Summary of Proceedings from the Latin American Epidemiology Network La Red Latinoamericana de Investigadores en Drogas (REDLA) June 2008 Acknowledgements the both the Inter-American Drug Abuse Control Commission (CICAD) and the The Inter-American Observatory on National Institute on Drug Abuse Drugs (OID/CICAD), and the National (NIDA). Institute on Drug Abuse (NIDA) would like to recognize the work done by the The network is comprised of academic members of the Latin American drug researchers from a variety of institutions research network – Red in Latin America. Members are Latinoamericana de Investigadores en nominated by the national drug Drogas (REDLA), and their commissions of the OAS member states, contributions which have made this and are selected by a review by the report possible. We would also like to coordinating teams at CICAD and extend our appreciation to the other NIDA. The REDLA also includes researchers who contributed information liaisons to the CICAD network of for this report. The following paper is a National Observatories on Drugs in synopsis of findings from the REDLA Latin America, the National Hispanic members. Sources for this paper were Science Network on Drugs in the United the presentations made at the REDLA States (NHSN) and voluntary Meeting on June 11 and 12. Summary participants vis a vis the NHSN. papers and copies of the presentations _________________________________ follow in this compendium. _________________________________ Inventory on Drug Research Programs in Latin American About the REDLA Network Universities The REDLA network is a group of The information presented on the academic researchers who share an inventory of drug research programs in interest in developing research on the Latin American universities showed that drug problem and whose geographic there are few programs in the region focus and arena is Latin America. aimed specifically at drug research. REDLA is supported and financed by Nevertheless, there are a variety of 1 Proceedings from the Meeting of the Red Latinoamericano de Investigadores sobre Drogas (REDLA), June 2008 academic programs that address the drug Brazil stands out as having the highest research theme. In the majority of cases rate of inhalant use among students in lines of research on drugs are the region, surpassing 15% for past year interdisciplinary. This could be an use. There appears to be a great deal of advantage in the sense that the drug use of pharmaceuticals without a phenomenon is not limited to once single prescription. The use of field, rather it tends to be a transversal benzodiazepines is common among the problem. general population (3.8% in the past The primary problem found year), while 5% of women report using across graduate level research programs benzodiazepines without a medical is the extremely low graduation rate. A prescription at some point in their large number of programs that offered lifetime. lines of research in the drug theme had a postgraduate completion rates between Colombia 2% and 12%. This problem was not In Colombia, the use of pharmaceuticals limited to programs in the drug theme, without a prescription among secondary but rather appears to be common across school students stands out as one of the graduate level studies, and represents a major drug misuse issues among minors. significant obstacle to any effort that 9.9% of secondary school students supports the education of future reported use of tranquilizers at some researchers in the health sciences field. point in their lifetime, while 6.3% _________________________________ reported use during the past year, and 5% during the past month. Marijuana Highlights from REDLA use was somewhat lower among secondary school students. Country Reports: Approximately 7.6% reported use of marijuana at some point in their lifetime. Argentina Past year and past month rates were The drugs seen as the primary problem 6.6% and 2.3% respectively. in Argentina are cocaine and marijuana. These two substances define problematic Costa Rica use for the country. Perception of risk There has been a general upward trend associated with marijuana and cocaine is in marijuana use since 2001 among both low in comparison to the rest of the males and females in the general South American region. The use of population. Lifetime use of cocaine pasta base or cocaine paste is also on the remained unchanged between 2001 (3%) rise in Argentina. The government of and 2005 (2005), but increased in Argentina believes that the country has women from (0.1% to 0.7%). The become a processing point for pasta base lifetime prevalence of crack use is at into cocaine HCL for eventual shipment about 0.9% overall, but this has been north. increasing since 1995. Dependency on crack is one of the principal reasons for Brazil seeking drug treatment in Costa Rica. Marijuana, inhalants, cocaine and pharmaceuticals without a prescription Chile are common drugs of misuse in Brazil. 