Diagnosis of macrosocial risks of drug use in Mexican municipalities / Diagnóstico de riesgos macrosociales del consumo de drogas en municipios de la República Mexicana

Abstract Introduction Factors associated with drug use are defined in terms of their proximity to the phenomenon and can be classified as individual, microsocial, and macrosocial. Macrosocial factors include variables of a geographic, economic, demographic, and social nature, which can be compiled from population censuses and surveys. Objective To determine the levels of risk for drug use in municipalities in Mexico based on macro-social indicators. Method Retrospective cross-sectional study, based on the analysis of population data, weighted by the Delphi method. Results Sixty-four municipalities with a high or very high risk of drug use were identified. Factors such as the volume of drug seizures, prevalence of student use, alcohol supply, and inequality among the population were weighted as the factors with greatest risk for drug use. Discussion and conclusion These data serve as a benchmark for guiding the efficient, rational administration of resources assigned for dealing with the problem of addictions, since they make it possible to identify localities with a greater need for care services.

Resumen Introducción Los factores asociados al consumo de drogas se definen en función de su proximidad con el fenómeno y pueden clasificarse en individuales, microsociales y macrosociales. Entre los factores macrosociales se incluyen variables de tipo geográfico, económico, demográfico y social, que es posible integrar a partir de censos y encuestas poblacionales. Objetivo Determinar niveles de riesgo del consumo de drogas en municipios de la República Mexicana con base en indicadores macrosociales. Método Estudio transversal retrospectivo, basado en el análisis de datos poblacionales, ponderados mediante el método Delphi. Resultados Se identificaron 64 municipios con alto o muy alto riesgo de consumo de drogas. Factores como el volumen de decomisos de drogas, prevalencia de consumo en estudiantes, oferta de alcohol y desigualdad entre la población fueron ponderadas como los factores de mayor riesgo para el consumo de drogas. Discusión y conclusión Estos datos representan un referente para orientar la administración eficiente y racional de los recursos destinados a atender el problema de las adicciones en tanto permiten identificar localidades que requieren servicios de atención con mayor prioridad.

Trends and patterns of marijuana use in men and women seeking drug treatment / Tendencias y patrones de consumo de mariguana en hombres y mujeres solicitantes de tratamiento

Abstract Introduction Marijuana is the world's most widely used illegal drug. In Mexico, it is the drug of choice for both male and female users of all ages, and there has been a recent increase in its use. Objective To describe drug use trends in people seeking treatment by sex and age range, and to explore different patterns. Method To provide a description of trends and rates of increase for the population attended between 2005 and 2016 and to make a comparative analysis of patterns of use in a sample of 11 595 marijuana users who received treatment in 2016. Results In general, there has been a greater increase in use in the group ages twelve to seventeen. The greatest increase in lifetime use was reported among women in this age range. The greatest increase in marijuana use in the past month was found among women aged eighteen to thirty-five. Women use a greater variety of substances, and a higher number of younger women report using cocaine, methamphetamines, benzodiazepines and hallucinogens than men. Discussion and conclusion Significant increases in marijuana use have been registered among girls under 18 and women in recent years. The differences in trends and patterns of use for men and women are being reduced and reconfigured.

Resumen Introducción La mariguana es la droga de mayor consumo en el mundo. En México, es la droga preferida por ambos sexos y en todos los grupos de edad, y en su consumo ha habido un incremento desde hace varios años. Objetivo Describir las tendencias del uso de mariguana en solicitantes de tratamiento, por sexo y rango de edad, y explorar diferencias en el patrón de consumo, según sexo. Método Se describieron tendencias y tasas de crecimiento en población atendida entre 2005 y 2016 y se realizó un análisis comparativo del patrón de consumo con una muestra de 11 595 usuarios de mariguana recibidos para tratamiento en 2016. Resultados En general, se registran mayores tasas de crecimiento en el grupo de 12 a 17 años. El mayor incremento del uso alguna vez en la vida corresponde a las mujeres de este rango; el del uso en el último mes y como droga de mayor impacto, a las de 18 a 35 años. Las mujeres consumen un mayor número de sustancias. Las de menor edad refieren el uso de cocaína, metanfetaminas, éxtasis, benzodiacepinas y alucinógenos en mayor proporción que los hombres. Discusión y conclusión Los menores de edad y las mujeres tienen un mayor peso en el aumento del uso de mariguana registrado en los últimos años. Las diferencias en las tendencias y el patrón de consumo entre sexos se están reduciendo y reconfigurando.

