Prevalence of cannabis use in Brazil: Data from the I Brazilian National Alcohol Survey (BNAS)

Aims

To estimate the prevalence of cannabis use in the last 12 months in the Brazilian population and to examine its association with individual and geographic characteristics.

Design

Cross-sectional survey with a national probabilistic sample.

Participants

3006 individuals aged 14 to 65 years.

Measurements

Questionnaire based on well established instruments, adapted to the Brazilian population.

Findings

The 12-month prevalence of cannabis use was 2.1% (95%CI 1.3–2.9). Male gender, better educational level, unemployment and living in the regions South and Southeast were independently associated with higher 12-month prevalence of cannabis use.

Conclusion

While the prevalence of cannabis use in Brazil is lower than in many countries, the profile of those who are more likely to have used it is similar. Educational and prevention policies should be focused on specific population groups.     

Cocaine Use in a National Sample of U.S. Youth (NLSY): Ethnic Patterns,Progression, and Predictors

This chapter investigates patterns of cocaine use and selected risk factors for Whites, Blacks and Hispanics in 1984 in a national sample aged 19-27, the National Longitudinal Survey of Youth (NLSY). Three issues are examined: the prevalence of the use of cocaine and other drugs; the order of initiation into the use of cocaine and other illicit drugs; and the predictors of cocaine use among young adults.     

Risk of Cocaine Use and Dependence

Data were obtained from the preliminary files (N = 8,038) of the 1985 National Household Survey on Drug Abuse (NHSDA). The analysis was restricted to 435 adults between the ages of 18 and 54 who had used cocaine in the past year. The questions in the survey were a subset of the Diagnostic Interview Survey (DIS). Odds ratios were computed by logistic regression using Logist. It was estimated that almost 1.6 million of the household population met DSM-III criteria for use, dependence, or combined use and dependence.     

Trends and Developments in Cocaine Use in Canada

Cocaine use began in Canada in the early 1970s. Cocaine users now represent about 20% of drug users in treatment and large numbers have been recently convicted for cocaine-related offenses. In general, cocaine use is now at a relatively low level in Canada, but there is a substantial cocaine and crack use problem. Rates of use are highest among students, young males and those in large cities. Use is declining among students and adults. Continued monitoring is essential.     

Alcohol consumption in late-life--the first Brazilian National Alcohol Survey (BNAS)

To investigate the alcohol consumption in later life in Brazil and its association with socio-demographic characteristics. This study was a cross-sectional analysis of nationally representative survey data. A multistage cluster sampling procedure was used to select 3007 individuals of 14 years of age and older from the Brazilian household population. In this study we analyzed data from all 400 participants who were over 60 years old. Alcohol Abuse and Dependence Syndrome was established according to DSM-IV and Risky Drinking was defined in two ways: heavy drinkers (>7 drinks/week) and as binge drinkers (>3 drinks/one occasion). Twelve percent of participants reported heavy drinking behavior while 10.4% and 2.9% were binge drinkers and alcohol dependent respectively. In the adjusted logistic regression only gender was associated with heavy drinking behavior. Males, the youngest and the wealthiest were more likely to report binge drinking behaviors. In conclusion, alcohol related-problems are common but under recognized among older adults. Health professionals should be aware that common definitions of alcohol abuse and dependence may not apply as readily to older people, who have had biological changes for alcohol tolerance and its effects on the Central Nervous System.     

Epidemiological Indicators and Ethnographic Realities of Female Cocaine Use

This study is an ethnographic examination of differences in the male- to-female ratio among cocaine users in epidemiological indicators from emergency room departments, local drug-user treatment programs, and the pretrial detention center. In-depth interviews were conducted with female cocaine users. The lower female ratio in drug treatment and emergency department sources seems related to barriers to drug-user treatment for women and the image of emergency departments as an extension of the criminal justice system. The women's involvement in visible illegal activities and their perception as easy arrestees may explain the arrestee data ratio. The findings indicate that epidemiological indicators may misrepresent the gender distribution among drug users.     

Development of a Drug and Alcohol Information Survey

Psychological measurement in regard to using drugs, alcohol, or other substances should attend to personological, attitudinal, and informational factors. Standardized tests are available for assessing personological and attitudinal variables, but not for knowledge. To develop a test of information, 45 multiple-choice items were correlated with total and part scores in samples of 132 men and 71 women; 35 items with significant (p<.05) coefficients and other desirable properties were retained for a Drug and Alcohol Information Survey (DAIS). For 33 male and 36 female college students participating in an intensive psychological assessment program, scores on the DAIS were positively associated with (1) ratings of modernity, sensation seeking, originality, and nonorderliness; (2) personality scales for status propensity, sociability, social presence, and rebelliousness; and (3) a nonverbal test of field-independent cognitive ability. High scorers on the DAIS also reported more frequent use of marijuana, alcohol, and tobacco than did students with low scores.     

