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The consumption of psychotropic drugs among Brazilian secondary school students was examined by comparing data from four surveys using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence. Students filled out the form in their classrooms without the presence of teachers. There was also a significant increase in frequent use of alcohol six times or more per month in 6 of the cities, from an average of 9. With respect to illegal drugs, there was a significant increase in lifetime use of marijuana a 3-fold increase from 2. Cocaine use increased 4-fold over the survey period 0. Lifetime use of cocaine significantly increased in eight capitals except Recife and Rio de Janeiro. Lifetime use of medications such as anxiolytics and amphetamines increased 2-fold on average over the survey period. Comparing the four studies, the main conclusion is that there were significant increases in the frequencies for lifetime use, frequent use and heavy use of many drugs. Trends in drug use among students in Brazil: analysis of four surveys in , , and Patients and Methods. There is widespread concern about drug use among students in many parts of the world. An indication of the magnitude of this use may be obtained from epidemiological surveys, which are essential to the framing of public policies and are internationally acknowledged as useful Many regional studies in Brazil have expressed concern over the use of psychotropic drugs among students Unfortunately, surveys tend to use different instruments so it is not always possible to compare their findings; furthermore, there are methodological problems involved in some studies. In , and , three further studies were performed using the same methodology and in the same cities, thus enabling us to compare student drug use at different points in time. A comparison of the findings of these four surveys is extremely important to understand the behavior of Brazilian students concerning psychotropic drugs over time. This paper reports on trends in drug use among Brazilian students and compares results from four nationwide prevalence studies. CEBRID used the same questionnaire for the four surveys in the same cities which was anonymously filled out in classrooms without the presence of teachers, after the organizers had briefly explained the aims of the survey. Students were free to answer in any way or to hand in a blank questionnaire. The questionnaire collected socio-demographic data gender, age, school grade, socioeconomic level , frequency of school attendance, use of non-prescription psychotropic drugs anxiolytics, amphetamines, anticholinergics, barbiturates, codeine-based cough syrups, and opiate analgesics , alcohol, tobacco and illegal drugs inhalants, marijuana and cocaine. A fictitious drug was included in the questionnaire to test for authenticity. Socio-economic status was measured using the scale of the Brazilian Association of Market Survey Institutes, which is based on consumption items and on the educational level of the head of the household. The scale classifies respondents in classes A to E, with A being the highest and E the lowest. Sampling was clustered by school and stratified for different neighborhoods in each city and their socio-economic characteristics into two stages, first by school then by class as proposed by Kish Data correction basically included three separate sub-phases. Since all questions contained several items, split-half reliability testing was applied to eliminate inconsistencies such as answering no to item 'a' lifetime use and yes to item 'b' used in the last year. We checked whether the drug mentioned was psychotropic or not or even if it belonged to the set of drugs in question. Typing errors were corrected, inconsistencies were reviewed manually and drugs were reallocated to their proper categories. All questionnaires containing affirmative responses for the fictitious drug, or containing more than three invalidated or blank responses were excluded from the questionnaire. Better analysis of the data related to psychotropic drug consumption over many years is required, in the form of a sequence of events. This presentation enables us to analyze developments and detect future trends. Therefore, the chi-square test for trends with a 5. This test is used 'if the table of data has two columns and three more rows or two rows and three or more columns , and the categories can be quantified' 19, This test determines 'whether there is a linear trend between row or column number and the fraction of subjects in the left column or top row ' Data were presented in an expanded form. In probabilistic sampling such as that used for the four surveys, results may be expanded to the entire population surveyed using sample weighting. The expansion fraction was the result of division of the total number of classrooms by the number of schools sampled. The sample design predicted that each student would have the same probability of being selected 19, Sample sizes were 16, in , 19, in , 24, in , and 15, in A larger number of female students were included in all four surveys, which is in line with the proportions recorded by the census in Brazil. In the fourth survey, Table 1 shows the frequency of lifetime use of psychotropic drugs in general by city. Nevertheless, taking the ten cities as a whole last line in Table 1 , it may be inferred that there was no change in the lifetime use frequency over the four studies. On the other hand, Figure 1 shows that inhalants were most frequently indicated as 'lifetime use' in all four surveys , , and , excluding tobacco and alcohol from the analysis. Note that, with the exception of Porto Alegre, where marijuana appears for the first time as the most frequently used drug for lifetime use, in the other cities surveyed, inhalants continued to be the drugs most frequently used for lifetime use. Among the six most frequently used drugs, a statistically significant increase in the number of students using these drugs was observed for three of them - marijuana, anticholinergics and cocaine. Noto, S. Nappo