evaluate changes in the prevalence of each drug over time and between groups. Findings The incidence analysis showed a negative effect of the program for alcohol initiation (aHR = 1.13, 95%CI 1.01; 127) but an opposite protective effect for the initiation of inhalant use (aHR = 0.79, 95%CI 0.66; 0.95). After 21 months, the prevalence of past-year use of alcohol changed from 30.1% to 49.8% in the intervention group and from 29.9% to 45.8% in the control group. Adolescents in the intervention group were 30% more likely to have reported past-year use of alcohol than students in the control group at 21 months (aOR = 1.30, 95%CI 1.02; 1.65). No effects of the program on past-month drug use were found. The Brazilian version of the Unplugged program may be misinterpreted by public school students, perhaps arousing their curiosity regarding alcohol use.

Consumo de marihuana en jóvenes universitarios: percepción de los pares / Marijuana consumption among university students: peer perception

RESUMEN A nivel mundial el uso de drogas es un problema, la magnitud del consumo y el daño asociado siguen en au mento. En Chile el mayor consumo en los jóvenes se registra en alcohol y marihuana. De acuerdo a la Teoría de Normas Sociales, la influencia de los pares junto a la sobrestimación del consumo de drogas son factores de riesgo relevantes. Objetivo: Evaluar la norma percibida del consumo de marihuana en los pares en estudiantes de las carreras de Enfermería y Educación de una universidad pública de una región del norte de Chile. Mate rial y método: Se realizó un estudio cuantitativo, descriptivo, transversal. La población participante del estudio fueron 166 estudiantes de segundo a cuarto año de las carreras de Educación y Enfermería de una universidad pública. Resultados: La mayoría de los participantes fueron mujeres (81%), estudiantes de Enfermería (76%) y solteros (75%). Destaca el alto consumo de marihuana tanto para las frecuencias alguna vez en la vida, último año como último mes (52, 54,8 y 25,5% respectivamente). Los estudiantes muestran sobrestimación del con sumo de marihuana en sus pares para la frecuencia de consumo último año (57% comparado con 54,8%), y último mes (80% comparado con 25,5%), los estudiantes de Educación muestran percepción de consumo ma yor a los de Enfermería (96% comparado con 78%) con diferencias estadísticamente significativas. Conclusión: Los estudiantes muestran sobrestimación del consumo de marihuana en sus pares para frecuencia de consumo último año. Según la Teoría de las Normas Sociales, la sobrestimación es un factor de riesgo. Es necesario im plementar en las universidades proyectos de información masiva respecto a las cifras de consumo real de drogas que presentan los pares, lo que ha mostrado resultados exitosos para disminuir la percepción errada y el riesgo de consumo.

ABSTRACT Worldwide drug use is a real problem. The magnitude of drug use and the associated damage keep increasing. In Chile, among young people, the most consumed drugs are alcohol and marijuana. This article describes the relationship between the perceived norm for marijuana use among peers and the uses reported by students. Objective: To evaluate the perceived norm in the use of marijuana among peers in the Education and Nurs ing Schools in a public and regional university. Method: This is a quantitative, descriptive and cross-sectional study. The participant sample of the study were 166 students in second and fourth year studying Education and Nursing at a public university. Results: Most participants were, women (81%), nursing students (76%) and single (75%). It is important to highlight the high percentages observed in the frequencies some time in my life, during the last year and last month (52, 54.8 and 25.5% respectively). There is an overestimation of the use of marijuana among peers for the frequencies last year (57% compared to a 54.8 %), and last month (80% compared to a 25%), the education students showed a greater perception of drug use than the nursing students (96% compared to 78%), with significant statistical differences. Conclusion: According to the Theory of Social Norms overestimation is a risk factor. It is important to inform the university community about the actual number of peers who use drugs in order to reduce wrong perceptions and risk of consumption.

Efficacy evaluation of the school program Unplugged for drug use prevention among Brazilian adolescents.

