Exploring the relationship between admixture and genetic susceptibility to attention deficit hyperactivity disorder in two Latin American cohorts.

Contemporary research on the genomics of Attention Deficit Hyperactivity Disorder (ADHD) often underrepresents admixed populations of diverse genomic ancestries, such as Latin Americans. This study explores the relationship between admixture and genetic associations for ADHD in Colombian and Mexican cohorts. Some 546 participants in two groups, ADHD and Control, were genotyped with Infinium PsychArray®. Global ancestry levels were estimated using overall admixture proportions and principal component analysis, while local ancestry was determined using a method to estimate ancestral components along the genome. Genome-wide association analysis (GWAS) was conducted to identify significant associations. Differences between Colombia and Mexico were evaluated using appropriate statistical tests. 354 Single-nucleotide polymorphisms (SNPs) and Single-nucleotide variants (SNVs) related to some genes and intergenic regions exhibited suggestive significance (p-value < 5*10e-5) in the GWAS. None of the variants revealed genome-wide significance (p-value < 5*10e-8). The study identified a significant relationship between risk SNPs and the European component of admixture, notably observed in the LOC105379109 gene. Despite differences in risk association loci, such as FOXP2, our findings suggest a possible homogeneity in genetic variation's impact on ADHD between Colombian and Mexican populations. Current reference datasets for ADHD predominantly consist of samples with high European ancestry, underscoring the need for further research to enhance the representation of reference populations and improve the identification of ADHD risk traits in Latin Americans.

Associated factors to non-medical and medical use of psychoactive medication among Mexican adolescents and adults in a national household survey.

BACKGROUND: Non-medical use of psychoactive medication is a public health problem. Studies in other contexts indicate that individual sociodemographic characteristics are associated with non-medical use, but these associations have not been assessed in the Mexican context. OBJECTIVES: To estimate the prevalence non-medical and medical use of psychoactive medication among Mexican adolescents and adults' medication users and to estimate the associations between sociodemographic characteristics and non-medical use of psychoactive medication, using data from a nationally representative sample. METHODS: Secondary analysis of data collected from the National Survey of Drug, Alcohol, and Tobacco Consumption (ENCODAT) 2016 to 2017. The analytical sample included people aged 12 to 65 years. The sample was stratified into two age categories: adolescents (12-17 years) and adults (18-65 years). Sub-analyses were performed to describe prevalence of use and non-medical use of psychoactive medication at the state-level. Descriptive statistics and multinomial logistic regression models were used to estimate associations between sociodemographic characteristics and medical, non-medical, and non-use of psychoactive medication in adolescents and adults. RESULTS: Among Mexican medication users in 2016, the national prevalence of non-medical use of psychoactive drugs was 19.6%; 22.2% among adolescents and 19.4% among adults. States adjacent to the US-Mexico border reported the highest levels of non-medical use of psychoactive medication. Illicit drug consumption was associated with non-medical use. Sociodemographic characteristics associated with non-medical use varied between adolescents and adults. CONCLUSIONS: There is a high proportion of non-medical use of psychoactive drugs among Mexican medication users, especially among young people. Understanding factors associated with the misuse of psychoactive medications in Mexico can inform policy for prevention and treatment.

The Prevalence of Symptomatology and Risk Factors in Mental Health in Mexico: The 2016-17 ENCODAT Cohort.

There is little recent information about the prevalence of symptomatology of mental health disorders in representative population samples in Mexico. To determine the prevalence of mental health symptoms in Mexico and its comorbidity with tobacco, alcohol, and drug use disorder (SUD), we used the 2016-17 National Survey of Drug, Alcohol, and Tobacco Use (Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco, ENCODAT 2016-2017). The data were collected from households using a cross-sectional, stratified, multistage design, with a confidence level of 90% and a response rate of 73.6%. The final sample included 56,877 completed interviews of individuals aged 12-65, with a subsample of 13,130 who answered the section on mental health. Symptoms of mania and hypomania (7.9%), depression (6.4%), and post-traumatic stress (5.7%) were the three main problems reported. Of this subsample, 56.7% reported using a legal or illegal drug without SUD, 5.4% reported SUD at one time on alcohol, 0.8% on tobacco, and 1.3% on medical or illegal drugs, 15.9% reported symptoms related to mental health, and 2.9% comorbidity. The prevalence found is consistent with those reported in previous studies, except for an increase in post-traumatic stress, which is consistent with the country's increase in trauma.

Changes in Attitudes toward People with Substance Use Disorder: A Comparative Study of the General Population in Mexico.

