OBJECTIVES: To estimate the prevalence and associated factors to psychotic substance use in low-income adolescents from the Caribbean region of Colombia

METHODS:A cross sectional study was conducted. Adolescents between 10-24 years of age residents in 21 municipalities were randomly selected from the population affiliated to a subsidized-regime insurance company between 2014-2018. A previously constructed questionnaire was used to obtain information regarding sociodemographic variables and potential risk factors. Prevalence of lifetime use of substance abuse was assessed. Bivariate and multivariate logistic regression models were used to establish associated factors. Absolute and relative frequencies were compared with the Chi² test and continuous variables were compared with the t-test. A p value <0.050 was considered significant

RESULTS:A total of 35,214 adolescents with a mean (SD) age of 16.0 (4.1) years were included. Of these, 55.7% were women and 63.9% lived in urban areas. The lifetime prevalence of psychoactive substance use was 1.9% (95% CI: 1.7-2.0) and a higher prevalence of use was found in males compared to females (2.8% and 1.1%). A positive association between age and substance use was found (10-14yr: 0.7%; 15-19yr: 2.4% and 20-24yr: 2.9%). Compared to tobacco (4.4%), alcohol (28.8%) was the most frequent substance consumed by individuals. Risk factors for substance consumption were (OR 95% CI) being older than 14 years (15-19yr=OR 3.2; 2.4-4.2 and 20-24yr=OR 4.4; 3.3-5.8)(p<0.001), feeling sad/empty most of the time (OR 2.3; 1.8-2.9), having suffered constant physical abuse by parents (OR 2.8; 1.0-6.9), have executed school bullying (OR 2.0; 1.5-2.6) and urban residence (OR 1.6; 1.3-2.1).

CONCLUSIONS:a correlation between substance use and adverse outcomes in mental health, family function and quality of life was found. Policies should consider the influence of social determinants of health in the consumption of psychotic substances in adolescents