In the course of the last three years, a wide range of epidemiological studies related to drug use has been conducted, both at a national and international level. Talking about national studies in the field of school population, surveys have been conducted in the states of Colima, Nuevo León and Jalisco, as well as surveys in university population, among others. Regarding tobacco use, several studies were made and they covered many cities of the country. About household surveys, the fifth National Addictions Survey (ENA) was carried out in 2008 and it provided data at a national and state level. The Global Survey of Smoking in Adults (GATS) was also made having nationwide coverage. In relation to tobacco use, the trend shows a decrease in the prevalence of consumption. This is shown in ENA 2008 and GATS, as well as school population studies in different states. For alcohol consumption, the situation is different; both for the prevalence and for the proportion of people who start its early consumption, significant increases have been reported throughout the country. Alcohol abuse remains constant and is similar between men and women. When considering the use of illegal drugs, there is an overall increase. As for marijuana, data indicates that its consumption has increased and that it remains as the primary drug of use. However, the main increase is for inhalants, particularly among school population and especially in women. For cocaine, data from United Nations shows a significant decrease in the supply of this substance due to the increase of seizures. Data from ENA 2008 shows that the use of this drug has doubled between 2002 and 2008. The United Nations report indicates that the increase in our country is apparent until 2005 and since then it has been decreasing. Methamphetamine use remains low and it does not increase. Only in the case of the population that goes to service centers for drug users, a high rate of consumption is found. Finally, the consumption of heroin and hallucinogens is low. Chihuahua remains as the state with the most problems in the use of heroine. Most recent surveys have allowed us to see, in general, some of the trajectories in adolescent mental health, where sexual abuse is presented first in women, followed by ADDH, then the consumption of legal drugs, antisocial behavior, use of inhalants and suicide attempt. Then drug consumption, marijuana and cocaine. In men, the sequence is similar, although they face ADDH first and then sexual abuse. In this context, the objective of this study is to assess the prevalence of drug, alcohol and tobacco use, as well as consumption trends in school population from 7th to 12th grade from Mexico City and its political delegations. Method To ensure the comparability with similar studies carried out in Mexico in school population, the methodology used in this study maintains the basic aspects of the previous measurements that have been made in students from 7th to 1 2th grade from Mexico City and other states. The project had the approval of the ethics committee from the National Institute of Psychiatry Ramón de la Fuente Muñiz, and was approved by the educational authorities of Mexico City to be applied in school population. The unit of analysis from which the information was obtained were the students enrolled in 7th to 12th grade in 2008-2009 from public and private schools in Mexico City. The sampling frame was developed based on the official records of the 2008-2009 school year. A non-response rate of 20%, a confidence level of 95% and an average absolute error of 0.004 were considered. The sample design was stratified by level of education (7th to 9th grades and 10th to 12th grades) and political delegations, which gave 32 different strata. It was also clustered by scholar group which was the primary unit of selection. The sample of groups and students were weighted considering the group, educational level and the delegation. A final sample of 22 980 subjects was obtained: 49.8% were female and 50.2% were men. 56.3% of the sample attended to 7th to 9th grades and 43.7% attended to 10th to 12th grades. In addition, most of the male and female adolescents were full-time students during the year prior to the study and only 7% of men and 5.1% of women were not students. 23.3% of men and 11.9% of women worked part or full time, and additionally, most of them had both parents. The information was obtained through a standardized questionnaire, which has been applied in previous surveys and has been previously validated. Due to the extension of the instrument, four forms were used to include various sections, the main part of questionnaire was administered to all subjects and the last two pages corresponded to forms, so each form was applied to one quarter of the sample. Alcohol consumption indicators used are comparable with WHO indicators, international observatories from Europe and the ones used in <<Monitoring the Future.>> Additionally, a significant amount of risk and protective factors related to drug use was evaluated. Results Regarding tobacco use, it decreased from 48.3% to 44.3% compared to the study made in 2006, and men were the ones who had the highest percentage (45.9%) compared with women (42.6%). Additionally, the average onset age is of 12.8 years. As for the current use of tobacco the situation is similar, the percentage is higher in men than in women and is much higher among students from 7th to 9th grades than among students from 10th to 12th grades. In the case of alcohol, its consumption has increased from 68.8% to 71.4%; it was similar in women compared to the last measurement and in men it increased. The prevalence of alcohol abuse decreased from 25.2% to 23.4% compared to the previous survey. However, the students who have taken alcohol had an average onset age of 12.6 years. The problematic alcohol consumption measured with the long version of AUDIT found that in 7th to 9th grades, 1 7.1 % of men and 1 6.3% of women reported having this type of consumption. In 10th to 12th grades, 36.5% of men and 28.5% of women also reported problematic use of alcohol. Regarding dangerous alcohol consumption, 7.2% of men and 6.7% of women presented it in 7th to 9th grades. Students from 10th to 12th grades had higher percentages being of 22.5% in men and 15.3% in women. The study shows a significant increase in drug consumption: during the last three years it has raised from 17.8% to 21.5%. Within each substance use, the consumption of inhalants, marijuana, hallucinogens, and methamphetamines has increased in comparison with the study of 2006. The preference by drug type has changed slightly over the past three years; in men marijuana has the first place of preference (14%), followed by inhalants (10.8%) and in third place of preference is cocaine (4.3%). Women prefer inhalants (10.0%), followed by marijuana (8.8%) and then tranquilizers (5.6%). In terms of additional behaviors evaluated on this study, it is noteworthy that the age of first sexual intercourse decreased by almost half a year in women. All other behaviors (suicide attempt, depressive symptoms, risky eating behaviors, antisocial acts) remained equal. Discussion In this context, the study results show a widespread use of drugs in the population, with major increases specially between women. Adding the presence of other problematic behaviors related to drug use, leads us to make a reflection on the general mental health problems experienced by the population and together they give a guideline for working immediately on various preventive actions. The work made with nursery and elementary boys and girls developing strategies and social skills that enable them to increase their personal and social resources; likewise, working with parents, teachers and health personnel, through positive parenting programs, in groups and teaching them directly effective strategies for interaction and discipline with their children or students under their charge through modeling, are factors that lead to better prevention in most sectors of population. A social policy that allocates more financial and human resources aimed to support these activities must be added to these efforts, especially to support research in general and particularly to support research that leads to develop optimal prevention practices for new generations. Therefore, the importance of translating these elements into action lies in the possibility of having healthier generations and a society with better expectations, approaches and opportunities for growing.