BACKGROUND: Substance use disorders are among the most stigmatized conditions worldwide. People with substance use disorder (PWSUD) are often considered responsible for their use of drugs. The objectives are to analyze changes in Mexican attitudes toward PWSUD in the general population over the period 2011 to 2016 and to use the latest Mexican household survey to determine which segments of the population are most likely to have negative attitudes. METHODS: Two representative national household surveys employing similar methodologies were conducted in Mexico in 2011 and 2016 with persons aged 12-65 years. Participants were asked about their attitudes toward PWSUD, and changes were compared across GLM. RESULTS: The surveys found a decrease from 2011 to 2016 in the number of respondents who considered PWSUD "sick" or in "need of help" and an increase in the number who believed they were "selfish" or "criminal". The 2016 survey found that men, people 18 years of age or older, people who do not use drugs and people with lower educational levels were the groups with the most negative attitudes toward PWSUD. CONCLUSIONS: These results suggest that it may not be recognized that PWSUD may have a health problem and that this helps to increase stigmatization towards this population.

Genome-Wide Analysis of Disordered Eating Behavior in the Mexican Population.

Alterations in eating behavior characterized eating disorders (ED). The genetic factors shared between ED diagnoses have been underexplored. The present study performed a genome-wide association study in individuals with disordered eating behaviors in the Mexican population, blood methylation quantitative trait loci (blood-meQTL), summary data-based Mendelian randomization (SMR) analysis, and in silico function prediction by different algorithms. The analysis included a total of 1803 individuals. We performed a genome-wide association study and blood-meQTL analysis by logistic and linear regression. In addition, we analyzed in silico functional variant prediction, phenome-wide, and multi-tissue expression quantitative trait loci. The genome-wide association study identified 44 single-nucleotide polymorphisms (SNP) associated at a nominal value and seven blood-meQTL at a genome-wide threshold. The SNPs show enrichment in genome-wide associations of the metabolic and immunologic domains. In the in silico analysis, the SNP rs10419198 (p-value = 4.85 × 10-5) located on an enhancer mark could change the expression of PRR12 in blood, adipocytes, and brain areas that regulate food intake. Additionally, we found an association of DNA methylation levels of SETBP1 (p-value = 6.76 × 10-4) and SEMG1 (p-value = 5.73 × 10-4) by SMR analysis. The present study supports the previous associations of genetic variation in the metabolic domain with ED.

Influence of Prevalence of Psychoactive Substance Use in Mexican Municipalities on Early Childhood Development.

Children's early development is influenced by characteristics of the child, family, and environment, including exposure to substance abuse. The aim was to examine the association of early childhood development (ECD) with the prevalence of psychoactive substance use in Mexican municipalities. We obtained ECD data from the 2015 Survey of Boys, Girls, and Women (ENIM, for its Spanish acronym), measured with the ECD Index. The prevalence of psychoactive substance use was estimated at the municipal level, using the 2016 National Survey of Drug, Alcohol, and Tobacco Use (ENCODAT, for its Spanish acronym). Multilevel logistic models were fitted to evaluate the association between drug use and inadequacies in ECD overall and in four specific ECD domains: socio-emotional, literacy-numeric, learning, and physical. Inadequate ECD was directly associated with illegal drug use (OR = 1.10; 95% CI: 1.03, 1.17). For the specific ECD domains, inadequate socio-emotional development was directly associated with illegal drug use (OR = 1.08; 95% CI: 1.01, 1.15). These findings suggest that exposure to illegal drug use may influence ECD, and especially can lead to socio-emotional problems, although this cannot be considered the unanimous determinant of the problems presented. The implementation of evidence-based interventions to prevent drug abuse is necessary.

Psychoactive Substance Use and Its Relationship to Stress, Emotional State, Depressive Symptomatology, and Perceived Threat During the COVID-19 Pandemic in Mexico.

People can increase their use of psychoactive substances in response to stressful situations as a maladaptive mechanism for reducing negative affective states. It is therefore necessary to examine changes in the use of such substances and their relationship to mental health in light of the COVID-19 pandemic. Objective: Evaluate the relationship between psychoactive substances and stress, emotional state, and symptomatology during the COVID-19 lockdown in Mexico. Method: A national survey was conducted, using the free Google Forms platform, of residents of Mexico aged 18 and older. The survey was disseminated through social media. Results: The sample comprised 4,122 individuals, mostly women (71.8%), with an age range of 18-81 years (M = 37.08, SD = 12.689), of which 46.8% were single, and 42.9% married. In general, there was a reduction in substance use during the first 2 months of the quarantine; the most commonly used substances were alcohol, tobacco, and tranquilizers. Respondents who described having greater use than before the pandemic presented greater stress, depressive symptomatology, and perceived threat than those who did not use substances. Conclusions: Respondents who did not use substances reported lower levels of stress, depressive symptomatology, impact of the coronavirus pandemic, and perception of its threat. Women reported greater stress, depressive symptomatology, and emotional intensity than men.

