The PACARDO research project: youthful drug involvement in Central America and the Dominican Republic.

OBJECTIVE: To estimate the occurrence and school-level clustering of drug involvement among school-attending adolescent youths in each of seven countries in Latin America, drawing upon evidence from the PACARDO research project, a multinational collaborative epidemiological research study. METHODS: During 1999-2000, anonymous self-administered questionnaires on drug involvement and related behaviors were administered to a cross-sectional, nationally representative sample that included a total of 12,797 students in the following seven countries: Costa Rica (n = 1,702), the Dominican Republic (n = 2,023), El Salvador (n = 1,628), Guatemala (n = 2,530), Honduras (n = 1,752), Nicaragua (n = , 419), and Panama (n = 1,743). (The PACARDO name concatenates PA for Panamá, CA for Centroamérica, and RDO for República Dominicana). Estimates for exposure opportunity and actual use of alcohol, tobacco, inhalants, marijuana, cocaine (crack/coca paste), amphetamines and methamphetamines, tranquilizers, ecstasy, and heroin were assessed via responses about questions on age of first chance to try each drug, and first use. Logistic regression models accounting for the complex survey design were used to estimate the associations of interest. RESULTS: Cumulative occurrence estimates for alcohol, tobacco, inhalants, marijuana, and illegal drug use for the overall sample were, respectively: 52%, 29%, 5%, 4%, and 5%. In comparison to females, males were more likely to use alcohol, tobacco, inhalants, marijuana, and illegal drugs; the odds ratio estimates were 1.3, 2.1, 1.6, 4.1, and 3.2, respectively. School-level clustering was noted in all countries for alcohol and tobacco use; it was also noted in Costa Rica, El Salvador, Guatemala, and Panama for illegal drug use. CONCLUSIONS: This report sheds new light on adolescent drug experiences in Panama, the five Spanish-heritage countries of Central America, and the Dominican Republic, and presents the first estimates of school-level clustering of youthful drug involvement in these seven countries. Placed in relation to school survey findings from North America and Europe, these estimates indicate lower levels of drug involvement in these seven countries of the Americas. For example, in the United States of America 70% of surveyed youths had tried alcohol and 59% had smoked tobacco. By comparison, in these seven countries, only 51% have tried alcohol and only 29% have smoked tobacco. Future research will help to clarify explanations for the observed variations across different countries of the world. In the meantime, strengthening of school-based and other prevention efforts in the seven-country PACARDO area may help these countries slow the spread of youthful drug involvement, reduce school-level clustering, and avoid the periodic epidemics of illegal drug use that have been experienced in North America.

The adolescent behavioral repertoire as a context for drug exposure: behavioral autarcesis at play.

AIMS: The aim of this study is to investigate suspected behavioral autarcesis. Autarcesis refers to a mechanism of non-specific shielding from or immunity to infection or disease. Here, suspecting that some facets of the adolescent behavioral repertoire (ABR) might shield youths from early drug involvement, we studied recent-onset occurrence of first chances to try a drug and first actual drug use, expressed as a function of five observed ABR dimensions: religious, socializing, sports-related, gender socialization, and home-based activities. DESIGN AND PARTICIPANTS: Nationally representative samples of school-attending youths were drawn in Panama, the five Spanish heritage countries of Central America and the Dominican Republic (n = 12797). MEASUREMENTS: Drug involvement and ABR were assessed via anonymous self-administered questionnaires. FINDINGS: A religious activity dimension and a separate sports dimension were associated inversely with recent onset of adolescent drug experiences, and a socializing activity dimension was related to an increased occurrence of these experiences. For example, for each unit increase of the religious activity dimension of the ABR, there was an associated reduced occurrence of the first chance to try tobacco (OR = 0.75, 95% CI: 0.63-0.90, P = 0.002). Adolescents at higher levels of sports activities and home-based activities were less likely to experience recent-onset actual use of marijuana (OR = 0.45, 95% CI: 0.30-0.67, P < 0.001; OR = 0.56, 95% CI: 0.32-0.99, P = 0.048, respectively). CONCLUSIONS: The study evidence lends some support for behavioral autarcesis. Manipulation of selected ABR dimensions might help prevent or reduce adolescent drug involvement, enhancing autarcesis as a protective mechanism.

The PACARDO research project: youthful drug involvement in Central America and the Dominican Republic

