Brazilian study on substance misuse in adolescents: associated factors and adherence to treatment Estudo brasileiro sobre abuso de substâncias por adolescentes: fatores associados e adesão ao tratamento

Objectives: To investigate developmental and environmental factors associated to substance misuse in adolescents seen at a university day-hospital in Brazil and to verify the correlations between those factors and adherence to treatment. To compare factors associated to substance misuse in adolescents with the available scientific literature and to suggest specific preventive interventions for a national policy in Brazil. Methods: Eighty-six adolescent’s guardians were evaluated at admission to the service by using a semistructured interview including sociodemographic data, family relationship, perinatal and pregnancy histories, psychomotor and educational development, social relations, history of previous illnesses and family diseases, including drug abuse. Results: The sample was predominantly male (90%). Adolescents referred from the criminal justice were older than those originating from other sources (16.4 x 15.4 years old p=.00). Forty-four percent of adolescents reported school failure, a level which is two times higher than Brazilian statistics. Forty percent of the sample had criminal involvement, mainly drug dealing. Cannabis was the most prevalent reported drug. Living with both parents was protective, delaying the age of initiation by one year. Domestic violence was more frequent among parents with illicit drugs abuse (38.1% x 12.5%, p<.05). Alcoholism and drug addiction in parents and relatives were about four times higher than those reported for the Brazilian population. No correlation was found between the investigated factors and adherence to treatment. Conclusion: Our results indicate that the programs must include treatment of adults and education of parents and parents to be. Withdrawal of treatment occurs in the first month, and seems to be related to factors extrinsic to the adolescent. Substance misuse. Adolescent. Treatment. Objetivos: Investigar fatores relacionados ao desenvolvimento e ambiente associados ao abuso de substâncias por adolescentes atendidos em hospital universitario brasileiro. Comparar esses fatores com a literatura cientifica disponivel e sugerir intervencoes preventivas para uma politica nacional no Brasil. Metodos: Foram avaliados 86 adolescentes na admissao ao servico atraves de uma entrevista semiestruturada, aplicada ao guardiao do adolescente e incluindo dados sociodemograficos, relacionamento familiar, historia da gravidez e perinatal, desenvolvimento psicomotor, educacional, relacionamento social, historia de doencas anteriores e familiares, incluindo abuso de drogas. Resultados: A amostra foi predominantemente masculina (90%). Os adolescentes encaminhados pela justica criminal eram mais velhos do que os encaminhados por outras fontes (16,4 x 15,4 anos,p=0,00). Tiveram repetencia escolar 44% dos adolescentes, duas vezes mais do que o relatado nas estatisticas brasileiras para a populacao geral. Tinha envolvimento com a justica 40% da amostra, principalmente por trafico de drogas. Cannabis foi a droga mais prevalente entre os relatos. Viver com ambos os pais foi fator protetor, atrasando a iniciacao as drogas em um ano. Violencia domestica foi mais comum entre pais que faziam uso de drogas ilicitas (38,1% x 12,5%, p<0,05). Alcoolismo e dependencia quimica por pais e familiares foram cerca de quatro vezes mais altos do que o relatado por outras amostras brasileiras. Nao se encontrou corre