Intimate-partner violence and its relationship with substance consumption by Mexican men and women: National Survey on Addictions / Violencia de pareja y su relación con el consumo de sustancias en hombres y mujeres mexicanos: Encuesta Nacional de Adicciones

Abstract Introduction Research findings about intimate-partner violence (IPV) have focused mostly on women as victims of violence. Recent studies show the importance of violence inflicted by women towards men or between same-sex couples. Objective To estimate the prevalence of intimate-partner violence and its association with alcohol and drug consumption in a representative sample of men and women in Mexico through secondary data analysis. Method The data come from a representative sample who filled out the section on intimate-partner violence in the Mexican 2011 Encuesta Nacional de Adicciones (National Survey on Addictions). Results The prevalence of intimate-partner violence in the last year was 17.6% against women and 13.4% against men. If one of the two partners consumed substances, the risk that men and women would experience violence increased, and that risk was even greater if both consumed. Discussion and conclusion This is the first time violence against men was reported in a Mexican national study. The findings show that gender-based violence should also be considered a result of social and cultural violence.

Resumen Introducción Los hallazgos de investigación sobre la violencia de pareja se han centrado principalmente en las mujeres como víctimas de la violencia. Estudios recientes destacan también la importancia de la violencia infligida por las mujeres hacia los hombres o entre parejas del mismo sexo. Objetivo Estimar la prevalencia de la violencia de pareja y su asociación con el consumo de alcohol y drogas en una muestra representativa de hombres y mujeres en México mediante un análisis secundario de datos. Método Los datos provienen de la Encuesta Nacional de Adicciones de México 2011, específicamente de una muestra representativa que contestó la sección sobre violencia de pareja. Resultados La prevalencia de violencia de pareja en el último año fue de 17.6% hacia las mujeres y de 13.4% hacia los hombres. Si uno de los dos integrantes de la pareja consumía sustancias, aumentaba el riesgo de que hombres o mujeres experimentaran violencia y ese riesgo era aún mayor si ambos consumían. Discusión y conclusión Esta es la primera vez que se reporta la violencia hacia los hombres en un estudio nacional mexicano. Los resultados muestran que la violencia de género también debe considerarse como resultado de la violencia social y cultural.

Cannabis Use in People With Obsessive-Compulsive Symptomatology: Results From a Mexican Epidemiological Sample.

Recent studies suggest that the endocannabinoid system could play an important role in the physiopathology of obsessive-compulsive disorder (OCD). There are reports of effective treatment with derivatives of tetrahydrocannabinol (THC). The study of the genetic factor associated with psychiatric disorders has made possible an exploration of its contribution to the pharmacological response. However, very little is known about the genetic factor or the prevalence of cannabis use in the Mexican population with OCD. The objective of this study is to compare the prevalence of use and dependence on cannabis in individuals with obsessive-compulsive symptomatology (OCS) with that of individuals with other psychiatric symptoms (psychosis, depression, and anxiety), and to explore the association between genetic risk and use. The study includes a total of 13,130 individuals evaluated in the second stage of the 2016 National Survey of Drug, Alcohol, and Tobacco Use (Encodat 2016), with genetic analysis (polygenic risk scoring) of a subsample of 3,521 individuals. Obsessive symptomatology had a prevalence of 7.2% and compulsive symptomatology a prevalence of 8.6%. The proportion of individuals with OCS who had ever used cannabis was 23.4%, and of those with cannabis dependency was 2.7%, the latter figure higher than that in individuals with other psychiatric symptoms (hypomania, 2.6%; anxiety, 2.8%; depression, 2.3%), except psychosis (5.9%). Individuals with OCS who reported using cannabis had an increased genetic risk for cannabis dependence but not for OCD. We thus cannot know how the increased genetic risk of cannabis dependence in people with OCD is influenced by their pharmacological response to derivatives of THC. The results, however, suggest paths for future studies.

Genome-wide association study of psychiatric and substance use comorbidity in Mexican individuals.