Comparación de Tres Modelos de Riesgo de Uso Nocivo de Alcohol en Estudiantes Mexicanos / Comparison of Three Risk Models of Harmful Use of Alcohol in Mexican Students

Resumen: El presente estudio se planteó como objetivo identificar correlatos psicosociales del consumo nocivo de alcohol en estudiantes mexicanos, así como probar comparativamente la validez y capacidad explicativa de tres modelos teóricos y de medición de estos factores, a fin de apoyar la investigación del problema y dar pauta al desarrollo de acciones preventivas teórica y empíricamente sustentadas. Estos tres modelos son: la teoría de las expectativas, la teoría del aprendizaje social de R. Akers y la teoría de la conducta planificada. Los hallazgos indican que los tres modelos tienen una buena capacidad predictiva del consumo nocivo de alcohol en la población de estudio. El mayor peso corresponde a las expectativas positivas asociadas a los efectos del alcohol, seguidas por el uso de alcohol entre pares, una baja percepción de riesgo y, como factor protector, la capacidad percibida para controlar la cantidad que se bebe. Los hallazgos reflejan la conveniencia de aplicar un modelo multivariado compuesto por variables provenientes de los tres modelos.

Abstract: The aim of this study was to identify psychosocial correlates of harmful alcohol use among young Mexican students, and to comparatively prove the predictive validity of three theoretical models, each one capable to support the research of the problem and to guide the design of theoretically and empirically grounded preventive and treatment programs: a) the alcohol expectancies theory, b) the social learning theory by R. Akers, and c) the planned behavior theory. Findings indícate that these three models are appropriate predictive models for harmful alcohol use in the studied group. The highest predictive weight belongs to positive expectancies associated to the effects of alcohol, followed by alcohol use among friends, low risk perception, and self-control of alcohol drinking as a protective factor. Findings suggest the convenience of the application of a composed multi-varied algorithm, integrated by factors and variables extracted from the three models.

Evaluación de un programa de prevención del consumo de drogas para adolescentes / Evaluation of a drug abuse prevention program for adolescents