Introducción En los últimos tres años, se ha realizado una amplia gama de estudios epidemiológicos, a nivel nacional e internacional, sobre el consumo de drogas. En cuanto a tabaco, la Encuesta Nacional de Adicciones 2008, la encuesta de GATS y los estudios estatales en población escolar muestran una tendencia importante a la disminución del consumo de la sustancia. Para el consumo de alcohol, tanto en la prevalencia como en la proporción de personas que inicia su consumo temprano, se han reportado incrementos. El abuso de alcohol se mantiene constante y similar entre hombres y mujeres. Al considerar el uso de drogas ilegales hay incrementos importantes. El incremento más pronunciado es el de los inhalables, especialmente en mujeres. En cuanto a la cocaína, la ENA 2008 señala que se ha duplicado el consumo y el informe de la ONU indica que al parecer el incremento se da hasta 2005 y a partir de ahí ha disminuido. Las metanfetaminas mantienen una prevalencia baja. Sólo entre quienes acuden a los centros de servicio para usuarios de drogas se encuentra un alto consumo. En este contexto, el objetivo de este trabajo es evaluar las prevalencias del uso de drogas, alcohol y tabaco, así como las tendencias de consumo en la población de estudiantes de enseñanza media y media superior de la Ciudad de México. Método El marco muestral se elaboró con base en los registros oficiales del ciclo escolar 2008-2009 de la Secretaría de Educación Pública (SEP). Se consideró una tasa de no respuesta de 20%, un nivel de confianza de 95%, con un error absoluto promedio de 0.004. El diseño de la muestra fue estratificado y por conglomerados; la unidad de selección fue el grupo escolar. Se obtuvo una muestra final de 22 980 sujetos y quedó conformada por 49.8% de mujeres y 50.2% de hombres. La información se obtuvo mediante un cuestionario estandarizado, que ha sido aplicado y validado en las anteriores encuestas. Los indicadores de consumo de alcohol, drogas y tabaco empleados son comparables con los indicadores de la OMS, de los observatorios internacionales de Europa y de los usados en <<Monitoring the Future>>. Resultados Con lo que respecta al tabaco, el consumo disminuyó de 48.3 a 44.3% y son los hombres quienes tienen el porcentaje más alto (45.9%) en comparación con las mujeres (42.6%). La edad de inicio promedio es de 12.8 años. En el caso del alcohol, el consumo se ha incrementado de 68.8 a 71.4%; se mantuvo similar en las mujeres y en los hombres se incrementó. En cuanto al consumo problemático del alcohol, medido con el AUDIT versión larga, se encontró que en secundaria, 1 7.1 % de los hombres y 16.3% de las mujeres reportaron tener este tipo de consumo. Para el bachillerato, 36.5% de los hombres y 28.5% de las mujeres reportaron un consumo problemático de alcohol. El estudio señala un incremento importante en el consumo de drogas en los últimos tres años, que de 1 7.8% ha pasado a 21.5%. Al interior de cada sustancia se observa que se ha incrementado el consumo de inhalables, mariguana, alucinógenos y metanfetaminas con respecto a 2006. En este contexto, la preferencia por tipo de droga ha cambiado ligeramente en los últimos tres años, de manera que en los hombres el primer lugar lo ocupa la mariguana (14%), seguido por los inhalables (10.8%) y en tercer lugar la cocaína (4.3%). Las mujeres prefieren los inhalables (10.0%), la mariguana (8.8%) y finalmente los tranquilizantes (5.6%). Discusión Los resultados indican un consumo de drogas importante en la población, con incrementos mayores en las mujeres, lo que debe dar pauta para trabajar inmediatamente en diversas acciones preventivas. El trabajo con los niños/as de preescolar y primaria, desarrollando estrategias y habilidades sociales para incrementar sus recursos personales y sociales, así como el trabajo con padres, maestros y personal de salud, en programas de parentalidad positiva, enseñando por medio del modelamiento estrategias efectivas de interacción y disciplina a sus hijos/as o estudiantes, son elementos que conducirán a una mejor prevención en diversos ámbitos y en la mayoría de los sectores de la población.