The combination of substance use and psychiatric disorders is one of the most common comorbidities. The objective of this study was to perform a genome-wide association study of this comorbidity (Com), substance use alone (Subs), and psychiatric symptomatology alone (Psych) in the Mexican population. The study included 3914 individuals of Mexican descent. Genotyping was carried out using the PsychArray microarray and genome-wide correlations were calculated. Genome-wide associations were analyzed using multiple logistic models, polygenic risk scores (PRSs) were evaluated using multinomial models, and vertical pleiotropy was evaluated by generalized summary-data-based Mendelian randomization. Brain DNA methylation quantitative loci (brain meQTL) were also evaluated in the prefrontal cortex. Genome-wide correlation and vertical pleiotropy were found between all traits. No genome-wide association signals were found, but 64 single-nucleotide polymorphism (SNPs) reached nominal associations (p < 5.00e-05). The SNPs associated with each trait were independent, and the individuals with high PRSs had a higher prevalence of tobacco and alcohol use. In the multinomial models all of the PRSs (Subs-PRS, Com-PRS, and Psych-PRS) were associated with all of the traits. Brain meQTL of the Subs-associated SNPs had an effect on the genes enriched in insulin signaling pathway, and that of the Psych-associated SNPs had an effect on the Fc gamma receptor phagocytosis pathway.

Association of MGAT4C with major neurocognitive disorder in the Mexican population.

BACKGROUND: Neurocognitive disorders (NCDs) are characterized by cognitive decline. Most genetic studies of NCDs have been focused on single-nucleotide polymorphism; other genetic variations, such as copy number variants (CNV), have been less explored. The aim of the present study was to explore CNVs associated with NCDs in a small sample of Mexican individuals and search for the frequency in a larger replication sample of individuals at high-risk for or diagnosed with NCDs. METHOD: The exploratory analysis analyzed whole-genome CNVs associated with NCDs in 1335 individuals, of whom 35 were diagnosed with NCDs and 1300 were population-based controls. Whole-genome CNVs were derived from PsychArray and the PennCNV algorithm. The frequency of associated CNVs in a sample of 277 individuals diagnosed with NCDs and 70 high-risk individuals was then determined using RT-PCR. RESULTS: The exploratory analysis identified one deletion associated with NCDs (p = 0.007) affecting the gene MGAT4C (Mannosyl (Alpha-1,3-)-Glycoprotein Beta-1,4-N-Acetylglucosaminyltransferase, Isozyme C). In the replication sample, a frequency of 3.97% was found in individuals diagnosed with NCDs and 1.43% in high-risk individuals. CONCLUSIONS: An association between a rare CNV on MGAT4C and cognitive impairment was found in this sample of the Mexican population. Nevertheless, studies with larger sample sizes are needed in order to further explore the association.

COVID-19 and alcohol in Mexico: A serious health crisis, strong actions on alcohol in response-Commentary on Stockwell et al.

The present text comments on Stockwell and colleagues' paper documenting the high burden of alcohol use in COVID-19 related mortality in the USA and Canada in North America and the absence of a control policy in several countries of the world. This comment adds information about the third country in North America, Mexico. It describes alcohol use during the COVID lockdown and its consequences, highlighting the control efforts through public health policies and ponders the weaknesses of the current response to the health crisis and opportunities in the aftermath.

The Identification of Admixture Patterns Could Refine Pharmacogenetic Counseling: Analysis of a Population-Based Sample in Mexico.

Pharmacogenetic analysis has generated translational data that could be applied to guide treatments according to individual genetic variations. However, pharmacogenetic counseling in some mestizo (admixed) populations may require tailoring to different patterns of admixture. The identification and clustering of individuals with related admixture patterns in such populations could help to refine the practice of pharmacogenetic counseling. This study identifies related groups in a highly admixed population-based sample from Mexico, and analyzes the differential distribution of actionable pharmacogenetic variants. A subsample of 1728 individuals from the Mexican Genomic Database for Addiction Research (MxGDAR/Encodat) was analyzed. Genotyping was performed with the commercial PsychArray BeadChip, genome-wide ancestry was estimated using EIGENSOFT, and model-based clustering was applied to defined admixture groups. Actionable pharmacogenetic variants were identified with a query to the Pharmacogenomics Knowledge Base (PharmGKB) database, and functional prediction using the Variant Effect Predictor (VEP). Allele frequencies were compared with chi-square tests and differentiation was estimated by FST. Seven admixture groups were identified in Mexico. Some, like Group 1, Group 4, and Group 5, were found exclusively in certain geographic areas. More than 90% of the individuals, in some groups (Group 1, Group 4 and Group 5) were found in the Central-East and Southeast region of the country. MTRR p.I49M, ABCG2 p.Q141K, CHRNA5 p.D398N, SLCO2B1 rs2851069 show a low degree of differentiation between admixture groups. ANKK1 p.G318R and p.H90R, had the lowest allele frequency of Group 1. The reduction in these alleles reduces the risk of toxicity from anticancer and antihypercholesterolemic drugs. Our analysis identified different admixture patterns and described how they could be used to refine the practice of pharmacogenetic counseling for this admixed population.