and E. Brazilian Journal of Medical and Biological Research, 37 4 : , The analysis of the frequency for lifetime use of drugs by sex comparing the four studies can be seen in Table 2. Table 3 shows drug consumption in general lifetime use by age group in the four surveys. No changes were observed over the years in any of the age groups studied. The most significant percentage of users was detected among students older than There were some extremely high percentages among very young students who had already used some kind of psychotropic drug during their lives. In a total of In the study of the lifetime use of psychotropic medications for the ten cities as a whole, there was a statistically significant increase in the use of amphetamines and anxiolytics. The same applied to marijuana and cocaine when comparing the four studies Table 4. Note also that lifetime use of alcohol and tobacco remained relatively stable in the comparison between the four surveys Table 4. The analysis of the frequent use trend in general six or more times in the 30 days preceding the survey for the ten cities is shown in Table 5. Table 6 illustrates the frequency of frequent use in percentage for the seven drugs most used by the students. Comparison of the four studies indicated that there was an increase in the frequent use of marijuana, amphetamines, anxiolytics and cocaine in the analysis of the 10 cities as a whole. Although inhalants showed the highest percentages for lifetime use, their frequent use remained stable between 1. Legal drugs followed the same trend as inhalants, and their frequent use varied from Concerning the use of heroin, 12 students in a universe of over 15, reported having injected this drug. Figure 1. Comparison among the surveys , , and for the six most used drugs in ten Brazilian capitals. There was a steep decline in percentage rates when analyzing lifetime use compared to heavy use. Lifetime use of alcohol and tobacco remained stable over the four surveys, although the percentages were always substantial, e. These numbers are far in excess of the usage of the other drugs and show that in Brazil the major public health problem concerning drug use involves legal drugs. Any prevention program must necessarily include these two substances. As far as the other drugs are concerned, comparison of the four surveys shows an upward trend in frequent use defined as more than six times per month for many drugs in many cities. It is important to emphasize that the use of marijuana increased in the 10 cities surveyed. Furthermore, for the first time ever, the Porto Alegre data showed that lifetime use of marijuana moved into first place in front of inhalants, which were relegated to second position. Inhalants have traditionally been the most widely used drugs in lifetime use. In this respect, the Porto Alegre data resemble those reported in many studies conducted in other countries such as the United Kingdom, Denmark, France, Spain, Portugal and the United States 22, In an attempt to explain changing frequencies of the use of marijuana in terms of lifetime use and heavy use, one must understand the behavior of young people towards drugs in general, since until recently there were many taboos and prejudices attached to drugs. One of the hypotheses that can be raised to explain this increase in consumption is that young people may feel freer to admit to a habit that has always been relatively frequent despite not being reported in surveys. The media has been taking a less prejudiced approach to marijuana users and different segments of the population have been involved in broader discussion of making the use of marijuana non-criminal. Another hypothesis is that the authorities have turned a blind eye to marijuana use, thus contributing to increased consumption. Reinforcing this idea are the reduced numbers of marijuana apprehensions by the Federal Police in recent years, in contrast to cocaine, for which apprehensions and hospital admissions have increased 24, Cocaine use has also grown over the four surveys. Lifetime use of cocaine increased in eight cities except Recife and Rio de Janeiro. Although the final numbers are relatively small, lifetime use of cocaine in was reported by only students 1. However, this 1. Regardless of these findings about the increased use of marijuana and cocaine, it is important to emphasize that the use of inhalants among students still remains an intractable problem and is sometimes overlooked and neglected. It is important to note that these drugs are potential causes of death, and some investigators have stated that use of inhalants is the gateway to the world of illegal drugs 15, In general, reports indicate increased use of psychotropic drugs by males, particularly illicit drugs 15,30, In fact, an analysis of the four surveys clearly shows a distinct preference for marijuana and cocaine among males compared to women. Males are also less fearful of being in contact with crime. Women prefer to make use of drugs in the form of pills, such as anxiolytics and amphetamines. One possible hypothesis for this result could be that females are brought up in a way that induces them to use these medications and are normally praised exclusively for their physical appearance. This 'upbringing' is probably related to the attitudes of their mothers and society in general, which demands that women be 'calm and skinny' These observations on gender-related differences in preference should not be overlooked when devising an effective prevention plan. Analysis of the four surveys on drug use according to the various age groups showed no increasing frequency of lifetime use for any of the age groups. This precocity may lead to a major risk of abusive use or even to future drug dependency. This is the period in their lives when teenagers are most vulnerable to drugs Although Brazil is a country of continental dimensions, no striking differences were observed concerning the use of drugs in general in the cities surveyed, which represent the five geographical regions. However, certain peculiarities were observed in some of the