This paper shows the evaluation of the effectiveness of a selective prevention on drug use in adolescents, based on the Theory of Planned Behavior by Azjen. To develop this program, different theoretical models were evaluated considering their suitability to the institutional context in which it will be implemented. The criteria used to select a model that could be useful as a basis to design and evaluate a preventive intervention for drug use included: a) incorporation of protective and risk factors that could be malleable; b) consistency, parsimony and theoretical economy; c) a demonstrated explanatory and predictive capacity; d) empirical effectiveness; e) practical applicability. One of the models that complies with these requirements is the Model of Planned Behavior by Azjen, which proposes that the most immediate causes for drug use are the intentions of the subject to consume them or not. These intentions are determinated by the «attitudes¼ toward drug use, by the normative beliefs or «subjective norm¼ and by the Perceived Behavior Control. Attitudes toward the behavior are a person's overall evaluation of the behavior (i.e drug use) and the corresponding positive or negative judgments about it. The normative beliefs or subjective norms are a person's own estimate of social pressure to use or not to use drugs. Subjective norms have two interacting components: beliefs about how other people, who may be significant to the person, would like them to behave (normative beliefs), and the positive or negative judgments about each belief (outcome evaluations). Perceived behavioral control is the magnitude to which a person feels able to carry out the behavior. It includes two aspects: how much control a person has over the behavior; and how confident a person feels about being able to perform or not the behavior. It is determined by control beliefs about the power of both situational and internal factors to inhibit or facilitate the performance of the behavior. Perceived behavioral control, the last element introduced in the theory, along with the attitude to conduct, and the subjective norm, contribute, all of them, to predict the behavior intention. Generally speaking, there is important empirical evidence concerning the predictive and explicative capacity of this model in different populations. Once the theoretical model was chosen, indicators related to constructs of the Theory of Planned Behavior were elaborated adapting these constructs to the features of middle education Mexican population by means of a series of interviews with focal groups. Based on these indicators, a scale was constructed to prove the explanatory capacity of the theoretical model in Mexican population. The reliability and validity of this self-applied questionnaire was proved. Once this was done, based on these antecedents, the model was adapted in a practical sense. This means that the content, objectives and techniques for a preventive intervention were developed. This preventive intervention was piloted and then evaluated through the aforementioned scale. The program included attitudinal and normative components, conformed by informative strategies and persuasive messages directed to an attitudinal change, as well as the development of strategies of behavioral control focused on social abilities that included components derived from social learning theory, and a series of cognitive behavioral techniques accorded to the Planned Behavioral Theory. It was expected a reduction in the drugs use intention by means of a change of drug use favorable beliefs as well as reinforcing unfavorable beliefs of drug use. It was also tried to change the perception about the magnitude of drug users in the subject's immediate surroundings and on its perception about social acceptance or tolerance for drugs. Also it was tried to increase the perception of self control, in order to the develop behavioral control skills to refuse the offer of drugs. The first sessions (devoted