Opportunities for Drug Use, Drug Use and Violence in Youth: an Approach to Explore Individual Factor

1
Opportunities for Drug Use, Drug Use and
Violence in Youth an Approach to Explore
Individual Factors and Characteristics of the
Micro and Macro-context From a Gender Perspective

• Fernando A. Wagner, Luciana E. Ramos-Lira

Drug Abuse Research Program, Morgan State
University, Baltimore, Maryland, US. Instituto
Nacional de Psiquiatría Ramón de la Fuente,
Mexico City, Mexico.
2
BACKGROUND
3

• Violent experiences have been found as an
  important factor related with drug involvement
  (Vermeiren et al., 2003) , particularly when
  these experiences occur during childhood or even
  adolescence (Ramos-Lira et al., 1998, 2001
  Bensley et al., 1999 Freeman et al., 2002 Dube
  et al., 2003 WHO, 2002).

4

• The literature also indicates that severity and
  the type of violence exposure may be directly
  associated with drug involvement (Clark, et al.,
  1997 Dube, et al., 2003 Freeman, et al., 2002,
  Pérez, 2000) and with the early initiation of
  substance use (Bensley et al., 1999 Pérez,
  2000).

5

• For example, a study with a US nationally
  representative sample of youth found that those
  who had experienced either physical or sexual
  abuse were twice as likely as their
  non-victimized peers to report past-year drug use
  or dependence (Kilpatrick et al., 2000).

6

• In Mexico, a study in a nationally representative
  sample of secondary and preparatory students
  showed that to be a victim or a perpetrator of
  sexual abuse were associated with the use of
  drugs (Ramos-Lira et al., 1998).

7

• Research has shown that epidemiological
  differences exist between different types of
  violence considering sex and age (National
  Academy of Assistance to Victims, 2002
  Medina-Mora et al., to be published WHO, 2002).

8

• There is a possibility that adolescents exposed
  to different types of violence initiate drug use
  early and/or report greater amount of illicit
  drug use.
• Moreover, the type of outcome maybe dependent
  upon the particular type of victimization
  experienced.

9
To begin to explore these issues, we studied the
association between exposure to violence, and
actual drug use of marijuana, cocaine and
inhalants among urban middle schools students
living in Mexico City (Wagner et al., 2003.
10
Also, we included the opportunities to use drugs,
-such as marijuana, inhalants and cocaine- in
this study.
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12

• Wagner Anthony advanced evidence to support the
  idea of drug exposure opportunities as a
  mechanism that may be helpful to understand
  gateway drug use (Wagner Anthony, 2002).

13

• The concept drug exposure opportunities refers
  to the chance an individual may have to use any
  particular drug to use a drug after actively
  seeking out the opportunity or else, to having
  been exposed to an opportunity without any active
  involvement (Wagner, et al., 2003).

14
The study was done in an area of Mexico City that
has some particular characteristics that make it
very interesting for this kind of research the
Downtown area.
15
Mexico City has experienced a marked
deterioration of its downtown area, leading to
the loss of population and growing demographic
discontinuity, empty spaces that disturb the
urban profile and social fabric, leading to an
absence of law and order that feeds the process
of decadence (CESPEDES, 2001).
16
Drug trafficking, broken families, the existence
of several neighborhoods with a high risk of drug
consumption, the lack of services and the poor
quality of the latter, psychosocial stress and
its repercussions on health, unemployment and
underemployment, together with a high percentage
of floating population has turned the area into a
breeding ground for crime and drug and arms
trafficking.
17
GRAPH 1 Total prevalence of drug use
Lifetime Last year Last moth
Mexico City (D.F.)
Cuauhtémoc
Sources De la Serna Rojas, .Estrada
Medina-Mora, 1991 Castro, 1992. 1991,1993 y
1997. Villatoro et al. (2001). Global Report.
INP-SEP.Mexico.
18
GRAPH 2 Last year drug use trends in male Mexican
students (D.F.)
Sources De la Serna Rojas, .Estrada
Medina-Mora, 1991 Castro, 1992. 1991,1993 y
1997. Villatoro et al. (2001). Global Report.
INP-SEP.Mexico
19

GRAPH 3 Last year drug use trends in female
Mexican students (D.F.)
Sources De la Serna Rojas, .Estrada
Medina-Mora, 1991 Castro, 1992. 1991,1993 y
1997. Villatoro et al. (2001). Global Report.
INP-SEP.Mexico
20
GRAPH 4 Total prevalence of drug use by age in
Mexican students (D.F.)
Sources De la Serna Rojas, .Estrada
Medina-Mora, 1991 Castro, 1992. 1991,1993 y
1997 Villatoro et al. (2001). Global Report.
INP-SEP.Mexico
21

• According to Canclini (1998) the population
  growth that occurred over the past fifty years
  contributed to the decline of Mexico Citys
  downtown areas as well as that of other cities
  around the world, a phenomenon now known as urban
  culture.

