Resumen de Consumo de drogas en mujeres asistentes a centros de tratamiento especializado en la Ciudad de México

P. Isaías Castillo Franco, Alma Delia Gutiérrez López

• español

  Introducción En los estudios del consumo de drogas en México existe información principalmente de tipo epidemiológico, la cual ha tomado en cuenta diversos sectores de la población abierta, por ejemplo la estudiantil, los centros de tratamiento, los organismos no gubernamentales, los niños en condición de calle, los centros de readaptación social e incluso la población rural. Dichos estudios dan cuenta del consumo de drogas por género y no permiten observar las características específicas de éste únicamente en mujeres, ya que las proporciones del uso de drogas son divergentes y en algunos casos extremas a las presentadas por hombres.

  Metodología El objetivo de este estudio es determinar la existencia de diferencias significativas en las características sociodemográficas, así como en los factores asociados con la demanda de tratamiento y con el consumo de drogas de acuerdo con la edad de ingreso al tratamiento. El estudio se realizó mediante un análisis bivariado y se basó en mujeres usuarias de drogas que solicitaron atención en Centros de Integración Juvenil (CIJ). Igualmente, se utilizó información del consumo de drogas de CIJ. Además, se extrajo una muestra no probabilística intencional de 754 mujeres que acudieron entre julio y diciembre de 2004 a las unidades de la Ciudad de México y se dividió en tres grupos de edad: 1) de 12 a 20 años; 2) de 21 a 39 años y 3) de 40 años y más.

  Resultados En promedio, al momento de ingresar a los CIJ las mujeres contaban con 31 años. La edad de inicio del consumo de tabaco fue a los 16.4 años, la de bebidas alcohólicas a los 17 años y la de drogas ilícitas a los 18.5 años. El tabaco (71.6%) fue la principal sustancia con la que iniciaron el consumo de drogas. Sin embargo, la droga ilícita de inicio más utilizada fue la mariguana (43.5%). Las drogas más consumidas alguna vez en la vida —durante el último año y el último mes—, así como las de preferencia y de mayor impacto fueron: tabaco, bebidas alcohólicas y mariguana.

  Al comparar los tres grupos de edad se observó que en el grupo 1 la mayoría no cuentan con pareja, se dedican a estudiar o trabajar y acuden condicionadas por la familia o por la escuela debido, principalmente, al consumo de drogas ilícitas y de bebidas alcohólicas. En este grupo los problemas asociados con su consumo son de tipo familiar y escolar, y las drogas más usadas fueron: tabaco, alcohol, mariguana, inhalables y cocaína. El segundo grupo se caracteriza porque en su mayoría son solteras, se dedican a estudiar o trabajar, acuden principalmente por iniciativa propia debido al consumo de tabaco y drogas ilícitas. Las acciones realizadas contra el consumo han sido principalmente la interrupción voluntaria sin apoyo y el acudir a grupos de autoayuda. En este grupo, los principales problemas asociados con el consumo fueron los familiares, de salud y psicológicos, y las principales drogas consumidas fueron: tabaco, alcohol, cocaína, mariguana, depresores e inhalables. Por último, el tercer grupo se caracteriza porque tienen pareja, se dedican a trabajar o al hogar; acuden principalmente por iniciativa propia en busca de un tratamiento para el consumo de tabaco. La acción predominante de este grupo contra el consumo de drogas ha sido la interrupción voluntaria sin apoyo y los problemas asociados a su consumo son de salud y familiares. Las sustancias que predominan en este rango de edad fueron el tabaco y el alcohol.

  Discusión Los resultados obtenidos ofrecen un parámetro útil para desarrollar alternativas de atención que tomen en cuenta distintos factores. Por ejemplo: la edad de las usuarias, así como los problemas familiares, sociales y de salud que enfrentan, las sustancias que han utilizado y las que están consumiendo en ese momento. Esto permitirá dar un mejor trato a toda usuaria que decida acudir a algún centro de tratamiento especializado, y así propiciar una mejor utilización de recursos económicos y humanos, pues se proporcionaría una atención específica de acuerdo a sus necesidades. Por ejemplo, en el tercer grupo los programas de atención podrían estar enfocados al uso de tabaco, mientras que en el segundo grupo podrían considerar tratamientos donde también se tome en cuenta el consumo de tabaco y de drogas ilícitas.

• English

  Introduction There is plenty information about drug consumption in Mexico which examines from an epidemiological perspective several social groups such as: general population, student population, treatment centers, non–governmental organisms, homeless children, social re–adaption centers and even rural areas. However, these studies report drug consumption by gender and do not allow a precise analysis about specific characteristics in women, as the proportions of drug use are divergent and in some cases extremely different from those shown by men.

  This study analyses, specifically, women that received treatment according to age when admitted to a specialized institution, since it has been shown that age can influence drug use as well as treatment required. Also, it allows the introduction of prevention and treatment programs specifically for women.

  Methodology The objective of this study is to determine if there are significant differences in certain socio–demographic characteristics as weel as in factors related to the demand of drug treatment and consumption, according to female drug users age when admitted to treatment in CIJ.

  The study was based on information from the System of Epidemiological Information on Drug Consumption of CIJ. The design was exploratory, transversal and with a bi–varied analysis. The sample was non probabilistic and intentional, consisting of 754 drug users that arrived for the first time to CIJ between July and December 2004 in Mexico City.

  Furthermore, the sample was divided into three groups, according to admission age, as follows: Group 1. Women between 12 and 20 years old (n = 242); group 2. Women between 21 and 39 years old (n = 277), and group 3. Women 40 years old and older (n = 231).