to work on subjective norm) were directed to create an interest in the participants regarding to their relation with favorable situations to drug consumption, and to modify their perception about the real magnitude of drug use and about approval and social tolerance to them, both topics frequently overestimated for some adolescents. These sessions were also devoted to identifying beliefs associated with drug use and the value that participants give to these beliefs, in order to question those that are established upon false premises. The next sessions (devoted to perceived behavioral control) had as an objective to learn appropriated behavioral responses to confront risk situations, in order to increase the perception of self-control in those circumstances. This was achieved by means of modeling, essay and reinforcing techniques. This model was designed to be applied in groups no greater than 15 persons, twice a week in five sessions of 50 minutes each. The program was applied by professional personnel such as psychologists or social workers with previous experience in drugs use prevention. The program was implemented in three groups (one for each grade) of five high schools in Mexico City and was applied to three groups of school, randomly chosen; other three groups, in the same grades, were used as control groups. The groups were randomly chosen. Other three groups, in the same grades, were used as comparison groups. Then, the final sample was composed by 250 participants (96 from intervened groups and 154 from comparison groups) from 1 2 to 15 years old, and with slightly more men than women, but equivalent for cases and control. The results showed that the intervened group had a statistical significant reduction in the intention of drugs use. On the contrary, the comparative group showed an increasing intention to use them. With respect to the set of variables that predicted the behavioral intention, the perceived behavioral control stands out as the variable that had the greatest change. There were no significant differences in pre-post measures in the control group. Differences between pre-post measurements were also contrasted between both groups using a Student's /test that showed significant differences in perceived behavioral control and behavioral intention variables. Finally, in order to get a greater control on the test scores, an ANCOVA analysis was applied using the post-test scores as dependent variable and the pre-test scores as covariables. This analysis was useful to corroborate the significance of the drug use intention in the future, mainly in situations that require an amount of self-control, while attitude and normative variables did not show significative changes. Outcomes confirmed the pertinence to give greater resources (time, quantity, and complexity of activities, didactic materials, etc.) to the sessions devoted to developing behavioral control skills. These results can be considered satisfactory, because the main objective of the program was to reduce the intention to use drugs; however, it is also necessary to strengthen the attitudinal and normative components. It is necessary to consider that the variable «subjective norm¼ obtained the lowest levels in confidence, possibly because of the use of self-reported answers in a variable so sensitive to the influence of social elements. For this reason, it is necessary to develop questions that diminish this element that, according to Doll and Azjen, can explain, even a 5% of variance in «behavioral intention¼. Finally, it must be considered that this evaluation shows the effectiveness of the program to achieve the expected changes in behavioral intention variable only in controlled situations. It is necessary to investigate if it is possible to obtain similar results in more usual conditions and with other populations. This means that as well as to grant the internal validity of the evaluation it is also necessary to establish its external validity.

