Introduccion

El aumento del uso de sustancias entre hombres y mujeres, registra un comportamiento diferente entre ambos grupos.

La revisión de la bibliografía indica que existen diferentes variables que diferencian el consumo entre hombres y mujeres, tales como datos sociodemográficos, patrones de uso y problemas aso ciados. Ambos grupos emplean las sustancias como un medio para disminuir y/o resolver problemas. Sin embargo, una vez que el usuario se instala en la carrera de consumo, se incrementa la percepción de problemas de manera paralela con el patrón de consumo. En esta comunicación se analizan diferencias y semejanzas del consumo en hombres y mujeres de acuerdo a los resultados del sistema de reporte de información en drogas (SRID) que es una herramienta diagnóstica y para la alerta de los aspectos más importantes del uso de drogas en la ciudad de México.

Objetivo

Presentar las diferencias y similitudes del uso de sustancias entre hombres y mujeres respecto al perfil sociodemográfico, patrón de consumo, problemas asociados y tendencias de uso.

Metodología

Instrumento: se emplea la cédula "informe individual sobre consumo de drogas" que recoge información sobre los principales indicadores del fenómeno. Se aplica en los meses de junio y noviembre en instituciones de atención a la salud y procuración de justicia, entrevistando a aquellas personas que reconocen haber consumido cualquier sustancia al menos alguna vez en la vida, con el propósito de intoxicarse.

Muestra: se analizaron 694 casos evaluados en noviembre de 2004: 618 hombres y 76 mujeres. Para el análisis de tendencias se consideraron 7,396 hombres y 843 mujeres, captados entre 1999 y 2004.

Resultados

Los datos sociodemográficos indican que 89% son hombres, de ellos 60% solteros y 64% de nivel socioeconómico bajo. De las mujeres 73.6% son solteras y 62.7% de nivel socioeconómico bajo. En cuanto a la edad de los hombres, la mayor proporción de ellos tiene 30 años o más (32.9%) y la edad de las mujeres es de entre 15 y 19 años (34.2%). La ocupación de los hombres es empleado o comerciante en 34.6% de los casos y la de las mujeres es estudiante en 34.7%. La escolaridad de los hombres es secundaria completa en 24.4%, mientras que en las mujeres (19.4%) secundaria incompleta.

El mayor uso de sustancias alguna vez en la vida tanto para hombres como para mujeres corresponde a mariguana, cocaína e inhalables.

La edad de inicio en los hombres es de 15 a 19 años y en las mujeres de 12 a 14. Las principales sustancias de inicio en hombres son la mariguana y la cocaína, y en mujeres los inhalables.

En cuanto a los problemas asociados al consumo, tanto hombres como mujeres muestran un importante aumento después de iniciar el consumo de sustancias, sin embargo las mujeres muestran mayor sensibilidad a los trastornos mentales, lo que plantea diferentes retos de intervención.

Conclusiones

Las mujeres muestran un aumento en el consumo de sustancias en comparación con años anteriores. Factores tales como la baja autoestima y la diferente permisividad social al consumo entre hombres y mujeres pueden ser hipótesis de futura investigación. Se sugiere que los estudios a futuro profundicen en las diferencias entre hombres y mujeres y que evalúen un espectro más amplio de componentes somáticos psíquicos y sociales asociados a consumo.

Introduction and background

Substance abuse in the world is reported higher among men than in women; nevertheless in different countries including mexico, use has increased among women during recent years. The distribution among male and female population is different according to each substance. Prevalence among both populations shows a preference for illegal drugs: mariguana, cocaine, solvent-inhalants and in a lesser degree, heroine. Meanwhile among women the mainly used substances are medical, such as sedatives and stimulants.

Nevertheless in recent years there has been a higher involvement of female population in the use of illegal substances. In different countries it has been observed a high level of use among women and a trend of age of first use at earlier ages. In different countries research findings indicate a high level of use among young women that resembles the patterns of men; nevertheless among women who are older the levels of use are relatively low. At the same time there is more participation of women in delictive activities.

The information reporting system on drugs (srid) of the national institute of psychiatry has evaluated the problem of drug use among men and women in the mexico city area from 1987 up to this date through a transversal study and carried out every 6 months. Results obtained, identify the most important trends of this problem and also describe its nature and evolution.

