Drug use opportunities and the transition to drug use among adolescents from the Mexico City Metropolitan Area
Introduction
Being presented with an opportunity to use drugs is the first step of drug involvement such that drug use is only possible given exposure to drug use opportunities. Understanding the phenomena of drug use opportunities has been deemed important for understanding the mechanisms of transition from one stage of drug involvement to another (Wagner and Anthony, 2002) and has clear implications for preventive strategies aimed at reducing drug use by reducing drug use opportunities. Furthermore, many factors found to be related to drug use (gender, parental monitoring, etc.) may actually only be related to drug use insofar as they relate to exposure to drug opportunities rather than the decision to use once an opportunity has been presented (Chen et al., 2005, Delva et al., 1999; Van Etten and Anthony, 1999). Reliable data on drug use opportunities in different cultural contexts may account for some of the large variation in drug use prevalence in different countries.
During adolescence the opportunities for drug use increase dramatically as compared to childhood. The lifetime prevalence of illicit drug use among adolescents aged 12–17 in Mexico City is 5.1% for males and 3.0% for females, the drug of choice being cannabis. This is similar to the national estimate of 4.9% for males but greater than the national estimate of 1.6% for females. In the Northern states which border the U.S. and lie on major drug trafficking routes, drug use has risen above the national average (Bucardo et al., 2005). However these estimates are still less than in other non-Latin American countries (Medina-Mora et al., 2003). One possible explanation for this difference is fewer opportunities for use. The only other study on drug opportunities exposure in the Mexican population that we are aware of found one in four students from two Mexico City middle schools to have been exposed to drug opportunities (Wagner et al., 2003). Since only 59% of Mexican youth between 16 and 18 attend school (Secretaría de Educación Pública, 2006), and adolescents in school have less risk of drug use, this data has clear limitations. A study of secondary school students in seven Latin American countries, not including Mexico, estimates that 11% of students have had drug use opportunities (Dormitzer et al., 2004). This compares with 78% of US young adults having an opportunity to try cannabis by age 21 (Chen et al., 2005).
Because of the importance of drug opportunities exposure to the early stages of drug involvement and the paucity of information for the Mexican population, the objective of this article is to estimate (1) the lifetime prevalence and age of first opportunity to use any type of illicit drug among a representative household sample of adolescents aged 12–17 in the Mexico City Metropolitan Area, (2) the prevalence of drug use given the opportunity to use, (3) the time latency between first opportunity and first use, (4) the socio-demographic correlates of having an opportunity to use drugs and (5) the socio-demographic correlates of drug use given the opportunity. The socio-demographic correlates studied include sex, age, student status, parental monitoring, parental educational attainment, parental drug problems and religiosity. These factors are all well-known determinants of substance use (Anthony and Helzer, 2002).
Section snippets
Sample
This survey, the Mexican Adolescent Mental Health Survey, was carried out as part of the World Health Organization's World Mental Health Surveys Initiative (WMHSI, 2005). The survey was based on a stratified multistage probability sample of adolescents aged 12–17 that are permanent residents of the Mexico City Metropolitan Area. Being a permanent resident refers to those who normally eat, sleep, prepare meals, and shelter themselves in private household units thus excluding institutionalized
Sample distribution
The sex and age distribution of the sample is presented in Table 1 with the first column showing the un-weighted sample distribution, the second column the weighted sample distribution and the final column the distribution of the adolescent population according to data from the 2000 Census of Housing and Population (INEGI, 2000) for the Mexico City Metropolitan Area. The most relevant variable for post-stratification was age, since the participants in the survey sample were more likely to be
Summary of the results
One in three adolescents in Mexico City has had the opportunity to try illicit drugs; of those, one in six has done so, the majority when presented with the opportunity for the first time. Males, older adolescents, school drop-outs, and those whose parent has had drug problems are more likely and religious adolescents less likely to have been exposed to drug use opportunities. Given the chance to try drugs, older adolescents and school drop-outs are more likely and those with high parental
Acknowledgements
The Mexican Adolescent Mental Health Survey was supported by the National Council on Science and Technology in conjunction with the Ministry of Education (grant No. CONACYT-SEP-SSEDF-2003-CO1-22) and by the National Institute of Psychiatry Ramon de la Fuente Muñiz (DIES- 4845). The survey was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. We thank the WMH staff for assistance with instrumentation, fieldwork, and data analysis. These
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