Uso não prescrito de tranquilizantes entre estudantes no Brasil
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Data
2013
Autores
Opaleye, Emérita Sátiro [UNIFESP]
Orientadores
Noto, Ana Regina [UNIFESP]
Tipo
Tese de doutorado
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ISSN da Revista
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Introdução: O uso nao prescrito de medicamentos psicotropicos entre jovens tem crescido mundialmente e se tornado objeto de preocupacao nos ultimos anos. Os tranquilizantes estao entre os medicamentos mais utilizados, com grande potencial para uso inadequado, abuso e dependencia, especialmente em populacoes mais vulneraveis como os adolescentes. Este estudo descreve o padrao de uso de tranquilizantes sem receita medica por estudantes brasileiros e identifica caracteristicas dos adolescentes e da exposicao a essas substancias que estao associadas ao consumo nao prescrito. Metodos: As analises foram realizadas a partir de uma amostra randomizada e estratificada de 47979 estudantes de 10 a 18 anos de nivel fundamental e medio da rede publica e privada de ensino nas 27 capitais brasileiras. Os dados foram obtidos por meio da aplicacao de um questionario de autopreenchimento sobre uso de tranquilizantes sem receita medica e demais substancias psicotropicas (alcool, tabaco, maconha, cocaina/crack, ecstasy, Benflogin®, anabolizantes, anfetaminas e opioides), variaveis sociodemograficas (idade, genero, classe socioeconomica, tipo de escola e regiao do pais), indicadores de acesso (ja ter recebido prescricao medica e uso de tranquilizantes por familiar ou amigo) e tambem percepcao de risco. Modelos de regressao logistica foram realizados para verificar associacao entre uso na vida nao prescrito de tranquilizantes e os fatores previamente mencionados. Resultados: O uso na vida de tranquilizantes sem receita medica foi relatado por 3,9% dos participantes, sendo o diazepam o medicamento mais consumido. O principal motivo de uso foi automedicacao e mais de 80% mencionou ter obtido o medicamento atraves da familia ou disponivel em ambiente familiar. O consumo foi duas vezes mais prevalente entre meninas e alunos provenientes de classes socioeconomicas mais favorecidas e escolas privadas. Houve associacao entre uso nao prescrito de tranquilizantes e uso na vida de alcool, de tabaco, de drogas ilicitas e de outros medicamentos sem receita medica. O uso sem prescricao medica de tranquilizantes pelos adolescentes tambem foi associado ao uso de tranquilizantes por algum parente ou amigo, ja ter recebido uma prescricao medica anterior de tranquilizantes e a uma baixa percepcao de risco de uso regular da substancia. A prescricao medica tambem esteve associada a uma baixa percepcao de risco do adolescente ao uso regular nao prescrito. Conclusao: O uso de tranquilizantes sem receita medica por adolescentes pode indicar o consumo de outras substancias, incluindo combinacoes de risco, como o uso concomitante com alcool. Ha influencia direta (oferta) e indireta (acesso e uso) da familia, e a prescricao medica tem um papel reforcador sobre o uso nao prescrito, inclusive reduzindo a percepcao de risco dos adolescentes. Os riscos decorrentes do uso de tranquilizantes sem prescricao medica devem ser abordados em fases iniciais de programas preventivos sobre drogas, e maior atencao pode ser dada aos grupos de maior risco ao consumo, como meninas e adolescentes com maior poder aquisitivo. Os medicos devem ser alertados sobre o efeito da prescricao medica de tranquilizantes acerca de um eventual uso nao prescrito entre adolescentes, sendo judiciosos ao prescrever para esta faixa etaria. Da mesma forma, adultos devem ser orientados quanto a importancia de nao compartilhar seus psicotropicos ou deixa-los acessiveis para adolescentes
Background: The use of a psychotropic medication without a prescription among young people appears to be a growing global problem. Tranquilizers are used in large scale, with great potential of misuse, abuse and dependence, especially in more vulnerable populations such as adolescents. This study aims to describe the patterns of nonprescribed use of tranquilizers by Brazilian students and to identify these adolescents' characteristics as well as the exposure variables (characteristics) that may lead to (may imply) the use of tranquilizers without a proper prescription. Methods: Analyses were made from a dataset of a randomized and stratified sample of 47979 students aged 10 to 18, attending middle and high school in private and public schools, from the 27 Brazilian state capitals. We used a self-report questionnaire to obtain information regarding the nonprescribed use of tranquilizers and other substances (alcohol, tobacco, marijuana, cocaine/ crack, ecstasy, Benflogin®, amphetamines and opioids), sociodemographic variables (age, gender, socioeconomic status, type of school and country region), access indicators (having received a medical prescription for tranquilizers and use of these substances by a relative or a close friend) and risk perception. Logistic regression models were performed to verify association between nonprescribed lifetime use and the factors we mention above. Results: Nonprescribed lifetime use of tranquilizers was reported by 3.9% of respondents and diazepam was the most cited