Other different methodological approaches have been used to get a deeper understanding of the nature and extent of this problem. School population survey (ene) oriented to evaluate the prevalence during the autumn of 2003, among high school students, reveals that 9.6% of male students and 4.8% of females have ever used mariguana some time, 5.3% of males and 2.7% of females have ever used cocaine sometime. Women using tranquillisers constitute 5.3%, and solvent-inhalants 3.8%.

The national survey on addictions (ena) carried out in 2002 among general population, reveals that substance abuse includes one woman out of every 4 men. According to this methodology 8.59% of men in general population and 2.11 of women have ever used some other drug, besides alcohol and tobacco. Mariguana (3.48%) and cocaine (1.23%) are the main used substances in the category ever used.

Results of the system for epidemiological surveillance of addictions (sisvea) indicates that for year 2004 at national level 95.0% of males were in treatment due to mariguana and heroine use, followed by 93.0% of patients treated for cocaine. Female population used tranquillisers 13.8%, solvents - inhalants 7.6% and 7.0% cocaine.

As it can be observed the above results support the existence of different patterns of substance use between men and women.

Objective

The objective of this communication is to analyze the results of the information reporting system on drugs considering similarities and differences between men and women regarding different variables associated to substance use such as sociodemographic profile, patterns of use, associated problems and trends of use. This information is a result for the second semester of 2004.

Material and method

Srid is a transversal study with two cross cut evaluations carried out twice a year. Information is gathered by means of a survey applied during an interview. Each evaluation gives a cross view of the problem in such moment of its history, and at present, information is available from 1987 to this date. The survey evaluates variables suggested by mexican research, experiences from other countries with information on systems for drugs already functioning, variables suggested by world health organization, and finally proposals obtained by discussion and agreement with experts of the participant health and justice agencies.

The survey is applied during june and november each year and after the evaluation period, the information is compiled processed, analyzed and compiled in a report made by the national institute of psychiatry. This information is available for partici-pant agencies, state officers, and general public.

Results

The results from srid for november 2004 indicate that from 694 cases studied, 89% were males, 60% single and 64% of low socioeconomic level. Of the women surveyed 73.6% are single and 62.7% from low socio-economic level.

The main age group for men is in the range of 30 and more years, for women it is between 15 to 19. Occupational status for men is employee and business (34.6%) and for women, student (34.7%). School level for men is high school completed (24.4%), for women it is 19.4% unfinished high school.

Ever some time use of substances indicate that mariguana is employed by 70.7% males and 65.8% females. Cocaine among women and men is respectively 65% y 56.6%; solvent inhalants is 37.4% for men and 30.3% for women. Amphetamines and other stimulants report 6.6% for women and 5.5% for men; sedatives and tranquillisers reach 14.5% for women and 13.4% for men.

Age of first use for men is 15 to 19 years and for women 12 to 14. Substance of first use for men is mariguana (45.3%), for women is solvent inhalants (45.0%), followed by cocaine: 19.0% for men and 10.0% for women.

Problems preceding drug use regarding family are 15.9% for men, and 11.8% for women; nervous problems: 7.4% for men and 2.6% for women.

Problems derived of drug use among women are those refer-ring to family interaction 57.9% and 49.4% for men; nervous problems: 30.3% and 26.5%; finally, psychological problems among women 39.5% and 23.5% each.

Possible explanations for such results are the following:

- Social devaluation towards women: women are subject to social pressures regarding child rising, household work, etc. This kind of work is seldom recognized and appreciated, and such situation could be a risk factor for substance use. The same is true for the pregnancy periods, because women are emotionally more vulnerable and as a result some substances are used as a tool to soothe personal, family and couple problems.

- Social attitudes towards substance use are different for men and women. Substance use in the case of male population is regarded as an open, allowed and prestigious behaviour; never-theless for women it is hidden, prohibited and devaluatory. Thus for women substance use becomes a private behaviour, out of sight, denied; a sort of relief valve in face of the need to relax, feel pleasure and socialize. Substance use then becomes a "necessary" instrument to cope with tensions but at the same time excludes women of the social scene.

- Among men and women the fantasy of solving everyday problems through the use of substances is frequent. This is a paradox since at the same time users perceive that problems become worse as a result of substance use. The clarification of such motivations is a matter for further research.

Conclusions

Further research is needed to explain the differences between patterns of substance use of men and women; this is so for motivation of onset and maintenance of substance use.

Finally the information gathered by the srid has been a valuable tool as an early warning system on substance use, it is a diagnostic resource for decision and policy making as well as for intervention and treatment planning in mexico city.