Innovative Identification of Substance Use Predictors: Machine Learning in a National Sample of Mexican Children.

Machine learning provides a method of identifying factors that discriminate between substance users and non-users potentially improving our ability to match need with available prevention services within context with limited resources. Our aim was to utilize machine learning to identify high impact factors that best discriminate between substance users and non-users among a national sample (N = 52,171) of Mexican children (i.e., 5th, 6th grade; Mage = 10.40, SDage = 0.82). Participants reported information on individual factors (e.g., gender, grade, religiosity, sensation seeking, self-esteem, perceived risk of substance use), socioecological factors (e.g., neighborhood quality, community type, peer influences, parenting), and lifetime substance use (i.e., alcohol, tobacco, marijuana, inhalant). Findings suggest that best friend and father illicit substance use (i.e., drugs other than tobacco or alcohol) and respondent sex (i.e., boys) were consistent and important discriminators between children who tried substances and those that did not. Friend cigarette use was a strong predictor of lifetime use of alcohol, tobacco, and marijuana. Friend alcohol use was specifically predictive of lifetime alcohol and tobacco use. Perceived danger of engaging in frequent alcohol and inhalant use predicted lifetime alcohol and inhalant use. Overall, findings suggest that best friend and father illicit substance use and respondent's sex appear to be high impact screening questions associated with substance initiation during childhood for Mexican youths. These data help practitioners narrow prevention efforts by helping identify youth at highest risk.

Attitudes towards safe consumption sites among police and people with lived experience in Tijuana, Mexico: initial report from the field / Actitudes sobre salas de consumo seguro entre policía y personas con experiencia vivida en Tijuana, México: informe inicial de campo

Abstract Introduction Mexico northern border has high levels of heroin use. For more than 10 years, the country has implemented several harm reduction interventions to reduce the risks associated with drug use. New strategies such as Safe Consumption Sites (SCS) must be considered as a next step to service vulnerable populations and increase their health outcomes. Objective This report seeks to measure and compare attitudes on a potential SCS intervention in Tijuana among police and people with lived experience (PLE) in heroin use in the city. Method Two parallel studies on police practices and everyday experiences of heroin users in Tijuana were able to ask similar questions about attitudes toward SCS and its implementation in the city. They conducted quantitative interviews with 771 active police officers and 200 PLE while in rehabilitation services. Results Both groups showed a high personal support for SCS of nearly 82% and a perceived implementation success around 80%. Officers reported 58.9% peer support for SCS while PLE 79%. Around 76% of both groups agreed that a SCS would help to improve their personal health. Finally, 86.2% of the officers would refer people to a SCS while 62.5% of PLE would use the service. Discussion and conclusions The strong positive attitudes from police officers and PLE towards SCS in the city of Tijuana reported in both studies indicate the possibility of a successful implementation of a SCS. This intervention would represent an innovative way to protect PLE from police harassment and victimization, helping reduce HIV and HCV risk behaviors while improving community health.

Resumen Introducción En la frontera norte de México hay niveles altos de consumo de heroína. Durante más de 10 años, el país ha implementado diversas intervenciones de reducción de daños para minimizar los riesgos asociados con el uso de sustancias. Los sitios de consumo seguro (SCS) se deben considerar como una opción que brinde servicios a poblaciones vulnerables para mejorar su salud. Objetivo Este reporte mide y compara actitudes entre policías y personas con experiencia vivida (PEV) en uso de heroína en Tijuana, relacionadas con una posible implementación de SCS en la ciudad. Método Dos estudios paralelos sobre prácticas policiales y experiencias cotidianas de usuarios de heroína en Tijuana incluyeron preguntas similares sobre actitudes hacia los SCS y su implementación en la ciudad. Se realizaron 771 entrevistas cuantitativas con oficiales de policía y 200 con PEV internadas en centros de rehabilitación. Resultados Ambos grupos mostraron un alto apoyo hacia los SCS cercano al 82% y un éxito percibido en implementación del 80%. Los oficiales reportaron 58.9% de apoyo entre pares a las SCS y del 79% entre PEV. Un 76% en ambos grupos coincidieron que un SCS ayudaría a mejorar su salud personal. Finalmente, el 86.2% de los oficiales referirían hacia un SCS, mientras que 62.5% de PEV las usarían. Discusión y conclusiones Las actitudes hacia los SCS indican una posible implementación exitosa de SCS en la ciudad. Esta intervención representaría una forma innovadora de disminuir el acoso y victimización policial hacia las PEV, reduciendo los factores de riesgo de VIH y VHC, mejorando la salud comunitaria.