drug. The main reason to use tranquilizers without a prescription was self-medication and more than 80% of adolescents had obtained them within their own home or by means of a relative. Girls were twice more likely than boys to report the use, as well as adolescents from private schools and higher socioeconomic status. Nonprescribed lifetime use of tranquilizers was associated with lifetime use of alcohol, tobacco, illicit drugs and nonprescribed use of other medications. The nonprescribed use was also associated with having received a medical prescription in the past, the use of tranquilizers by a relative or close friend, as well as low risk perception to the regular nonprescribed use of tranquilizers. Medical prescription was likewise associated with low risk perception among those who ever used tranquilizers. Conclusions: Adolescents’ non-medical use of prescription tranquilizers might indicate the use of other substances including risky combinations such as prescription tranquilizers and alcohol. Family may act directly, by offering, or indirectly, by allowing access and self use. Prior medical prescription might reinforce this behaviour, as well as reduce adolescents’ risk perception. The risks that result from nonmedical use of prescription anxiolytics should be addressed during the early stages of drug prevention programs, and more attention should be given to high risk groups, including girls and adolescents with higher purchasing power. Physicians should be warned about the effect of prescription tranquilizers regarding possible misuse among adolescents, and ought to be judicious when prescribing for this age group. Likewise, adults should be counselled about the importance of not sharing their psychotropic drugs and not leaving them accessible to adolescents.
Background: The use of a psychotropic medication without a prescription among young people appears to be a growing global problem. Tranquilizers are used in large scale, with great potential of misuse, abuse and dependence, especially in more vulnerable populations such as adolescents. This study aims to describe the patterns of nonprescribed use of tranquilizers by Brazilian students and to identify these adolescents' characteristics as well as the exposure variables (characteristics) that may lead to (may imply) the use of tranquilizers without a proper prescription. Methods: Analyses were made from a dataset of a randomized and stratified sample of 47979 students aged 10 to 18, attending middle and high school in private and public schools, from the 27 Brazilian state capitals. We used a self-report questionnaire to obtain information regarding the nonprescribed use of tranquilizers and other substances (alcohol, tobacco, marijuana, cocaine/ crack, ecstasy, Benflogin®, amphetamines and opioids), sociodemographic variables (age, gender, socioeconomic status, type of school and country region), access indicators (having received a medical prescription for tranquilizers and use of these substances by a relative or a close friend) and risk perception. Logistic regression models were performed to verify association between nonprescribed lifetime use and the factors we mention above. Results: Nonprescribed lifetime use of tranquilizers was reported by 3.9% of respondents and diazepam was the most cited drug. The main reason to use tranquilizers without a prescription was self-medication and more than 80% of adolescents had obtained them within their own home or by means of a relative. Girls were twice more likely than boys to report the use, as well as adolescents from private schools and higher socioeconomic status. Nonprescribed lifetime use of tranquilizers was associated with lifetime use of alcohol, tobacco, illicit drugs and nonprescribed use of other medications. The nonprescribed use was also associated with having received a medical prescription in the past, the use of tranquilizers by a relative or close friend, as well as low risk perception to the regular nonprescribed use of tranquilizers. Medical prescription was likewise associated with low risk perception among those who ever used tranquilizers. Conclusions: Adolescents’ non-medical use of prescription tranquilizers might indicate the use of other substances including risky combinations such as prescription tranquilizers and alcohol. Family may act directly, by offering, or indirectly, by allowing access and self use. Prior medical prescription might reinforce this behaviour, as well as reduce adolescents’ risk perception. The risks that result from nonmedical use of prescription anxiolytics should be addressed during the early stages of drug prevention programs, and more attention should be given to high risk groups, including girls and adolescents with higher purchasing power. Physicians should be warned about the effect of prescription tranquilizers regarding possible misuse among adolescents, and ought to be judicious when prescribing for this age group. Likewise, adults should be counselled about the importance of not sharing their psychotropic drugs and not leaving them accessible to adolescents.
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Citação
OPALEYE, Emérita Sátiro. Uso não prescrito de tranquilizantes entre estudantes no Brasil. 2013. 213 f. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2013.