22

• Slowly, the global experience of urban matters is
  lost, with solidarity and the sense of belonging
  growing weaker.
• Consequently, Canclini proposes that identities
  are also redefined. This redefinition is not only
  limited to community or regional conditions of
  culture, since globalization involves consumption.

23

• A study developed across urban neighborhoods of 9
  countries (South Africa, Thailand, Czech
  Republic, Brazil, Mexico, Iran, India, Nigeria,
  and Indonesia) showed that community problems,
  deviance of friends, and age consistently were
  associated with greater risk for negative
  outcomes related to violence and substance use
  (Report for World Health Organization, Tolan,
  Schoeny Slavick, 2004)

24
The results of the study in middle schools
students in Downtown area, showed that Six out
of ten students in this sample had been violently
victimized (59.6) Of these, two out of five
experienced violence at home the same proportion
at school, 30 at street and 15 in other places.

25
One out of four had been exposed to opportunities
to use marijuana, inhalants and cocaine
(23.3) One out of 12 students had used drugs
(8.6)
26
Students who had been victimized were five times
more likely to have had an opportunity to use
drugs, compared to those who had not been
victimized (aOR5.4 95 CI, 3.4, 8.6). Males,
compared to females, were more likely to have
used drugs (aOR1.5 95 CI, 1.0, 2.2).
27
Students who were victimized were three times
more likely to have used drugs (aOR3.3 95 CI,
1.7, 6.4) However, no association between
victimization and drug use was found, once
exposure to opportunities to use drugs was taken
into consideration (aOR 1.5 95 CI, 0.6, 3.9)
28

• Notwithstanding some important limitations of
  this study, the finding that violent experiences
  in adolescents are associated with exposure to
  opportunities to use drugs and actual drug use
  warrants further study and discussion.

29

• Particularly it is important to go deep in the
  relation between childhood and adolescent abuse
  and drug involvement (Bulik et al., 2001 Dilorio
  et al., 2002 Hyman Sinha, 2004 McMillan, et
  al., 2001 Scheider Irons, 2001) particularly
  it is necessary to consider the effect of
  different types of violent exposure.

30

• Nevertheless, the fact that in this group of
  young people the association between violent
  victimization and drug use can be traced back to
  differences in exposure to opportunities, make us
  think that in settings where more drugs are
  available there is a higher risk of drug use
  because there is also more violence or other
  hazardous life conditions.

31

• A great opportunity to study these issues is
  doing cross-cultural research, considering
  factors related with the macro and micro contexts
  i.e, structural characteristics of the country
  and the particular community and also with
  personal variables

32

• In the case of the area in which the study was
  done, between 1990 and 1996 crime rose by 100,
  from 365 attacks a day to 692.17 (40).
• Drug selling has grown, particularly cocaine
  dealing which has also changed the way it is
  used. The way crime takes place has undoubtedly
  changed. Violence has increased and robberies are
  more aggressive while gangs are more organized
  with guns, cars and drugs.

33

• In this respect, young people and teenagers are
  seriously at risk.
• They turn are a captive market that grows very
  easily, and when they are hooked by these gangs
  they are used as sellers or dealers. Young drug
  dealers are known as mules, camels or
  connections.
• Generally, drug dealers use these people because
  of the low pay they can give them or because they
  can be paid in kind

34

• In the case of United States, Tolan and Morris
  (in process of publication) propose that
  theoretical analyses and empirical evidence
  suggest that the inner-city is a distinctive
  social ecology due to the concentration of
  poverty, the lack of resources and integration
  into the larger civic and economic organization,
  and the presence of multiple social problems.

35

• These features affect development of children,
  family management and functioning, and the nature
  and level of risk for those growing up in these
  communities.
• That risk seems to be greater for most social
  problems, including some forms of drug abuse. In
  addition, the distinctive social ecology may
  indicate a need for variation in prevention
  efforts.

36
SITUATION IN THE REGION
37

• Latin America and the Caribbean have presented
  economic and demographic changes that have caused
  great difficulties for the population as a whole
  and for young people in particular.

38

• Latin America is the region with the most unequal
  income distribution. Likewise, there was a
  significant increase in poverty, particularly
  urban poverty, during the 1980s.
• In the early 1990s, although poverty continued to
  rise in absolute terms, it experienced a relative
  reduction in countries where inflation was
  drastically reduced.

39

• Be that as it may, poverty levels in the
  mid-1990s persisted at higher levels than in the
  1980s.
• Bustelo and Minujin (undated) suggest that an
  area of social and economic vulnerability has
  been created, which is expanding in absolute and
  relative terms, and includes the structurally
  poor, the newly poor and broad sectors of the
  middle classes.

40

• As a result of all these factors, these authors
  envisage a society in which vulnerability is on
  the rise, with increasingly heterogeneous and
  complex situations of poverty and social
  exclusion.

41

• These changes at the macro level possibly have
  affected youth, making them more vulnerable,
  which, together with the drug preparation and
  trafficking industry, has exposed them to a
  series of challenges and risks that expose them
  to problematic contact with drugs.
• This includes involvement with the sale and
  purchase of illegal substances.