The influence of perceived parenting on substance initiation among Mexican children.

Parents shape their children's behaviors and impact their developmental trajectories. Despite this, few studies have examined the potential relationship between child reported parenting factors and lifetime substance use and use intentions. The current study examined the potential impact of parenting factors (i.e., positive parenting, supervision, parental illicit substance use, substance-specific communication) on early substance use and intentions among Latinx children. Data for the present study utilized a representative sample of Mexican children (n = 52,171; 5th and 6th grades) who participated in a national survey on substance use. Children reported their demographics, lifetime substance use/intentions, and perceived parenting characteristic and practices. Child reported parental (i.e., individual or both parents) illicit substance use was associated with the largest increases in risk for reporting lifetime use of all substances examined. Higher levels of positive parenting were consistently associated with reductions in risk for reporting intentions for and use of all substances examined. Parent-child substance specific communication was not significantly related to child reported lifetime use or use intentions, with the exception of a minor decrease in the odds of reporting lifetime inhalant use. Supervision was associated with small to modest increase in risk. Substance use prevention efforts targeting Latinx populations may benefit from promoting positive parenting and direct supervision during childhood. Targeted prevention efforts may be needed for Latinx children exposed to parental illicit substance use, as they may be especially at risk for early substance initiation.

Magnitude and extent of gambling disorder in the Mexican population / Magnitud y extensión del juego patológico en la población mexicana

Abstract: Introduction: Gambling disorder is characterized by an uncontrollable need to gamble, lack of control over gambling, prioritizing gambling over other activities, and continuing to gamble despite the negative consequences this entails. Worldwide, between .1% and 5% of people show signs of problem gambling and between .1% and 2.2% present a positive result in gambling disorder criteria. Objective: To determine the extent of the problem of gambling disorder in Mexico and to identify and analyze the demographic groups in which it occurs. Method: ENCODAT 2016-2017 is a probabilistic, multi-stage survey with national and state representativeness. The sample comprises 56 877 people who answered a standardized questionnaire that collects information on addictive substance use and other areas such as gambling disorder. Results: A total of 24.5% of the population aged 12 to 65 have played a betting game at lifetime. Men have higher statistically significant prevalences than women in nearly all types of gambling and in six of the nine symptoms of gambling disorder. In Mexico, .3% of the target population meet the criteria for gambling disorder, with adolescents showing the highest percentage (.4%). Discussion and conclusion: It is necessary to reinforce public policies for this issue that include the development of preventive actions targeting the adolescent and youth population in Mexico, and to ensure the adequate monitoring of authorized centers.

Resumen: Introducción: El juego patológico se caracteriza por la necesidad incontrolable de jugar, la falta de control sobre el juego, la prioridad de jugar sobre otras actividades y de continuar jugando a pesar de las consecuencias negativas. A nivel mundial, entre .1% y el 5% de las personas muestra señales de juego problemático y del .1% al 2.2% presenta un resultado positivo en los criterios de juego patológico. Objetivo: Conocer la extensión del problema del juego patológico en México e identificar y analizar los grupos demográficos en los que se presenta. Método: La ENCODAT 2016-2017 es una encuesta probabilística y polietápica con representatividad nacional y estatal. La muestra fue de 56 877 personas, las cuales contestaron un cuestionario estandarizado que recaba información sobre consumo de sustancias adictivas y otras áreas como el juego patológico o ludopatía. Resultados: El 24.5% de la población de 12 a 65 años ha jugado algún juego de azar alguna vez en la vida. Los hombres presentan prevalencias estadísticamente significativas más altas que las mujeres en casi todos los tipos de juegos y en 6 de los 9 síntomas de juego patológico. En el país, el .3% de la población objetivo cumple con los criterios para juego patológico, y los adolescentes muestran el mayor porcentaje (.4%). Discusión y conclusión: Es necesario reforzar políticas públicas sobre el tema que incluyan el desarrollo de acciones preventivas dirigidas a la población adolescente y joven del país, así como incidir en el monitoreo adecuado de los centros autorizados.

