People who inject drugs (PWID) and HIV/aids cases in Mexico City: 1987-2015.

BACKGROUND: The purpose of this study is to describe the characteristics of individuals who inject drugs, to explore use trends in the past 25 years, and to review the profile of users of various drugs, both legal and illegal, that have been used intravenously without medical prescription in Mexico City. METHODS: Information was drawn from the Drug Information Reporting System (SRID, 1987-2015) and data from the National Center for the Prevention and Control of HIV/aids (CENSIDA, 1983-2018). SRID is based on two 30-day cross-sectional evaluations carried out during June and November. It has served as an uninterrupted epidemiological surveillance system for 32 years, operating both in health and justice institutions in Mexico City and the metropolitan area. The timely identification of changes in use patterns is regarded as the most consistent tool to track the trajectory of the phenomenon. CENSIDA cases were analyzed based on the number of HIV and aids positive injectable drug users during the same period of time in Mexico City. RESULTS: Cocaine users represented the highest number of cases, with a total of N = 293. Back in 2000, the use of this substance showed a significant increase of up to 50%. In turn, heroine and opiates user trends by sex increased from being almost non-existent in 1987 to 13% in 1994. Results provide evidence of the changes in the number of users over the years, with the largest increases being recorded in 1996 (16.5%), 1999 (17%), and 2010 (13%). CONCLUSIONS: The increase observed in the results coincides with domestic and world political situations that have caused an upturn in the use of some substances over the years. It is not far-fetched to think that in the coming years there will be an increase in the number of individuals who inject drugs due to the high production and availability of heroin in Mexico and the emergence of fentanyl use as indicated by ethnographic research in Mexico City and the deaths linked to its consumption. The latest reports, published in 2018, documented at least five cases of fentanyl users.

Activo distribution and paraphernalia among "street children" / Distribución del activo y la parafernalia entre "niños de la calle"

Abstract Introduction The use of solvent inhalants has been documented in Mexico since the 1970s. Nevertheless, very little is known about the distribution and use dynamics among "street children". Few have ventured to study this issue because of the difficulties involved in working with marginalized, relatively inaccessible populations. Objective To analyze the distribution and consumption dynamics of activo, as it is known among street children in downtown Mexico City, and to document the paraphernalia and argot associated with these practices. Method This is a qualitative, descriptive, and interpretative study guided by the "Meeting Place" approach used by Hughes (1977), which has been adapted to Mexican population by Ortiz (1979). We also used ethnographic observation techniques and a social and immersion mapping of street spaces that allowed us to contact and relate to both informants and users. Results We identified activo distributors and storage areas; user groups were made up of men and women in a 7-3 ratio; physical and psycho-social characteristics of sellers and users, and some street argot and paraphernalia that allowed us to understand the dynamics of distribution and consumption. Discussion and conclusion The activo market is both captive and hidden; it is detrimental to the physical and mental health of street children, and is fostered by social exclusion and the lack of legislation.

Resumen Introducción El consumo de solventes inhalables se ha documentado en México desde la década de 1970; sin embargo, poco se sabe sobre la dinámica de distribución y consumo entre los "niños de la calle". Este tema se ha estudiado poco por las dificultades inherentes al trabajo con poblaciones marginales y de difícil acceso. Objetivo Analizar la dinámica de distribución y consumo del "activo" entre los "niños de la calle" de la zona centro de la Ciudad de México, así como documentar la parafernalia y el argot asociados a estas prácticas. Método Es un estudio de tipo cualitativo, de carácter descriptivo-interpretativo, guiado por el enfoque llamado "Lugares de Reunión" empleado por Hughes (1977) y adaptado a población mexicana por Ortiz (1979). También se emplearon técnicas etnográficas de observación, mapeo social e inmersión en los espacios de calle, que sirvieron para contactar y establecer un vínculo con los informantes y consumidores. Resultados Se identifican distribuidores y zonas de almacenamiento del activo; grupos de consumidores formados por hombres y mujeres en una proporción de 7 a 3; signos físicos y características psicosociales de vendedores y usuarios, así como el argot y parafernalia; lo que permite comprender la dinámica de distribución y consumo. Discusión y conclusión El mercado del activo es cautivo y oculto, deteriora la salud física y mental de los "niños de la calle" y es promovido además por la exclusión social y la falta de legislación.