BACKGROUND: Most Brazilian schools do not have a continuous program for drug use prevention and do not conduct culturally adapted activities for that purpose. This study evaluated the impact of the Unplugged program on drug use prevention among children and adolescents in public middle schools of Brazil. METHODS: A non-randomized controlled trial was conducted in 2013 with 2185 students in 16 public schools from 3 Brazilian cities. The intervention group attended 12 weekly classes of the Unplugged program for drug use prevention, and the control group did not attend to any school prevention programs in the same year. Multilevel analyses were used to evaluate temporal and between group changes in the consumption of each drug. RESULTS: The study suggested that there was no evidence that Unplugged effected 11- to 12-year-old students. However, the program seemed to stimulate a decrease in recent marijuana use (transition from use to non-use in 85.7% of intervention cases and 28.6% of control cases, OR = 17.5, p = 0.039) among 13- to 15-year-old students. In addition, students in this age range who received the Unplugged program had similar drug consumption levels to those observed before the program began. However, students in the control group presented a significant tendency to increase marijuana use and binge drinking. CONCLUSIONS: This study adds to the evidence of program efficacy among Brazilian middle school students by presenting marginal effects on binge drinking and marijuana use. An 18-month randomized controlled trial is recommended for a future study.

The association of psychiatric symptomatology with patterns of alcohol, tobacco, and marijuana use among Brazilian high school students.

BACKGROUND AND OBJECTIVES: Studies have highlighted psychosocial factors associated with drug use among adolescents. Association of specific psychiatric comorbidity with substance use has not been properly established in Brazil. This study aimed to investigate alcohol, tobacco, and marijuana use by 15-18-year-old high school Brazilian students and to estimate associations with psychiatric symptoms. METHODS: A cross-sectional survey of 4,034 students from 128 public and private schools in São Paulo State was carried out using a two-step probability sample. Data were collected through self-report standardized questionnaires including questions on substance use patterns and the Strengths and Difficulties Questionnaire (SDQ). Key outcome variables were past-month use and past-month frequent use of alcohol, tobacco and marijuana. Questionnaires with missing information were excluded, resulting in a final sample of 2,532 adolescents. Weighted data was analyzed through logistic regressions, adjusted by gender and by socio-economic status (SES). RESULTS: Regarding SDQ total score, 43.6% of students had no psychiatric symptoms, 7.9% had subclinical symptoms and 48.5% presented clinically significant symptoms. Respondents with a clinically significant SDQ score were more likely to be past month alcohol (aOR = 1.51; 95%CI 1.22-1.88), tobacco (aOR = 1.82; 95%CI 1.25-2.66), and marijuana (aOR = 1.79; 95%CI 1.21-2.64) users as compared to those with no symptomatology. DISCUSSION AND CONCLUSIONS: Psychopathological symptoms were associated with alcohol, tobacco and marijuana use by 15-18-year-old adolescents. These associations should also be considered when planning public policies of mental health promotion. SCIENTIFIC SIGNIFICANCE: This study discusses the importance of the association between psychopathological symptoms and substance use in a middle-income country, with high level of social inequalities, in a state representative sample. (Am J Addict 2016;25:416-425).

Prevalencia de consumo de marihuana en estudiantes de secundaria de instituciones educativas estatales de Ventanilla / Prevalence of marijuana use among secondary school students of State educational institutions of Ventanilla

Objetivos: Determinar la prevalencia del consumo de marihuana en los estudiantes de nivel secundaria de las I.E. estatales de Ventanilla 2014. Material y Métodos: Se realizó un estudio descriptivo de corte transversal, la recolección de datos se llevó acabo en los meses de mayo a septiembre, en una muestra de 4095 estudiantes que se obtuvo mediante el cálculo muestral por afijación proporcional de una población de 13 232 estudiantes de 22 instituciones educativas estatales de los turnos mañana y tarde, quienes aceptaron participar en el estudio mediante el asentimiento y consentimiento informado. Resultados: La prevalencia de vida de consumo de marihuana en los adolescentes fue 9%, prevalencia de consumo en el último año 7,4% y en el último mes 5,9%. La prevalencia de año según sexo es mayor en varones que en mujeres con un porcentaje de 9,5 y 5,5% respectivamente, y la prevalencia de vida del consumo de marihuana según edad es a los 15 años, con un porcentaje de 24,1%. Conclusiones: La prevalencia de consumo de marihuana es mayor en la región Callao, los adolescentes varones presentan una mayor prevalencia del consumo de marihuana a diferencia de las mujeres.