National trends in alcohol consumption in Mexico: results of the National Survey on Drug, Alcohol and Tobacco Consumption 2016-2017 / Tendencias nacionales del consumo de alcohol en México: resultados de la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017

Abstract: Introduction: Worldwide, binge drinking of alcohol has increased, especially among young people. In Mexico, various epidemiological sources allow us to account for the growth this pattern of consumption has had. Given this context, the Encuesta Nacional de Consumo de Drogas 2016-2017 (ENCODAT) shows the evolution in alcohol consumption. Objective: To determine the prevalence and national and regional trends, as well as state variations of alcohol consumption in the population aged 12 to 65. Method: The ENCODAT 2016-2017 is a random, probabilistic, and multi-stage study with national and state representation. The sample consisted of 56 877 people who answered a standardized questionnaire through ACASI (self-administered computer interviews) that collects information about the use of tobacco, alcohol, and medical and illegal drugs. Results: Binge drinking past month increased from 12.3% to 19.8% from 2011 to 2016. A similar situation occurs in daily use (from .8% to 2.9%) and weekly binge drinking (from 5.4% to 8.5%). The age of onset has remained stable since 2011 (16.6 years for men, 19.2 years for women in 2016). Meanwhile, 2.2% reported alcohol dependence. The states with the highest prevalence of binge drinking are Nuevo León (30.3%), Jalisco (27.7%) and, Coahuila (27.5%). Discussion and conclusion: The results show that alcohol use increased with respect to 2011, especially in women; data on treatment seeking indicate that women who use alcohol are also the least likely to seek help. Given this context, it is necessary to have specialized spaces that provide treatment in keeping with use-based needs and gender condition.

Resumen: Introducción: A nivel internacional, el consumo excesivo de alcohol ha aumentado, principalmente entre la población joven. En México, diversas fuentes epidemiológicas dan cuenta del crecimiento de este patrón de consumo. Dado este contexto, la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017 (ENCODAT) muestra la evolución en el consumo de alcohol. Objetivo: Conocer las prevalencias y tendencias nacionales y regionales, así como las variaciones estatales del consumo de alcohol en la población de 12 a 65 años. Método: La ENCODAT 2016-2017 es un estudio aleatorio, probabilístico y polietápico con representatividad nacional y estatal. En la muestra participaron 56 877 personas que contestaron un cuestionario estandarizado mediante ACASI (entrevistas auto-administradas por computadoras), que recaba información sobre consumo de tabaco, alcohol y drogas médicas e ilegales. Resultados: El consumo excesivo en el último mes se incrementó de 12.3% a 19.8% de 2011 a 2016. Una situación similar ocurre en el consumo diario (de .8% a 2.9%) y consuetudinario (de 5.4% a 8.5%). La edad de inicio se ha mantenido estable desde 2011 (16.6 años hombres; 19.2 años mujeres en 2016). En tanto, el 2.2% reportó dependencia al consumo de alcohol. Las entidades con las prevalencias más altas en consumo excesivo son Nuevo León (30.3%), Jalisco (27.7%) y Coahuila (27.5%). Discusión y conclusión: Los resultados muestran que el consumo de alcohol creció con respecto a 2011, especialmente en mujeres. Datos sobre la asistencia a tratamiento, indican que éstas son también quienes menos acuden. Dado este contexto, es necesario contar con espacios especializados que brinden atención conforme a las necesidades de consumo y de condición de género.

Contextual factors associated with marijuana use in school population / Factores contextuales asociados con el consumo de marihuana en población estudiantil

Abstract Introduction Marijuana use among the student population has increased in Mexico and Latin America. There are social, interpersonal and individual factors associated with the onset and continuation of marijuana use. These include the availability of drugs in the community, opportunity for use, low perceived risk of harm from marijuana use and social tolerance by family and close friends. Moreover, these factors increase the probability of experimenting with other drugs, polysubstance use and dependence. Objective To identify the relationship between the level of urbanization, drug availability, exposure to opportunity for use, risk perception and social tolerance of the level of marijuana use among Mexican middle and high school students. Method The results are drawn from various surveys conducted in Mexico City and the National Survey of Drug Use among Students 2014. A total of 114 364 middle and high school students participated (49.8% boys and 50.2% girls). Results Of the respondent 10.6% had used marijuana at least once (12.9% boys and 8.4% girls). The variables that predicted higher marijuana use were drug use approval by family and best friend,, the level of urbanization and low risk perception. Discussion and conclusion Action must be taken on the factors mentioned to decrease the availability and use of drugs in the environment, and raise awareness of their consequences. These elements must be introduced systematically and creatively into preventive programs in this area.