Comorbidity and Global Functioning (DSM-III-R Axis V) in a Brazilian Sample of Cocaine Users

We assessed the mental disorders rate in treatment-seeking, non-intravenous cocaine users in a Brazilian outpatient clinic, and evaluated how comorbidity affects global functioning. Fifty male nonintraveneous cocaine users from an outpatient clinic were interviewed with semistructured instruments based on DSM-III-R criteria. All subjects met the DSM-III-R criteria for “cocaine abuse” or “dependence” during the last 6 months. The lifetime Axis I or Axis II disorders rate was 69%, with a higher prevalence of anxiety disorders (31%) and depressive disorders (20%). By using a multivariate analysis, the number of personality disorders, the number of psychiatric diagnoses, and the presence of depressive and anxiety disorders were found as significant factors associated with poor global functioning among nonintraveneous cocaine addicts.     

Cocaine-Profiles,Drug Histories,and Patterns of Use of Patients from Brazil

We studied profiles and drug histories of 294 cocaine users from 15 treatment services in São Paulo, Brazil during 1996-1997. Mean age of subjects was 27 years, and 90% were male. Over 50% had used five different substances apart from cocaine, usually tobacco, alcohol, cannabis, tranquilizers, and solvents. Mean age at first cocaine use was 18.9 years by which time 87% had snorted the drug. Thirty-two percent had injected cocaine, 82% had smoked crack, and 74% reported a full route transition. Sixty-three percent reported daily cocaine use. Median duration of cocaine use was 6.3 years. Acts of acquisitive crime were common, and 56% had been arrested. Our finding are discussed in terms of implications for prevention and treatment.     

Cocaine Use in Arrestees: Refining Measures of National Trends by Sampling the Criminal Population

Estimates of drug use in the United States are typically computed from surveys of household members or students. The Drug Use Forecasting (DUF) program estimates drug use in arrestees in the nation's largest cities, using self-reports and urinalysis. DUF results show high rates of recent cocaine use in arrestees. A more accurate picture of U.S. drug use trends requires objective measures in criminal and hidden populations in addition to household members and students.     

"Crack,Cocaine and Heroin: Drug Eras in Williamsburg,Brooklyn, 1960-2000"

This article traces the development of crack markets in Williamsburg, Brooklyn in the period 1980-2000. It seeks to explain why crack appeared so late on the scene there and why, when it did, its markets were different from those found in many other neighborhoods. The article is based upon more than 20 years of ethnographic observations in Williamsburg and adjacent neighborhoods, and upon in-depth interviews with drug distributors, users and neighborhood residents. While other areas had their own patterns, the crack scene in Williamsburg was especially affected by the heroin-and-cocaine era that preceded it. A full understanding of both of these eras - the heroin-and-cocaine era of the 1970s and early 1980s and the crack era of the late 1980s and early 1990s - requires an accounting of how local, regional, national and international forces intersect to produce different market structures and different drug "epidemics" and outcomes. This work demonstrates how local-level changes in consumer demand for a variety of drugs, evolving patterns of use, and the locally specific community structure affect the social organization of drug distribution and have a historical dynamic that both precedes and determines the story of any single drug in any locale.     

Gender Differences in the Use of Alcohol and Psychotropics in a Brazilian Population

This cross-sectional, interview-based survey aimed to assess the use of licit substances in terms of gender and sociodemographic factors in the city of Pelotas, southern Brazil. Subjects aged 15 years and over and living in urban areas were eligible and a total of 1277 subjects were interviewed. The prevalence of alcohol consumption was 54.2%; 11.9% (21.7% of men and 4.1% of women) reported potentially harmful levels of alcohol use (“at-risk alcohol intake”); 4.2% were classified as manifesting alcohol dependence by CAGE questionnaire. At-risk alcohol intake and subjects with a positive CAGE score were more common among males aged 35–54 yrs. Among the youngest age group, the prevalence of CAGE positive score was similar for males and females, while subjects with lower educational levels showed a higher prevalence. Women were more likely than men to report the use of psychotropic drugs (15% vs. 7%). These results highlight the importance of substance use in Brazil, and suggest that gender differences must to be taken into consideration when planning intervention programs in developing countries.     

Estimating Local and National Problem Drug Use Prevalence from Demographics

Objective:?To assess the applicability and validity of the Multiple Indicator Method for combining sparsely available local prevalence estimates of problem drug use into a national estimate. Method?:?Local estimates of problem drug use were available in seven out of the 27 addiction treatment regions in the Netherlands. Using demographic variables as predictors and under varying regression model specifications estimates were obtained for the remaining 20 regions and aggregated into national ones. These outcomes were compared with one obtained with the methodologically unrelated Treatment Multiplier Method. Results:?All results point to a prevalence of 0.32% in the population of 15–55 years (or 0.27% in the population aged 15–64). Discussion:?The applicability and validity of the Multiple Indicator Method – and adaptations thereof – for getting regional and national prevalence estimates from incomplete data remains subject of further research. However, the results found here and elsewhere more than justify an interest in future research efforts.     