  Results The sample showed a 31 years old average (DE=14.8) upon being admitted to CIJ: 51.2% were single, 32.6% were married or lived in cohabitation, 30.1% have studied high school; 32.8% stated that they had remunerated employment, 25.4% were homemakers and 23.8% were students. On average tobacco consumption starting age was 16.5 years old (DE = 5.3), alcoholic drinks 17 years old (DE = 5.9) and illegal drugs 18.5 years old (DE = 9.2).

  Tobacco (71.6%) was the main substance with which these women started drug use, followed by alcoholic drinks (19.9%). The most frecuently used illegal drugs as "first" substances were: marijuana (43.5%), solvents/removers (14.8%) and cocaine hydrochloride (11.8%).

  The most frecuently consumed drugs once in a lifetime were: tobacco (89.3%), alcoholic drinks (77.3%), marijuana (30.4%), crack (18.4%), cocaine hydrochloride (17.0%) and solvents and removers (15.4%). During the last year of use they were: tobacco (82.9%), alcoholic drinks (65.6%), marijuana (19.4%), crack (15.3%), cocaine hydrochloride (10.9%) and solvents and removers (10.1%). During the last month of use they were: tobacco (77.2%), alcoholic drinks (47.3%), marijuana (10.7%), crack (9.5%). In these three stages they consumed on average, including tobacco and alcoholic drinks, 2.9, 2.3 and 1.7 drugs respectively.

  Additionally, the sample shows that drugs prefered by women as well as those drugs that were harmful and damaging to their family, work or social life in the last year of use were: tobacco (48.9% vs 46.0%), alcohol drinks (20.0%) and crack (10.1% vs 10.7%).

  Furthermore, when comparing age groups it was observed that there were differences (p≤0.05) regarding marital status, education and occupation; finding, as could be expected according to the cycle of life, a larger proportion of women without partners in group 1 and 2; while the larger proportion of women that have at least 10 years of education (high school or more) were found in groups 2 and 3.

  The larger number of employed and unemployed women were found in group 1 while the largest percentage of homemakers were found in group 3.

  Likewise relevant differences were found (p≤0.05)regarding the following events: seeking treatment for tobacco use, alcohol and/or illegal drugs; seeking treatment by own initiative or conditioned by their family or due to medical guidance; interrupting consumption voluntarily without support and participating in self help groups; and current health, family, work, as well as psychological problems caused by drug consumption.

  The larger cases that were admitted because of illegal drugs or alcohol consumption were found in group 1, followed by group 2; while those admitted due to tobacco consumption were found in group 3. In the group 3, there was largest percentage of women seeking profesional help by their own will or following medical guidance, while those attending conditioned by their family were found in group 1.

  Additionally the largest proportion of women who attended support groups or that interrupted drug consumption at one time or another without support were found in group 2.

  The highest percentage of family problems associated to drug consumption was found in group 1; while health problems were found in group 3 and psychological or labor problems in group 2.

  Regarding drug consumption there were some relevant differences (p≤0.05) in the categories of "first used" drugs, such as: drugs consumed once in a lifetime, consumption in the last year, consumption in the last month, drug of preference during the last year, drug of greatest impact during the last year of consumption and consumption of two or more substances in the same day during the last year.

  According to once in a lifetime consumption, there were relevant differences (p≤0.05) between groups mainly in the use of: tobacco, alcoholic drinks, marijuana, cocaine, depressors and stimulants. However, between group 1 and 2 there were also differences (p≤0.05) in the consumption of inhalants.

  In the last year and in the last month at consumption, all groups differ from each other (p≤0.05) in tobacco and alcohol use. Also, in the last year of consumption differences were observed in the use of depressors.

  Also, when comparing groups 1 and 2 (p≤0.05) there were also found relevant differences in tobacco, marijuana, cocaine and inhalants consumption during the last year and the last months of consumption.

  Regarding consumption of alcoholic drinks, marijuana and inhalants once in a lifetime—in the last year and in the last month of consumption—, the highest proportion was found in group 1, as that found in cocaine in group 2 and that of tobacco in group 3.

  Even though tobacco, alcoholic drinks and illegal drugs were drugs of preference and of greatest impact during the last year of consumption, they showed different proportions between groups as follows (p≤0.5): group one reported the highest percentage of illegal drugs and alcohol while in group three the higher percentage was found in tobacco; and in group 2 tobacco and illegal drugs also yielded high percentages.

  Lastly, most cases where two or more drugs were consumed in the same day during the last year of consumption were found in group one, differing (p≤0.05) to those of group 2.

  Discussion Consequently it is very important to study drug users taking into account characteristics that allow us to provide information about their specific needs.

  This study offers evidence of relevant differences between women who seeked treatment at CIJ as well as differences related to age when admitted for treatment and that contributes useful elements to make progress in the development of differentiated preventative care and treatment for women in specialized institutes.

  Despite their limits, the results obtained offer a useful parameter for developing health care alternatives that will take into account factors such as drug users age, family, as well as social and health problems, substances that they have used in the past and those that they are consuming.

  As a result, this study will allow us to improve specific treatments for each drug user that decides to seek specialized treatment; as well as to save human and economic resources. Taking the group of 40 years and older into consideration, the need for care programs focused on the use of tobacco becomes evident. In addition, in the group of women between 21 and 39 years old the programs could consider diverse treatments and even combine them where the consumption of tobacco and illegal drugs, as well as the organic and psychological damage caused by these is taken into account. In the group of women under 21 years old, the necessity to apply multiple treatments that take into consideration the consumption of alcohol and illegal drugs, as well as developing strategies that involve both families and schools, is detected.

  The findings coincide with those presented by the United Nations Office on Drugs and Crime, indicating that international policy should propose the application of specific treatment with women who consume illegal substances and that the reduction programs of drug consumption and demand should be conceived in such a way that they respond both to the needs of the general population and also to determined groups of the population.