Resumen Introducción El consumo de mariguana en población estudiantil se ha incrementado en México y América Latina. Existen factores sociales, interpersonales e individuales asociados con el inicio y la continuación de su consumo. Entre ellos encontramos la disponibilidad de drogas en la comunidad, la oportunidad de consumo, la baja percepción de riesgo por consumir mariguana, la tolerancia social de la familia y la de los amigos cercanos. Además, estos factores aumentan la probabilidad de experimentar con otras drogas, ser policonsumidor y producir dependencia. Objetivo Conocer la relación entre el nivel de urbanización, la disponibilidad de drogas, la exposición a la oportunidad de consumo, la percepción de riesgo y la tolerancia social con el nivel de consumo de mariguana en los estudiantes mexicanos de secundaria y bachillerato. Método Los resultados parten de diversas encuestas realizadas en la Ciudad de México y de la Encuesta Nacional de Consumo de Drogas en Estudiantes 2014. Participaron 114 364 alumnos de secundaria y bachillerato (49.8% hombres y 50.2% mujeres). Resultados El 10.6% consumieron mariguana alguna vez (12.9% hombres y 8.4% mujeres). Las variables predictoras de un mayor consumo de mariguana fueron la tolerancia ante el consumo de drogas de la familia y del mejor amigo, el nivel de urbanización y una baja percepción de riesgo. Discusión y conclusión Es necesario incidir en los factores señalados con objeto de disminuir la disponibilidad y el consumo de drogas en el entorno, así como en el conocimiento real de sus consecuencias. Estos elementos deben introducirse sistemática y creativamente en los programas preventivos del área.

El consumo de drogas en estudiantes de México: tendencias y magnitud del problema / Drugs use in Mexican students: trends and Magnitude of the problem

RESUMEN Introducción: El consumo de drogas y sus consecuencias sociales y de salud son del interés de múltiples sectores. Las encuestas en estudiantes son estrategias epidemiológicas para monitorear el problema, las cuales se complementan con encuestas de hogares y en grupos especiales de la población, lo que permite ver anticipadamente fenómenos que posteriormente son evidentes en la población general. Además de las tendencias y del patrón de consumo de drogas, estos estudios muestran la influencia de otros factores que incrementan el uso y sus consecuencias. Objetivo: Conocer las prevalencias de uso de drogas, alcohol y tabaco en estudiantes de primaria (5° y 6°) y secundaría-bachillerato de México y sus Estados. Método: Es una encuesta probabilística en población escolar 5° y 6° de primaria, secundaria y bachillerato con representatividad nacional y de cada Estado del país. La muestra fue de 52 171 alumnos en primaria y 114 364 en secundaria-bachillerato. La información se obtuvo mediante un cuestionario estandarizado y validado en encuestas anteriores. Resultados: El consumo de tabaco alguna vez fue de 30.4% y la edad promedio de inicio de esta sustancia fue 13.4 años. El 53.2% ha bebido alcohol y 14.5% ha bebido en exceso. La prevalencia de consumo de drogas alguna vez fue de 17.2%. Las drogas de preferencia son la mariguana (10.6%), seguida de inhalables (5.8%) y cocaína (3.3%). Discusión y conclusión: El crecimiento del consumo de sustancias, principalmente mariguana y alcohol, resalta la importancia de la creación de nuevas estrategias de prevención para disminuir los índices de consumo entre los estudiantes.

ABSTRACT Introduction: Drug use and its social and health consequences are subject of interest. Students' surveys are epidemiological strategies to monitor this problem, and they are complemented with household and specific population surveys. All this can show in advance some phenomenon that later is visible in general population. Besides drug use trends and patterns, these studies show the influence of other factors that may increase the drugs use and their consequences. Objective: To know the drugs, alcohol and tobacco use prevalences in elementary (5th and 6th grade), middle and high school students (7th-12th grades) of Mexico and its States. Material and methods: This survey is a probabilistic elementary-high school students' survey with national and statal representativity. The study sample had 52 171 elementary students and 114 364 middle and high school students. The information was obtained with a previously standardized and validated questionnaire. Results: The lifetime tobacco use was 30.4% and the average onset age was 13.4 years old. 53.2% has drunk alcohol and 14.5% has binge drinking. Any drug use lifetime prevalence is 17.2%. The preferred drugs are marihuana (10.6%), followed by inhalants (5.8%) and cocaine (3.3%). Discussion and conclusion: The increase in drugs use, specially of marihuana and alcohol, highlights the importance of creating new prevention strategies focused to decrease their use rate among students.