The Dynamic Relationships of the Cocaine System in the United States

The nonlinear effects of cocaine availability, the potential user population, price, and purity on cocaine consumption are defined and incorporated in a dynamic simulation model. Confidence in these relationships is supported by the model's behavior which closely replicates the historical performance of the US cocaine system from 1975 to 1982. The model may be adapted for regional applications and to countries other than the United States.     

Factors Influencing Initiation of Cocaine Use Among Adults: Findings from the Epidemiological Catchment Area Program

This study assesses the effect of a number of risk factors on the initiation of or progression in cocaine use using longitudinal analysis of data from the Epidemiological Catchment Area Study. Evidence is presented showing that depression is associated with initiating cocaine use. Becoming employed is positively associated with the risk of cocaine initiation.     

Prevalence and Correlates of Alcohol Abuse and Dependence in Lebanon: Results from the Lebanese Epidemiologic Survey on Alcohol (LESA)

The current article aimed to determine the 12-month prevalence and correlates of DSM-IV alcohol abuse and dependence in a nationally representative sample of Lebanese adults. One thousand participants collaborated in face-to-face interviews in 2011. Prevalence of 12-month alcohol dependence was 5%, with a higher risk for those who were men, unmarried, the youngest adults (aged between 18 and 34 years old), students, participants with a liberal occupation, participants with a low income, participants with a positive family history of alcohol misuse, and smokers. Prevalence of 12-month alcohol abuse was 6.2%, with a higher risk for those who were men, students, employees, and Druze and Christians compared to Muslims. Current alcohol abuse and dependence were found to be very highly prevalent in Lebanon.     

Exploring the Relationship Between Race and the Use of Cocaine

Abstract

In 1986, Congress passed the Anti-Drug Abuse Act, legislation that provided harsh new penalties for violations involving crackcocaine. Penalties for powdercocaine offenses, however, were not altered proportionally. This legislation has been denounced on the premise that it unfairly targets minority offenders who are presumed to use crack cocaine more than its powder counterpart. To date, however, only a small body of scholarly research has examined the relationship between race and the preference for crack versus powder cocaine, and no studies have examined this nexus over time. In the present study, a temporal exploration is undertaken with a sample of 6,732 adult Houston arrestees surveyed through the Drug Use Forecasting (DUF) Program between 1990 and 1994. Logistic regression identified that the two most powerful predictors of self-reported three-day powdercocaine use were being white and ever having injected drugs illegally. The two most powerful predictors of self-reported three-day crackcocaine use were being black and ever having injected drugs illegally. While being white was a strong predictor of three-day powdercocaine use each year between 1990 and 1994, the association between being black and having recently used crackcocaine diminished considerably over time. Legal implications are assessed in light of the current findings.     

DSM-5 Tobacco Use Disorder and Sleep Disturbance: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III)

Introduction: The DSM-5 Tobacco use disorder diagnosis incorporates tobacco misuse, addictive behaviors and withdrawal symptomology. Tobacco use is bidirectionally associated with sleep pathology; however, no epidemiological studies have yet evaluated the associations between DSM-5 Tobacco use disorder and self-reported sleep disturbance. The current study aimed to evaluate health, medical and sleep-related factors among individuals within this diagnostic stratum. Method: A total of N = 36,177 adults who participated in the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) were included for analyses. The adjusted odd ratios (AOR) for individual classifications of DSM-5 Tobacco use disorder among those with subjective sleep disturbances were used as the primary outcome measure and relevant demographic, clinical and medical factors were considered in all univariate and multivariable analyses. Results: Current and lifetime DSM-5 tobacco use disorder diagnoses were associated with poorer health and medical outcomes and higher rates of subjective sleep disturbances (all p < 0.001). Associations between current and lifetime DSM-5 tobacco use disorder and subjective sleep disturbances were maintained in multivariable analyses following adjustment for a range of health, lifestyle, and psychiatric factors (adjusted OR 1.11, 95%CI 1.00–1.23 and adjusted OR = 1.24, 95%CI 1.15–1.34, respectively); however, these relationships were fully explained by diagnoses of DSM-5 alcohol use disorder. Conclusions: Data from this large, representative survey indicate that the association between DSM-5 Tobacco use disorder and sleep disturbance is explained by underlying diagnoses of DSM-5 alcohol use disorder. Multifaceted substance abuse treatment protocols may improve treatment outcomes for affected patient groups.