Se presentan los resultados de la evaluación de la eficacia de un programa de prevención selectiva del consumo de drogas para adolescentes, basado en la teoría de la conducta planificada de Ajzen. Para el desarrollo de este programa se identificaron y evaluaron distintos modelos teóricos. Los criterios considerados para seleccionar un modelo que pudiera servir de base para el diseño y evaluación de una alternativa de intervención preventiva del uso de drogas, teórica y empíricamente sustentada, comprendieron: a) la inclusión de factores de riesgo o protectores maleables; b) consistencia, parsimonia y economía teóricas; c) probada capacidad explicativa y predictiva; d) eficacia empírica; e) aplicabilidad práctica. Uno de los modelos teóricos que cumplen satisfactoriamente estos requisitos es el Modelo de la Conducta Planificada de Ajzen, el cual plantea que la causa más inmediata del uso de drogas son las intenciones del individuo respecto a consumirlas o no. Estas intenciones están determinadas a su vez por dos componentes; por una parte, las actitudes hacia el consumo, y por otra, las creencias normativas o norma subjetiva. Las actitudes están conformadas por el conjunto de creencias sobre las consecuencias del consumo y por el valor afectivo que tales consecuencias tienen para el sujeto. Las creencias normativas o norma subjetiva también están determinadas por dos componentes. Por un lado, la percepción de que otras personas significativas para el sujeto aprueban o desaprueban el consumo y, por otro, la motivación del sujeto para acomodarse a las expectativas o deseos de estas personas. El control conductual percibido, último componente introducido en la teoría, contribuye ¡unto con la actitud hada la conducta y la norma subjetiva a predecir la intención conductual. En general, se cuenta con importante evidencia empírica acerca de la validez predictiva y explicativa de este modelo, en relación con el consumo de drogas entre distintas poblaciones. Una vez elegido el modelo teórico se elaboró una escala de medición para probar su capacidad explicativa para el caso de uso de drogas en población mexicana. Probada la capacidad explicativa del modelo, se llevó a cabo su adaptación práctica, en términos de desarrollar contenidos, objetivos y técnicas de una intervención preventiva basada en el mismo. Por último, se realizó la prueba piloto y la evaluación de la aplicación controlada de tal intervención. La evaluación de resultados se apoyó en un diseño experimental con prueba-postprueba y un grupo control. El programa se aplicó en cinco escuelas secundarias de la Ciudad de México. Se intervino a tres grupos de cada escuela, uno por grado, elegidos aleatoriamente. La muestra final, una vez depurada, quedó conformada por 250 jóvenes (96 casos y 154 controles) de entre 12 y 15 años de edad. Para la evaluación se utilizó una cédula creada ex profeso y probada previamente en una muestra de 1 200 alumnos, mostrando buenos niveles de confiabilidad y validez. Los resultados muestran que en el grupo intervenido tuvo lugar una disminución estadísticamente significativa de la intención de usar drogas, en tanto que los alumnos del grupo comparativo mostraron, por el contrario, un incremento en la intención de uso durante el mismo lapso. Del mismo modo, entre las variables antecedentes de la intención conductual, a saber, actitud, norma subjetiva^ control conductual percibido, la variable que mostró un mayor cambio fue esta última. También se contrastaron las «puntuaciones de ganancia¼ (diferencias antes-después) del grupo de los casos contra las del grupo de los controles, con lo que se pudo observar que las diferencias significativas entre ambos grupos se presentaron en las variables control conductual percibido e intención conductual. Finalmente, mediante el Modelo Lineal General (MLG) ANCOVA, se pudo corroborar la significativa reducción de la intención de utilizar sustancias y el incremento en la percepción de autocontrol, mientras que la actitud y la variable normativa no mostraron cambios significativos, lo que confirma la pertinencia de haber dotado de mayores recursos (tiempo, número y complejidad de las actividades, materiales didácticos, etc.) a las sesiones dedicadas al desarrollo de habilidades de control conductual, sobre la base previamente probada, tanto en población anglosajona como entre jóvenes mexicanos, de que esta variable suele tener un mayor peso en la explicación de la intención de usar drogas.

