[The characteristics of opiate users seen in an emergency service]. / Características de los consumidores de opioides visitados en un servicio de urgencias.

INTRODUCTION: Despite of the fact that it was reported for years that emergency rooms are the first health services where drug users attend, there are very few direct studies of this population. In most emergency room studies, the information was obtained from data available in the clinical records, and in very few drug users were interviewed. With the aim of having a deeper knowledge of opiate users who attend the emergency room it was planned to carry out a cross-sectional study interviewing them. The aims of this paper are to describe demographic characteristics, patterns of drug use and to know whether they contact first to an emergency room or to a treatment centre. METHODS: The sample included all patients detected and referred by the doctor as being current opiate users, defined as any use in the 30 days prior the interview. A descriptive bivariate analysis with simple stratification was carried out. RESULTS: Of the subjects referred by the doctor 383 opiate users were interviewed and 76 were not interviewed. The male/female ratio for the 383 interviewed opiates users was 2. Women were younger than men (25.8 vs 28.3, p (3/4) 0.001). Heroin or cocaine ever injected was reported by 93% and 76% reported injecting in the last 30 days. The mean age at the first use of heroin was higher for those who started use during 1989 or after (21.6) than those who started before 1989 (17.9) (p (3/4) 0.0001). Patients attending the emergency room for organic pathology were older (28.5) than those who attended for withdrawal (26.2) and those who attended for overdose (27.3) (p (3/4) 0.05). Thirty eight percent reported to attend first an emergency room for a drug related problem since they started drug use, and 47% to contact first with a treatment centre for drug dependence. CONCLUSION: Drug users interviewed seem to be more heavy users than those who started drug treatment in the public centres of Barcelona in 1992. Also, the hypothesis that emergency rooms are for this population the first contact point with health services is not supported by this study.

[Prevalence of human immunodeficiency virus and risk behaviours among opioid users seen in an emergency room]. / Prevalencia de la infección por el virus de la inmunodeficiencia humana y conductas de riesgo en consumidores de opioides visitados en un servicio de urgencias.

INTRODUCTION: As prevalence of HIV-1 among drug users in Spain is high and it is difficult to contact them because of their hidden behaviors, emergency rooms are one of the health facilities where they can be located. A cross-sectional interview study was planned. The aims of the study were to estimate prevalence of HIV-1 and to describe risk behaviors. METHODS: The sample included all patients that in spring 1992 were detected and referred by the doctor as being current opiate users, defined as any use in the 30 days prior the interview. Drug users who did not know their HIV status or were negative for more than six months were asked to provide a urine sample to test HIV serology. A descriptive analysis with simple stratification was carried out. Row and adjusted odds ratio were used to analyse association between different variables and HIV status. Logistic regression was used to examine variables associated with HIV infection and risk behaviors (injecting drug use, sharing needles, and no use of condom). RESULTS: Three hundred and eighty three opiate users were interviewed. It was possible to know HIV status of 94% of the subjects. Of them, 61% were positive (219). The best adjusted logistic model to predict associated variables with HIV included being female, primary school level, sickness absence, to attend because of organic pathology, and more years of parenteral use. Seventy five percent of the sample injected drugs during the past 30 days, and among them 30% shared syringes. The variables associated with a higher probability of having injected heroin or cocaine in the last 30 days were to have completed at least primary education, to be unemployed or reliant on illegal activities, not to be in drug treatment, and a larger number of drugs used in the last 30 days. A higher probability of sharing syringes was associated with a lower educational level, not to be in drug treatment, to live alone and a higher number of drugs used during last 30 days. Twenty one percent of the subjects who were sexually active always or nearly always used condom with regular partners and 56% with casual partners. Women were more likely to use condom than men with casual partners. Subjects who shared syringes during last 30 days were nearly three times more likely not to use condom with casual partners. CONCLUSIONS: Although a high prevalence of HIV-1 was estimated among opioid users seen in an emergency room, it is not higher than estimates for intravenous drug users recruited from treatment centres, prison or needles exchange programs. A high frequency of risk behavior was also observed indicating a need to develop specific prevention programs for drug users.

[The consumption of tobacco, alcohol and noninstitutionalized-use drugs by middle-school students of Terrassa]. / Consumo de tabaco, alcohol y drogas de uso no institucionalizado en los alumnos de enseñanza media de Terrassa.

BACKGROUND: Because adolescence is the stage during which most people begin their drug use, we wanted to investigate adolescent's use of and attitudes towards drugs. This paper aims to describe prevalence of students (14-18 years old) drug use in the city of Terrassa (Spain) for the school year 1994-1995. METHODS: A school survey was carried out for a representative sample of 1,269 students. A questionnaire was developed following W.H.O. guidelines. It includes information on demographic characteristics, legal and illegal drug use, information and attitudes towards drugs, and other related factors. RESULTS: Thirty seven percent smoked within the last 30 days, and 60% drunk alcohol. Thirty-two percent had been drunk at least once. Cannabis was the most widely used drug (25.9%) followed by hallucinogens (7.2%), tranquillizers (4.4%), inhalants (4.3%), amphetamines (4%), cocaine (1.7%) and heroin (0.2%). The prevalence for the use of cannabis within the last 30 days was 11%, and around 1% for the use of all other drugs within the same period of time. Increased drug use was observed with age. No differences among sexes were observed for prevalence of tobacco and alcohol use, although boys showed a more intensive pattern. For the other drugs, higher prevalence was observed in the male population except for tranquillizers whose use was more prevalent among women. CONCLUSIONS: The high prevalence of drug use observed, suggest the need to introduce more extensively programs for the prevention of drug use, beginning in primary school.