cities, probably due to local habits or to a larger supply of certain drugs. In the three cities in the Northeast Fortaleza, Recife and Salvador an upward trend in lifetime use was observed regarding the use of anticholinergic substances mainly Trihexyphenidyl. This peculiarity of the Northeast region is also seen in studies involving other segments of the population, such as street children Another interesting regional aspect is the use of benzamide an anti-inflammatory and cycloplegic eye drops eye drops with a benzydamine chlorhydrate base used by ophthalmologists to dilate pupils , which is abusively used nasally and presents anticholinergic effects. There is no control over the sale of these medications in this country. It is therefore important to take into account cultural peculiarities in the elaboration of programs of drug abuse prevention. The media has overreacted to a hypothetical 'explosion of heroin usage' in Brazil. This trend was not observed in the present statistical data. This raises the question of whether the media functions as a promoter, popularizing certain drugs. Nevertheless, the determination of whether or not heroin is present in our daily lives is a matter that must be looked into urgently. Finally, another aspect of the results that should be emphasized was the discrepancy between student age groups and school years. Some studies have associated drug abuse with poor school performance, failure to pass to the next grade and dropping out 36, In Brazil the discrepancy between school year and student age is so significant that one cannot draw any conclusions as to whether drug abuse is related to it or not. Nevertheless, we may state that the elementary school system of this country is flawed in many aspects and has no appeal to the students, so that half of the total number of students are not in the school year corresponding to their age group. When comparing the four studies the major conclusion is that there were significant increases in the lifetime use, frequent use and heavy use for many drugs. These results also indicate the need for more regular studies of this nature that will permit us to monitor drug use trends over the years and ensure the means of providing preventive measures which are adequate to our reality. Address for correspondence: J. E-mail: galduroz psicobio. Open menu Brazil. Brazilian Journal of Medical and Biological Research. Open menu. Text EN Text English. Key words: Students, Trends, Inhalants, Cocaine, Marijuana, Surveys, Brazilian students Introduction There is widespread concern about drug use among students in many parts of the world. Qualitative analysis Since all questions contained several items, split-half reliability testing was applied to eliminate inconsistencies such as answering no to item 'a' lifetime use and yes to item 'b' used in the last year. Drug analysis We checked whether the drug mentioned was psychotropic or not or even if it belonged to the set of drugs in question. Statistical analysis Better analysis of the data related to psychotropic drug consumption over many years is required, in the form of a sequence of events. Results Sample sizes were 16, in , 19, in , 24, in , and 15, in Substance misuse among native and rural high school students in Quebec. International Journal of the Addictions , Edwards RW Drug use among 8th grade students is increasing. Salud Mental , Prevalence of volatile inhalant inhalation among junior high school students in Japan and background life style of users. Addiction , Inhalant use in the United States. Substance use among schoolchildren in the north of England. Drug and Alcohol Dependence , Murad JE Drug abuse among students in the State of Minas Gerais, Brazil. Bulletin on Narcotics , Parte II: Meninos de rua e menores internados. Aspectos sociofamiliares do consumo de tabaco por adolescentes escolares da rede privada do Distrito Federal. Souza DPO Zar JH Biostatistical Analysis 2nd edn. Prentice Hall, Inc. National Institute on Drug Abuse Trends in Drug Use Among 8th, 10th, and 12th Grades. Jornal Brasileiro de Psiquiatria , A review of solvent abusers and their management by a child psychiatric outpatient service. Human Toxicology , 1: Inhalant abuse and heroin addiction: a comparative study on opiate addicts with and without a history of sniffing. Addictive Behaviors , A new trend in solvent abuse deaths? Medicine, Science and the Law , Recreational use of inhalant drug by adolescents: a challenge for family physicians. Family Medicine , Barnes GE Solvent abuse: a review. Morton HG Occurrence and treatment of solvent abuse in children and adolescents. Pharmacology and Therapeutics , Early drinking onset and its association with alcohol use and problem behavior in late adolescence. Preventive Medicine , Carlini EA Addiction , News and Notes. The residual cognitive effects of heavy marijuana use in college students. Journal of the American Medical Association , The impact of alcohol consumption and marijuana use on high school graduation. Health Economics , 5: History Accepted 05 Jan Received 24 Apr This work is licensed under a Creative Commons Attribution 4. Figures 1 Tables 6. Stay informed of issues for this journal through your RSS reader. PDF English. Google Google Scholar.

Introduction: Drug Markets and Violence in Recife, Brazil

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Official websites use. Share sensitive information only on official, secure websites. This is an open-access article distributed under the terms of the Creative Commons Attribution License. View full-text article in PMC. Rev Lat Am Enfermagem. Table 2. Absolute and relative distribution of the study population according to the issues related to the consumption of alcohol and other illicit drugs. Recife, PE, Brasil, In the last 30 days, have you consumed at least one drink containing alcohol? How many doses did you drink per day? How did you get the drink you consumed? During your life, how many times have you been drunk? During your life, how many times have you used illicit drugs?

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