Published online Mar 22, 2018. doi: 10.5498/wjp.v8.i1.33
Peer-review started: November 4, 2017
First decision: December 11, 2017
Revised: December 23, 2017
Accepted: January 19, 2018
Article in press: February 8, 2018
Published online: March 22, 2018
We sought to improve on the few existing studies about drug and substance abuse among high school students in Jalisco, Mexico; particularly its association with health, behavior and psychosocial problems in order to provide evidence for possible prevention and treatment needs. Jalisco is an important state in Mexico for its strategic geo-politic location as a narcotic production enclave and a route for drug trafficking directed to the United States, and also because it is a large contributor of documented and undocumented workers to that country. The socio-economic change from a from a production entity to a consumer one could be taking place.
There has not been a published regional or state drug abuse survey performed in Jalisco, a state in the West Central Region of Mexico, for more than a decade. The most recent available information comes from the Mexican National Survey. However, the figures may not apply directly to Jalisco given the significant heterogeneity within this particular region on the one hand and on the other, because of the limitations of the methodology utilized for the national surveys: household and, most frequently, indirect interviews.
The aim objectives were to investigate the prevalence of substance use and associated factors amongst high school students from the Mexican West-Central State of Jalisco, to explore the association between drug involvement and selected psychosocial factors, and to identify treatment and prevention needs.
We designed a cross-sectional survey using a multi-stage, random sample of 2832 high school students, from 25 public high schools distributed in 10 geo-political sub-regions in the State of Jalisco, Mexico. The participants were given a paper-and-pencil survey based upon an adapted version of the drug use screening inventory (DUSI-RM). The DUSI showed adequate psychometric characteristics in this population. The statistical tests included multivariate analyses with logistic regression models to estimate the association of each DUSI-RM domain with the use of tobacco, alcohol, as well as marijuana and cocaine use, while controlling for age, sex, and socio-economic status. The analyses were done with STATA version 10.0 (STATA Corp, College Station, TX, United States).
An estimated 44% of the students had smoked tobacco and 35% of the students reported alcohol consumption within the past-year. The rate of alcohol use was higher among older students, males, and those with higher DUSI scores. By contrast, 6.8% of the students reported having used marijuana, cocaine, or both. Of all 10 DUSI domains behavioral problems, deviant peer affiliation, and troubled families were independently associated with drug use.
The main findings of the present study demonstrate higher rates of tobacco, alcohol , and illegal drug use among high school students in Jalisco, Mexico, compared to national rates although similar to those reported for tobacco, alcohol, and marijuana in México city, the largest city in the country. Appropriate interventions for the use of both legal and illegal substances in young people should be planned and executed accordingly. New prevention efforts are urgently needed to target youth at the early stages of drug use to stop or delay their further involvement. These results suggest that there is an epidemiological transition in the prevalence and patterns of drug use in the state of Jalisco which could be influenced by geographical and economical factors like the local production of legal (alcohol) and illegal drugs (marijuana and methamphetamines). This is the first study representative of the West Central area in Mexico. These data corroborate national trends of increased prevalence of illegal drug use and, in some cases (cocaine), even higher rates. The results however, are similar to those from studies conducted in Mexico city, the largest city in the country. Some areas of the country, like Jalisco, may be changing from a predominantly productive area to a mixed productive-consumer area. We conducted a study in an area with a relatively high production of illegal drugs (marijuana and synthetic drugs) and obtained results of higher use rates than the national surveys and comparable to those obtained in the largest urban area of the country (Mexico city). Similar studies should be conducted in other high and low production areas to investigate the influence of production factors on drug use prevalence. With this study we could confirm the hypothesis that the prevalence of drug use in the State of Jalisco was higher than that reported in national surveys. One of the reasons for those differences could me in the methods employed confidential direct anonymous questionnaires in this case compared to home indirect interviews in the national surveys. The methodology used for designing and conducting drug and substance use national surveys should be improved.
We suggest that epidemiological studies by independent researchers with up-to-date methodology, similar to the one presented herein should be conducted in other Mexican states independently from official national surveys.