42

• One important factor is the specific link between
  the United States and Mexico. The two countries
  share a border and growing economic
  interdependency.
• While the United States has one of the most
  serious drug abuse problems in the world, Mexico
  is one of the most important areas for production
  and trafficking.

43

• Nowadays both countries are seriously affected by
  drug dealing, production, consumption and the
  violence resulting from this, meaning that they
  are also affected by illegal arms trading and
  money laundering (Secretaría de Relaciones
  Exteriores, 1997).

44

• As Valenzuela (1997) points out, in the case of
  Mexico drug dealing is one of the sociocultural
  components of the end of this century that has
  become a definitive life project for many
  millions of people.
• Unfortunately, the possibility of obtaining drugs
  at all levels of society has expanded while drug
  dealing has become a major source of income.

45

• Estimates of the number of young people living
  in poverty have concluded that there are
  approximately thirty-five million impoverished
  young people in the region (Organización
  Iberoamericana de la Juventud, 1994).

46

• In Mexico, youths aged between 15 and 24
  represent 27.9 of the total population (15), a
  proportion that tends to increase in urban
  settings.
• Nowadays, 48.7 live in cities with over 100,000
  inhabitants and 27.2 in communities with 2,500
  to 99,999 inhabitants. (Pérez-Islas, 2002).

47

• Enormous inequity, coupled with a lack of
  opportunities, which are worsening due to the
  current financial crisis, are affecting the
  population in Mexico, as well as in other
  developing countries (Miranda, 2003).

48

• One aspect to emphasize is that international
  migration has also seen drastic changes although
  movement between countries persists, especially
  across borders, as part of a historical pattern,
  the region is a source of emigration with a range
  of destinations that has progressively expanded.

49

• Virtually all countries have experienced an
  increase in the number of their immigrants and it
  is estimated that nearly 20 million Latin
  Americans and Caribbeans live outside their
  country of birth, particularly in the US

50

• It is estimated that Mexicans account for 54 of
  regional immigrants, followed by Cubans,
  Dominicans and Salvadorans and that family
  remittances have exceeded twenty-three thousand
  million dollars (Chackiel, 2004), playing a key
  macroeconomic role in countries such as Mexico.

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FACTORS TO CONSIDER FOR A CROSS- CULTURAL
COMPARISON
52

• Given that men and women have different positions
  in the Mexican an US societies, as well as
  male-female differences in drug and violence
  involvement, it is important to consider a gender
  perspective in this project.
• A gender perspective will allow understanding
  identity issues related with masculinity and
  feminity that influence youngsters risks of drug
  use and violent behaviors.

53

• In Mexico, different studies (Barquet, 1994
  Esteneiou, 1996 Lagarde, 1990 Ravelo, 1995)
  confirm the disadvantages for women in terms of
  work, including unfavorable job conditions, lower
  wages and employment with less status than men.

54

• Cultural beliefs in terms of gender
  relationships, including family, marriage, and
  motherhood, are very important to understand the
  situation of women and men in Mexico.

55

• Particularly important are the conceptions of
  masculinity and femininity constructed on the
  basis of family roles such as mother and son,
  brothers and sisters, and the idea of masculine
  superiority. These imply unequal relations
  between sexes.

56

• The principle of male superiority assumes beliefs
  such as males are more intelligent and stronger
  than women in both physical and emotional aspects
  and that women must be obedient.

57

• Historically, the myth of the Mexican woman is
  related to a binary and divided entity the
  good woman and the bad woman.
• This division is associated with moral standards
  in which women would be demigoddess, morally
  superior and spiritually stronger than men (Ary,
  1990, p. 74).

58

• The ennoblement of female chastity has been
  labeled as marianismo (see Lefley et al., 1993),
  and has been considered the counterpart of
  machismo.

59

• The concepts are complementary aspects of gender
  machismo represents the male ideology and
  masculinity and marianismo, through the cult of
  the Virgin, represents the feminine counterpart
  (Melhus, 1990, p. 41).

60

• These are normative representations rather than a
  classification of actual behavior (Riquer, 1989).
  
• Nevertheless, the powerful subjective effect of
  these images need to be recognized and understood
  (Amuchástegui, 1996).

61

• Studies in U.S. have shown that Latinos hold more
  traditional attitudes toward women (see Lefley et
  al., 1993).
• Also, Mexicans and Mexican-Americans are more
  conservative and sustain more rigid expectations
  about gender roles than other groups (Williams,
  1984).

62

• It could be very interesting try to explore
  gender issues such as roles and identities to see
  their impact in the use of drugs.

63

• In populations of Mexican American adults the
  role of gender identity and ethnic identity on
  drug use and restraint has been explored, showing
  interesting results related with constructs such
  as male privilege and marginal identities
  (Garfinkle et al., 2003)
• Needles to say, these factors are of great
  interest for a comparison between Mexicans and
  Mexican American in US