Perceptions of professionals regarding interventions involving family members responsible for justice-involved youth with substance use disorders in Santiago, Chile.

BACKGROUND: Eliciting professionals' experiences of current drug treatment programmes can lead to improvements of these youth-centred programmes through the involvement of the concerned youths' families. We explored perceived barriers amongst professionals concerning interventions incorporating parents or guardians responsible for justice-involved youth with substance use disorders. METHODS: We conducted semi-structured in-depth interviews with fourteen female and four male professionals, each representing one of eighteen programmes under the Chilean National Drug Treatment Programme (2016-2017), who were tasked with contacting and/or intervening in the families of justice-involved youth. Subsequently, we performed traditional content analysis. RESULTS: The professionals identified four key barriers impeding interventions: (1) parents' non-adherence to the treatment and issues relating to their role fulfilment; (2) tensions within the programme design that constrain the families' involvement in the interventions; (3) the lack of a supportive professional network offering interventions that complement drug treatment; (4) the problematic and dangerous living contexts of these families that discourage family involvement. Additionally, professionals identified intervention needs for improving treatment outcomes. CONCLUSIONS: The negative perceptions of professionals regarding the interventions as well as families and family contexts of justice-involved youth, and the lack of support from other programmes, induced feelings of hopelessness and pessimism amongst the professionals regarding the effectiveness of the Chilean National Drug Treatment Programme. It is essential to consider professionals' perspectives not only to benefit from their expertise, but also to assess whether their perspectives may hinder the implementation of changes when attempting to innovate drug treatment modalities aimed at improving their outcomes.

Parental protective and risk factors regarding cannabis use in adolescence: A national sample from the Chilean school population.

Background: Research has increased our understanding of the parental factors associated with the initiation and development of cannabis use disorder in adolescents, but few studies about this have been performed in middle- or low-income countries.Objective: First, to examine whether perceived past parental drug use, parental monitoring, and attitude toward adolescent cannabis use are associated with general and problematic cannabis use in Chilean adolescents. Second, to explore whether perceived past parental drug use weakens the associations of protective factors with general and problematic adolescent cannabis use.Methods: Regression analyses were performed on cross-sectional data from a multistage probabilistic sample stratified by clusters (municipalities, school and grade) of 43,060 students (47% male, mean age 15.5 years) from grades 8 to 12, which was collected from the Chilean National School Survey on Drug Use (2013).Results: Perceived past parental drug use increased the likelihood of adolescent cannabis use in general, but not its problematic use. Parental monitoring of adolescents' whereabouts and parental opposition to adolescent cannabis use decreased the likelihood of adolescent cannabis use in general, as well as problematic use. Perceived past parental drug use only interacted with parental monitoring of school activities.Conclusions: In line with research from the United States, the Netherlands and Spain, parental monitoring of adolescents' whereabouts and a strong parental opposition to cannabis use appear to be protective factors, irrespective of past parental use. However, the effectiveness of monitoring adolescents' school activities seems to decrease when parents are perceived as having used drugs in the past.

Marijuana Use and Dependence in Chilean Adolescents and Its Association with Family and Peer Marijuana Use.

PURPOSE: The purpose of the study is to examine (1) whether family and peer marijuana use are independently related to adolescent marijuana use in Chile, (2) whether family and peer marijuana use are associated with adolescent marijuana dependence in adolescents using marijuana, and (3) whether the adolescent's age moderates the association between family or peer use and adolescent marijuana use and/or dependence. METHOD: This study used data from the National Survey on Drug Use in the General Population in Chile (a cross-sectional observational study), which was conducted in 2008 and 2010 in 4413 adolescents aged 12-19. Adolescents answered questions about their past-year marijuana use and dependence (ICD-10 criteria) and the marijuana use of their family and peers. Logistic regressions were performed while controlling for confounders. RESULTS: Adolescents who had a family member who used marijuana were five times more likely to use the drug. Adolescents with a close friend who used marijuana were eight times more likely to use marijuana. When adolescents were using marijuana, they were three times more likely to be dependent if they had a family member who used the drug. However, no significant relationship was found between peer use and dependence. No statistically significant interactions were found between family or peer use and age. CONCLUSION: Family and peer marijuana use was independently associated with adolescent's past-year marijuana use; however, only family marijuana use was statistically associated with adolescent's marijuana dependence.