El consumo de solventes inhalables en la festividad de San Judas Tadeo / Solvent inhalants use in the San Judas Tadeo feast

INTRODUCCIÓN: A San Judas Tadeo se le considera en México el patrón de las causas difíciles y desesperadas. Entre las creencias populares, se piensa que los "niños en situación de calle" se acogen a él para que les proteja y ayude a dejar de consumir drogas. OBJETIVO: Conocer el espacio social del uso de solventes inhalables en el marco del culto a San Judas Tadeo, a partir las prácticas y experiencias vividas con los niños en situación de calle de la zona del Centro Histórico de la Ciudad de México. MÉTODO: Se aplicó la metodología conocida como "Lugares de Reunión" propuesta por Hughes y adaptada por Ortiz, en un periodo de trabajo que abarcó del año 2011 a inicios del 2014. Se utilizó la observación no participante y la participante, así como la entrevista no estructurada a informantes no calificados, a calificados y a clave. RESULTADOS: Se documentaron 22 celebraciones del día de San Judas incluyendo dos fiestas anuales. Se entrevistaron a más de 300 usuarios de solventes inhalables y los resultados mostraron, entre otras cosas, que la edad promedio es de 25 años, que se desempeñan en subocupaciones informales y a la mendicidad en la vía pública. Todos consumen activo, pero con diferencias en la intensidad, con periodos alternantes de consumos altos y bajos y consideran que es prácticamente imposible dejar de consumirlo. DISCUSIÓN Y CONCLUSIÓN: El vínculo entre el consumo de inhalables y el culto a San Judas Tadeo en los niños en situación de calle, es ficticio.

INTRODUCTION: San Judas Tadeo is the patron saint of the difficult and desperate causes. Among popular beliefs, it is supposed that street kids pray to him and that he helps them quit the use of drugs. OBJECTIVE: Understanding the phenomenon of the misuse of solvents in the context of the san Judas Tadeo festivity among street children living in the Historical Center zone of Mexico City. METHOD: The "Meeting places" methodology developed by Hughes and adapted by Ortiz was applied from 2011 to 2014. Non-participant and participant observations, as well as unstructured and structured interviews to key informants were conducted. RESULTS: Twenty-two festivities of san Judas Tadeo were documented, and more than 300 solvent users were interviewed. The average age was 25 years. They were unemployed and begged for money. All of them were activo users which they administered with monas. They usually did it in binge patterns: use - non use, high - low use. DISCUSSION AND CONCLUSION: The link between the consumption of inhalants and the cult of St. Jude in children living in the streets is fictitious.

Poppers, una droga emergente: Resultados del Sistema de Reporte de Información en Drogas

Introducción En la Ciudad de México, de acuerdo con los resultados del Sistema de Reporte de Información en Drogas SRID, los primeros reportes del uso de poppers datan de 1988 y paulatinamente ha ido incrementado su consumo. Objetivo Dado que una de las finalidades del SRID es identificar nuevas drogas y áreas que requieren investigación más detallada, se realizará un estudio descriptivo a fin de conocer las características asociadas a su consumo. Material y método Para evaluar el consumo de poppers se analizaron los datos recopilados por el Sistema de Reporte de Información en Drogas durante el periodo 2000-2012 I; así como las tendencias de uso durante 24 años. El instrumento utilizado es la Cédula "Informe Individual sobre Consumo de Drogas" que se aplica en Instituciones de Salud y de Justicia del Distrito Federal durante los meses de junio y noviembre de cada año. Resultados Entre los resultados más relevantes se destaca que el consumo de poppers se presenta en el grupo de adolescentes de 15 a 19 y en los adultos jóvenes de 20 a 24 años. Otro de los datos sobresalientes son las edades de inicio del consumo de esta sustancia, así como la frecuencia con la que se consume. Conclusiones A partir de los resultados encontrados, es necesario plantear líneas de investigación que permitan conocer el consumo de esta sustancia en población joven.

Introduction In Mexico City, according to the results of the Information Report System in Drug SRID, the first reports about the use of poppers date from 1988. The consumption of poppers has gradually increased throw on the years. Objective Given that one of the purposes of the SRID is to identify new drugs and areas that require further investigation, a descriptive study was performed to determine the characteristics associated with the consumption of poppers. Materials and methods To evaluate the use of poppers, data collected by the Information Reporting System on Drugs will be analyzed, during the period 20002012 I, as well as the trends in use for 24 years. The instrument used is the card "Individual Report on Consumption of Drugs", which is applied in health and justice institutions of the Federal District during the months of June and November of each year. Results The most relevant results among poppers consumption occurs in the group of adolescents from 15 to 19 and young adults aged 20-24 years. Another outstanding data are the ages of first use of this substance, and the frequency with which it is consumed. Conclusions From the results, it is necessary to propose research lines that reveal the use of poppers in young people.

Tendencias del uso de drogas en la Ciudad de México (1986-2003). Sistema de reporte de información sobre drogas