Factores motivacionales protectores de la depresión y el consumo de drogas / Motivational protective factors for depression and drug abuse

As a part of a innovative research line on mental health and addictions focused to operationalize the clinical approach of Maslow's motivational theory, this study is focused to prove a theoretical multi-factorial model that presuppose a relationship between a set of psycho-social protective factors and affective disorders, attraction to drugs, and severity of legal and illegal drug use, all them mediated by the satisfaction degree of deficit needs and its pleasurable associated sensations. The study was implemented with a cross-sectional, ex-post-facto design, with a 241 sample made out by urban young adults that were actual illicit drug users, which used more than five times one of the next drugs: marijuana, cocaine, crack, inhalants, heroin or metamphetamine. These subjects had a 24,5 mean age (SD= 5,1), with a ratio of almost eight men at of each woman. More than half of them were single, a third part was married or lived together and the fifth part was separated or divorced. Half of participants had high school studies, a fourth part had college and 8% had superior level. Half of the subjects were employed, 10% were students, 4% were housemakers, 5% studied and worked simultaneously, and a third part did not work. A fourth part were referred to previous treatment(s) for drug abuse. Based on the diagnosis, marijuana was identified as a drug of greater impact (29,9%), followed by cocaine (27,4%), inhalants (16,2%), heroin (12.0%), crack (10%) and crystal (4,6%). It was applied a battery of instruments that included: a) A scale to test the Severity of drug abuse (alpha = .953), that included items to evaluate issues such as: the incapacity to control drug use; intense desire to use; increase in the consumption; inability to reject drugs; changes in mood; transgression of the rules; residual symptoms; fights, and self injures. b) The Beck Depression Inventory (alpha = .918), conformed by two factors, Affective-cognitive depression (alpha = .867), with items related to feeling punished, failed and guilty, and Physiological-behavioral depression (alpha = .853) with items associated to insomnia, feeling tired, irritable, unsatisfied and hesitated. c) A multifactorial scale of Degree of Satisfaction of Deficit Needs of Health and security (alpha = .876), with items such as: tranquility, confidence, order and education; authenticity (alpha = .878), with items like honesty, sincerity, respect and freedom; affective (alpha = .780), with items like affection, friendship and love; self esteem (alpha = .825), with items like recognition, work, success and money; and enjoyment (alpha = .910), with items like joy, amusement, happiness, play, laugh, sing and dance. d) A multi-factorial risk and protection scale of drug use and related syndromes (alpha = .794), with the following factors: satisfactory family relations (alpha = .850), satisfactory relation with friends (alpha =927) and individual ability for satisfaction (alpha = .841). e) A multi-factorial scale related with the attraction for legal and illegal drugs (alpha = .949), with a factor for alcohol attraction (alpha = .933), other factor for tobacco attraction (alpha = .890) and a factor for alcohol attraction (alpha = .926). Furthermore, two models were developed with three antecedent manifest variables: individual ability for satisfaction, satisfactory family relations and satisfactory relation with friends. Both models showed that individual ability for satisfaction predicts 17% of variance of the satisfactory family relations and 10% of the satisfactory relation with friends. The mediating latent variable Satisfaction degree of deficit needs showed different forms in each model because the first one included a) satisfaction degree of health and security needs, b) satisfaction degree of self esteem needs and c) satisfaction degree of enjoyment needs, whereas the second model, more parsimonious, kept the first two factors. Both models incorporate, as consequent latent variables, depression (explained in 53% of its variance in model 2) as well as the manifest variable of: severity of drug abuse (explained in 45%) and the mediating latent variable attraction for legal and illegal drugs with an explained variance of 32% (for example: <>). The models provide conceptual validity to the clinical approach of Maslow's theory, because it verifies that the unsatisfaction of deficit needs is related to: the presence of affective disturbance like depression; the attraction by legal and illegal drugs; and the severity of alcohol consumption and drugs. Model one includes among others the mediating variable satisfaction of the needs of self esteem, showing the influence of Jonah's complex usually related to the fear of recognition, success, etc. Model 2 is more parsimonious and reaffirms the importance of satisfying physiological and security needs, and its associated enjoinment. In adittion, it stands out that the individual capacity of satisfaction is related to the satisfaction of deficit needs causing the appearance of moments of joy, amusement and happiness, possibly associated with the Reward Circuit Activation. On the other hand, the individual capacity of satisfaction also maintains a direct relation with satisfactory relations with family and friends. Both variables have as well a positive influence in the satisfaction of deficit needs. Moreover, the individual capacity of satisfaction is related to the satisfaction of the deficit necessities, causing the appearance of moments of joy, amusement and happiness possibly associated with the reward circuit activation. On the other hand, the individual capacity of satisfaction also maintains a direct relationship with satisfactory relations with family and friends, which have also a positive influence to the satisfaction of the deficit needs and their associated enjoyment sensations, such as laugh, singing and dancing, that usually take place in social interactions. Also, it was shown how the individual aptitudes as well as relationships with others were substantial sources for satisfaction of deficit needs. Additionally, it was observed that a deficient degree of needs satisfaction was related to an increment in affection disturbances and in the severity of drug use, supporting the Maslow's psycho-pathogenesis construct. Finally, it was observed how a deficient degree of satisfaction also shows a direct relationship with the attraction to legal and illegal drugs, and is stand out how the presence of affection disturbances increases the attraction to drugs, which at the same time increases the severity of drug use.