2 Proceedings from the Meeting of the Red Latinoamericano de Investigadores sobre Drogas (REDLA), June 2008 In Chile the most commonly consumed remained stable, while inhalants and psychoactive substances in the general cocaine paste show decreasing trends. population are alcohol (72%), and tobacco (46.4%). Marijuana is the most Puerto Rico commonly used illicit substance (7%), The 2008 Household study in Puerto followed by cocaine (1.2%) and cocaine Rico estimated that the lifetime use of paste (0.6%). Trends over time have marijuana is about 15.5%, and for shown a significant increase in cocaine 6.3%. Heroin is also present in marijuana use between 2002 and 2006, the population, with at lifetime rate of while the use of cocaine and cocaine 1.3%. Among secondary school paste have remained stable. students, lifetime use of marijuana was estimated at about 7.4% and 4.6% for inhalants. Guatemala It is difficult to draw conclusions about the state of drug consumption in Increases in Drug Use Guatemala due to the lack of recent data. Argentina (2001-2005) and Brazil Previous studies are somewhat (2001-2005) report measurable increases contradictory in terms of drug use. This in the use of marijuana and cocaine use has to do with the type of studies in addition to increases in other illicit performed and lack of comparability substances. Chile showed marked between them. increases in marijuana use from 2001- 2005, while cocaine use remained relatively stable. However, use of Mexico Drug use rates in Mexico are highest cocaine paste (pasta base) increased in among the secondary school population. Chile during this period. Increases in Of key interest is the fact that marijuana use were found in Costa Rica differences in drug use by gender are as well. diminishing. Patterns of drug use vary _________________________________ by region, and are particularly high in Emerging Trends and Patterns of Use the regions that are contiguous with the across Countries: United States. Mexico also notes a high correlation between depression and drug Perception of Risk use in the country. Countries with time series data reported decreases in the perception of risk associated with drug consumption Peru Studies in Peru between 1998 and 2006 between 2001 and 2005, particularly demonstrate that alcohol and tobacco are with respect the consumption of the most commonly consumed marihuana. psychoactive substances, with higher consumption of both among males than The Culture of Self Medication – females. The proportion of alcohol users Nearly all the countries reported the use who demonstrated signs of alcohol of pharmaceuticals without a dependency in 2006 was 8.1%. prescription as a common occurrence. Marijuana is the most commonly For the most part there are few controls consumed illicit drug. The prevalence in place in Latin America regarding the and incidence of cocaine use have commercial purchase of prescription 3 Proceedings from the Meeting of the Red Latinoamericano de Investigadores sobre Drogas (REDLA), June 2008 drugs. Many countries do not require prescriptions for medications that would Merla – This is a new pattern reported be by prescription only in the United only by Brazil. Merla is a smokable States, and countries that do have laws, combination of cocaine paste or crack these are not carefully enforced or the with tobacco and cannabis. According system itself is abused. The overall to the Brazil data, normally users choose result is that it is both common practice either cocaine paste or crack, but rarely and culturally acceptable to use a variety are the two mixed. Cocaine paste of medications without a medical smoked alone may also be referred to as prescription. “merla”. In Brazil the use of benzodiazepines Heroin with Xylazine – A new pattern without a prescription is common, of use seen only in Puerto Rico is the especially among women. Rates of use mixture of heroin with xylazine, an of benzodiazepines among women were animal tranquilizer. This trend appeared 2.9% for past year use, and 1.91% for over the past two or three years, but past month use. In Chile, past year seems to be picking up momentum prevalence of use of tranquilizers among heroin users on the island. A without a prescription, among secondary 2008 qualitative study showed that about school students was 2.8% and 1.9% for ¾ of the population of heroin users that stimulants. An increase in were studied reported use of xylazine. pharmaceutical use without a prescription was seen in Mexico as well. Information Gaps It is clear that there is a great deal of “Binge Drinking” – Binge drinking is a high quality information on the behavior that was previously rare among epidemiology of drug use in the national Latin American youth. Nearly all the databases of the REDLA member countries report that their most recent countries. Nevertheless, it appears that drug surveys show some amount of this information is not being used to its binge drinking, defined as five drinks or full capacity.