Objective: To determine the prevalence of marijuana use among students in secondary level of IE State of Window 2014. Material and Methods: A descriptive cross-sectional study was conducted, data collection took place at the months of May to September; in a sample of 4095 students was obtained by the sample calculation proportional allocation of a population of 12807 students from 22 State educational institutions of the morning and afternoon, who agreed to participate in the study and signed the consent and informed consent. Results: The life time prevalence of marijuana on teens was 9%. The prevalence of use at the last year was 7.4% and the last month was 5.9%. The prevalence of year according to sex is higher in men than in women with a percentage of 9.5% and 5.5% respectively; and the life time prevalence of marijuana use according to age is 15 years represented by 24.1%. Conclusions: The prevalence of marijuana use is higher in the Callao region; adolescent boys have a higher prevalence of marijuana unlike women.

Long-term effects of the keepin' it REAL model program in Mexico: substance use trajectories of Guadalajara middle school students.

In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin' it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin' it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico.

El mito frente a la realidad

Contiene: Uso indebido y tráfico ilícito de - Las mentiras de la minimización de los riesgos del uso de

[Young men and psychoactive substances]. / Varones jóvenes y sustancias psicoactivas.

This study compares prevalence rates of psychoactive substances use in two samples of young men who were called to the Military Service Medical Examination, in Buenos Aires city, in two different periods of time: in 1992, a thousand nine hundred eighty men were included, and in 1994, a thousand four hundred eighty men answered the questionnaire. Same methodological procedures were applied in both periods. Marihuana consumption level showed no changes; little decrease were observed in cocaine declared consumption; alcohol abuse level also declined. Nevertheless, more than 3 of each ten young men recognized an alcoholic ingestion of more of 100 cc of absolute alcohol during the past 30 days before in both studies. Relations between use of legal and illegal psychoactive substances are explored in the 1994 sample.

Varones jóvenes y sustancias psicoactivas / Young men and psychoactive substances

En este artículo se presentan los resultados de un estudio comparativo sobre el consumo de sustancias psicoactivas en una población de jóvenes varones convocados al examen médico previo a su incorporación al servicio militar en la ciudad de Buenos Aires, en los años 1992 y 1994. En el primer año la muestra incluyó a 1.980 jóvenes, y en el segundo, a 1.480 jóvenes. En ambas oportunidades se utilizó igual metodología. No se observaron cambios en el patrón de consumo de la marihuana; se registro un ligero descenso en el consumo declarado de cocaína y una declinación en los niveles de abuso de alcohol. No obstante, más de la tercera parte de los jóvenes, en ambos períodos, reconocieron niveles de ingesta alcohólica de más de 100 cc de alcohol absoluto en los últimos treinta días anteriores a la encuesta. Se investiga, para el año 1994, el patrón del consumo de las sustancias legales en los que reconocieron haber consumido sustancias ilícitas alguna vez y los que no.

Varones jóvenes y sustancias psicoactivas / Young men and psychoactive substances

En este artículo se presentan los resultados de un estudio comparativo sobre el consumo de sustancias psicoactivas en una población de jóvenes varones convocados al examen médico previo a su incorporación al servicio militar en la ciudad de Buenos Aires, en los años 1992 y 1994. En el primer año la muestra incluyó a 1.980 jóvenes, y en el segundo, a 1.480 jóvenes. En ambas oportunidades se utilizó igual metodología. No se observaron cambios en el patrón de consumo de la marihuana; se registro un ligero descenso en el consumo declarado de cocaína y una declinación en los niveles de abuso de alcohol. No obstante, más de la tercera parte de los jóvenes, en ambos períodos, reconocieron niveles de ingesta alcohólica de más de 100 cc de alcohol absoluto en los últimos treinta días anteriores a la encuesta. Se investiga, para el año 1994, el patrón del consumo de las sustancias legales en los que reconocieron haber consumido sustancias ilícitas alguna vez y los que no. (AU)

Review of the effects of Cannabis on mental and physiological functions: justification for an intensive and comprehensive programme for the health of the Caribbean people

This paper draws on scientific work done in the English-speaking Caribbean in an attempt to assess the specific effects of the chronic use of Cannabis on psychological and physiological processess. Evidence is reviewed concerning the interaction of this psychotomimetic compound on cognitive functioning and the possible sequelae of altered mental states giving rise to psychopathology. The physiological work evaluates studies relating to Cannabis smoke and lung function. In addition, the work reveals some exciting findings of the impact of Cannabis on the reproductive process. The implications of these findings are discussed in view of our knowledge of the chronic use of Cannabis in Jamaica, and focusses attention on the long-term effects of this substance in the context of the abusing population