resumen está disponible en el texto completo

Abstract: Introduction: Currently, there are a number of methodological alternatives to find out the dynamics, the extension and the levels of drug use in the general population. The trends on drug use in our country llave registered important variations in the last 25 years. Among the most outstanding of these trends are: the high and stable use of marijuana, the increase in cocaine use and a decrease in the use of inhalants. Recently an increase in the use of these stimulants has been registered. The different studies show that these trends present some variations, since different group populations with different characteristics have been studied. This is the case of the data obtained by the Drug Information Reporting System -IRSD-which detects users with specific characteristics (regular drug users and advanced cases of addiction). Based on the facts mentioned above, the intention of this article is to present the main trends on drug use in Mexico City within the period between 1986 and 2003, according to the drug Information reporting System -DIRS- and to analyze these trends compared to other studies with different types of population. Background: The Information Reporting System on Drugs IRSD is a mechanism used to obtain data coming from diverse agencies that are related to the problem of the use of drugs; such agencies belong to the health sector or to the agencies of law enforcement. The main advantages of this type of systems are a low cost of operation -since it works with the infrastructure of the institutions that mainly conform the system- its easy application and that it provides current and fast information on the phenomenon. The continuous operation of the IRSD allows the accumulation of data with a sequence which makes possible the analysis of the trends on drug use, the identification of new groups at high risk and new drugs in the market. It also allows to identify the design of the preventive actions derived from the continuous analysis of information coming from its data bases. Mexico City has its own Drug Information Reporting System -IRSD- since 1986 coordinated by the National Institute of Psychiatry Ramon de la Fuente. Its objective is to count on a periodic and homogenous source of information which can be used as a diagnosis tool to design suitable programs of prevention appropriate to the Mexican population from a health perspective. The IRSD carries out semester evaluations of the phenomenon and has done now a total of 34. Method: Sample description: IRSD information between 1986 and June 2003 was used. This data base is conformed by 16,377 studied cases. It is a considered as «case¼ any person who recognizes to have consumed at least once in life some drug with the deliberate purpose of being intoxicated. The cases are also excluded from accidental or occupational exhibition and when only alcohol and tobacco have been consumed. Instrument: The Information is obtained from an individual scale applied twice a year, in health and justice agencies. This schedule collects information on the following aspects: socio-demographic profiles of the users, the reason for entering the institution, problems associated with the drug use and patterns of consumption of 12 drugs. For this article, only the information corresponding to the pattern of consumption was used to identify the trends. The analysis includes the information compiled by the IRSD during the period of 1986 and the first semester of 2003. Procedure: The instrument is applied twice a year, in periods of 30 days, during the months of June and November to any one who uses drugs and has entered the health and justice agencies for such reason. Once the period of information gathering is over, the applied instruments are sent by all the participant institutions to the National Institute of Psychiatry for their processing and analysis. Finally, the results are reintegrated into a report which is distributed among the participant institutions and people interested in this problem. Results: The analysis of the trends on drug use observed by the IRSD during the period 1986-2003 shows the following: Marijuana and inhalants reach the level of higher consumption for all drugs until the second semester of 1997. In the following years there is a decrease for these substances, particularly for inhalants. The trend of cocaine use shows significant changes. The first important increase in the levels of use was observed between the years of 1993 and 1997. At the end of this period the use of cocaine was reported by every 40 of 100 users. The following year this proportion went up to 63, which represents an increase of more than 50 per cent. From this year and up to date the trend shows a stable behavior with similar levels of use. In regard to hallucinogens low levels of consumption have been observed, during the 15 years of evaluation by the IRSD. Approximately five of 100 cases report their use by semester. Sedatives and tranquilizers show the highest increase during the first semester of 1993, with 28 users for every 100 cases; since then a decrease in consumption has been observed. The consumption of stimulants has presented a very irregular trend through the evaluations. For heroin use a very low percentage of consumption is observed with one out of every 100 cases. There was a slight increase only in two evaluations during the first semester of 1992 and 1993. Conclusions: The most outstanding results regarding the tendencies of consumption of addictive substances is the increase of cocaine use at the beginning of the nineties and has always showed a tendency do increase. In the last evaluation certain stability in its consumption, is observed, at least in the last two years. It is important to emphasize that the increase in the consumption of cocaine may probably be associated to its availability in Mexico as well as that for its derivatives. Equally significant within this period of evaluation is the decrease of inhalant consumption, specially during 1999. Some studies show a possible substitution of these substances by cocaine and or its derivatives. The trends of drug use provided by the IRSD must be interpreted taking into account that the drug user population included in the evaluations belongs to a sector that does not represent the whole universe of users in the general population. However the trends of drug use reported by the IRSD are in agreement with those reported by the surveys in general and school population, where marijuana, cocaine and inhalants were reported as the drugs of greater use among the Mexican population. It is important to note that when the lack of financial and or human resources become real obstacles to carry out sophisticated, extensive periodic studies to evaluate drug use, a system of this type is a valuable alternative for the developing countries.

El Sistema de Registro de Información sobre Drogas: un auxiliar diagnóstico en la evaluación de la farmacodependencia / The Drug Information Registry: a complementary diagnostic tool to evaluate pharmacodependence

El presente trabajo tiene como objetivo dar a conocer la utilidad del Sistema de Registro de Información sobre Drogas como fuente diagnóstica importante para la evaluación del fenómeno de la farmacodependencia en la Ciudad de México. Incluye una breve descripción del soporte metodológico de este sistema, se presentan de manera sintetizada algunos de sus resultados y se discute la importancia de sus datos como material de apoyo para el establecimiento de políticas en materia de investigación y prevención del problema. Se comentan las ventajas de contar con un sistema de este tipo sobre todo porque en nuestro país no existe un sistema de notificación obligatoria de uso de drogas.