OBJETIVO: Estimar el grado en que el consumo de drogas se produce y muestra una concentración en el nivel escolar entre adolescentes que asisten a la escuela en siete países de América Latina. Los datos presentados provienen del proyecto de investigación PACARDO, estudio epidemiológico conjunto multinacional. MÉTODOS: En el período de 1999­2000, se aplicaron cuestionarios anónimos autoadministrados sobre el consumo de drogas y conductas afines a una muestra transversal, representativa de la población nacional, que se compuso de un total de 12 797 estudiantes en los siguientes siete países: Costa Rica (n> 1 702), El Salvador (n> 1 628), Guatemala (n> 2 530), Honduras (n> 1 752), Nicaragua (n> 1 419), República Dominicana (n> 2 023) y Panamá (n> 1 743). (El nombre de PACARDO combina la PA de Panamá, la CA de Centroamérica y la RDO de República Dominicana). Se calcularon las oportunidades de exposición y el consumo de alcohol, tabaco, sustancias inhaladas, marijuana, cocaína (crack/pasta de cocaína), anfetaminas y metaanfetaminas, tranquilizantes, éxtasis y heroína sobre la base de las respuestas dadas a preguntas acerca de la edad en que se tuvo la oportunidad de probar cada una de las drogas, y en que se probó cada una de ellas, por primera vez. Para estimar las asociaciones de interés se aplicaron modelos de regresión logística con arreglo a la complejidad de la encuesta. RESULTADOS: Las siguientes fueron las frecuencias estimadas acumulativas del consumo de alcohol, tabaco, sustancias inhaladas, marijuana y drogas, respectivamente, en toda la muestra: 52%, 29%, 5%, 4% y 5%. Comparados con las mujeres, los varones fueron más propensos a consumir alcohol, tabaco, sustancias inhaladas, marijuana y drogas; las razones de posibilidades estimadas fueron, respectivamente, 1,3; 2,1; 1,6; 4,1 y 3,2. En todos los países se observó una concentración del consumo de alcohol y tabaco en el nivel escolar; el consumo ilegal de drogas también mostró una concentración escolar en Costa Rica, El Salvador, Guatemala y Panamá. CONCLUSIONES: Este informe arroja nueva luz sobre las experiencias de los adolescentes con la droga en Panamá, en los cinco países centroamericanos de tradición española, y en la República Dominicana. En él se presentan las primeras estimaciones del grado en que se concentra en las escuelas el consumo de drogas entre la juventud de estos siete países. Cuando se examinan a la luz de los resultados de encuestas escolares...

Estimated occurrence of tobacco, alcohol, and other drug use among 12 to 18 year old students in Panama: results of Panama's 1996 National Youth Survey on Alcohol and Drug Use

This report provides the first epidemiological evidence on tobacco, alcohol, and other drug use among school students in Panama, using data from a student survey completed in 1996. Specifically, we examine sex, age, grade level, type of school, and urban-rural variations in the occurrence of tobacco, alcohol, and other drug use. Estimates of lifetime prevalence and past-year use of these products were obtained using data from Panama's 1996 National Youth Survey on Alcohol and Drug Use (n = 6 477). To account for the multistage sampling design of the survey, all estimates and respective standard errors are derived by the Taylor series approximation method using Epi Info 6.0 CSAMPLE software. In general, more males, more older students, and more students in higher grades have used licit and illicit drugs, even though male-female differences tend to be small. Public-private school differences and urban-rural trends vary depending on the drug. The findings of this study are discussed in relation to the epidemiology and prevention of drug use in Panama. Based on these data, we seek to provide information to be used by the Government of panama in its planning for prevention programs directed toward students in Panamanian schools

Estimated occurrence of tobacco, alcohol, and other drug use among 12 to 18 year old students in Panama: results of Panama's 1996 National Youth Survey on Alcohol and Drug Use / Uso estimado de tabaco, alcohol y otras drogas en estudiantes panameños de 12 a 18 años: resultados de la Encuesta Nacional de Panamá sobre el Uso de Alcohol y Drogas en la Juventud

This report provides the first epidemiological evidence on tobacco, alcohol, and other drug use among school students in Panama, using data from a student survey completed in 1996. Specifically, we examine sex, age, grade level, type of school, and urban-rural variations in the occurrence of tobacco, alcohol, and other drug use. Estimates of lifetime prevalence and past-year use of these products were obtained using data from Panama's 1996 National Youth Survey on Alcohol and Drug Use (n = 6 477). To account for the multistage sampling design of the survey, all estimates and respective standard errors are derived by the Taylor series approximation method using Epi Info 6.0 CSAMPLE software. In general, more males, more older students, and more students in higher grades have used licit and illicit drugs, even though male-female differences tend to be small. Public-private school differences and urban-rural trends vary depending on the drug. The findings of this study are discussed in relation to the epidemiology and prevention of drug use in Panama. Based on these data, we seek to provide information to be used by the Government of panama in its planning for prevention programs directed toward students in Panamanian schools

Este informe presenta las primeras pruebas epidemiológicas del consumo de tabaco, alcohol y otras drogas en alumnos de escuelas panameñas, usando datos obtenidos mediante una encuesta estudiantil completada en 1996. En particular hemos examinado las diferencias por sexo, edad, grado escolar, tipo de escuela y residencia urbana o rural en el uso de tabaco, alcohol y otras drogas. Se estimaron la prevalencia vitalicia y el consumo previo de estos productos a partir de una encuesta nacional de la juventud efectuada en 1996 (n = 6 477). Debido al diseño muestral multietápico aplicado en la encuesta, todas las estimaciones y sus respectivos errores estándar se derivaron por el método de Taylor de series aproximadas aplicando el programa Epi Info 6.0 CSAMPLE. En general, los varones, los alumnos de mayor edad y los alumnos de grados superiores fueron los que mayormente habían consumido drogas lícitas e ilícitas, aunque fue pequeña la diferencia entre varones y hembras. Las difrencias entre alumnos de escuelas públicas y colegios privados y las tendencias observadas en habitantes de zonas urbanas frente a los de zonas rurales variaron según el tipo de droga. Los resultados de este estudio se examinan a la luz de la epidemología y prevención del consumo de drogas en Panamá. Partiendo de estos datos, esperamos poder proveer al Gobierno de Panamá información que le sea útil para planificar programas de prevención dirigidos a alumnos de escuelas panameñas.