Estudio de la relación entre consumo de drogas y migración a la frontera norte de México y Estados Unidos

resumen está disponible en el texto completo

Abstract: Since the beginning of the XX Century, migration has played an important role in the relations between Mexico and the United States. The main reasons behind most of these migration movements are to improve life conditions and already established social-familiar networks. It is estimated that approximately 390,000 Mexican people migrate each year to the United States. In 2002, Mexicans represented the biggest immigrant group, with 9.5 million people. Among the main elements that cause this migrating movement are: the increasing Mexican demographic population in prime working age, the insufficient creation of jobs, low salaries, as well as the high demand that exists for manpower in the United States, specially in the agricultural, industrial and service areas. There have been important changes in the migrating process, which modify usual behaviors, habits, values, attitudes and points of view by migrants, their families, their home town and their new environment. These changes can facilitate the development of some problems, at a public health level. Some such problems include stress, depression, risky sexual behavior, AIDS contagion, or increase in the abuse of alcohol and drugs. The Community Epidemiology Work Group and NIDA has reported that South and South East areas of the United States show a high cocaine, heroine, methamphetamine, and ecstasy abuse. Most such areas are located at the Mexican border, and this problem seems to affect both countries the same. Method. The study involved following transversal, ex post facto comparisons of migrant and no migrant users drugs. The main objectives included: a) To identifiy abuse levels of migrating drug users, and compare these results with those of Mexican resident drug abusers (non migrating); b) To identify abuse levels in migrating people before and after they moved into the United States and/ or Mexican border cities, and their degree of abuse upon returning to Mexico; c) To explore any relationships between migrating and increased drug consumption, such as heroine and methamphetamine. The participant selection procedure involved intentional, sampling by using pairs. Inclusion criteria included using ilegal drugs, being new patient in the Treatment area of Centros de Integración Juvenil (CIJ), and having migrated to any Mexican border cities and/or the United States in the last five years, and stayed for a period of three months or more. The CIJ operating units that participated in the study included those in Cancán, Celaya, Chihuahua, Ciudad Juárez, Colima, Guadalajara, Hermosillo, Laguna, La Paz, León, Los Mochis, Monterrey, Puebla, Zacatecas and Zamora. These units were selected because of their high number of patients who are methamphetamine or heroine abusers, as well as for including a considerable rate of migrating people to the United States. The groups included 92 drug abusers, of which 46 went to the mexican north border or to the United States cities, and 46 non migrants. Data was gathered through the application of a questionnaire. Main findings. Some of the results revealed that 97.8% of the participants were male, with an average age of 26 years old (SD=7.5), and 80% had studied elementary school or higher. 1. Characteristics of the migrating process. Drug abusers, who migrated to the northern Mexican border, mainly went to Baja California and Chihuahua states. The ones who went to the United Stated were living in California, Texas, Arizona and Illinois. Among the main reasons for migrating were personal development, getting a job or improving it. Migrants also stated that they were "seeking adventure", and, those who went to the United States, said that their purpose was to solve family problems, or to follow tradition. Most of them had planned to stay at their new home for just one season, although a majority stayed over one year. 2. Drug abuse. All participants had consumed alcohol and almost 90% of them had smoked tobacco at least once in their lives. The illegal substances consumed by both migrating and non migrating participants included, in decreasing frequency order: cocaine, marijuana, inhalants, methamphetamines and sedatives. Prevalence among the migrating abusers was higher. Non migrating abusers, also consumed tranquilizers, heroine and other opiates. On the other hand, migrating abusers, had consumed, at least once in a lifetime one or more of the following substances: ecstasy, crack, basuco, methamphetamine, amphetamines, LSD and PCP. Migrants showed a higher percentage of those who had used central nervous system inhibitors (except methamphetamine), and most of them had used a combination of drugs. Those migrating to the United States predominantly consumed drugs to stimulate the central nervous system or to produce hallucinations, and also used some other non specified substances. Drug preference perception. Both groups reported a preference towards marijuana and cocaine. However, migrating abusers showed an additional preference for methamphetamine use. Migrating abusers stated that the reason for consuming this drug was mainly seeking stimulation, just to feel active and euphoric. The ones who migrated to the United States mentioned that they consume methamphetamine because of labor reasons, such as to be more productive and alert. Drug abuse before, during and after migrating. Eighty percent of migrating abusers had already used drugs before leaving their home town. During the migrating process the drug abuse pattern changed by increasing the use of some other drugs. Migrating abusers mentioned that they had used cocaine at their home place, but that during the migrating process, its consumption was significantly higher. They also mentioned that they continued using cocaine when they came back home, although at a lower rate. There was no record of opiates' use such as morphine, darvon, nubain or methadone when these abusers were in their home town, before migrating. They started using these drugs when they arrived to the north of Mexico or to the United States, and they continued using them when they returned. Only some abusers had used methamphetamine, crack, heroine and PCP before migrating. However, when they arrived to their migrating place, the use of these drugs was highly increased although it was reduced considerably when they returned home. LSD was consumed only at the migrating places. The use of tranquilizers and mushrooms was slightly decreased during the migrating process, but it increased when abusers returned home. In the case of those who went to the border, heroine abuse increased, and it decreased as abusers returned home. Only some of them used methamphetamine and ecstasy at their migrating places. On the other hand, those migrating abusers that went to the United States increased their use of methamphetamine, ecstasy, cocaine, and crack, although it decreased when they returned home. Some migrating abusers started using heroin when they arrived to the border, and only continued consuming it when they came home.