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Lifetime prevalence of cannabis use is estimated 192 million adults worldwide (2017) and has increased by 16% in the last decade. However, data on quantity and frequency of use that can lead to harm is lacking. We have developed a survey to assess patterns of cannabis use and related harms in a sample of cannabis users. This paper focuses on evaluating the feasibility of the survey and the users' satisfaction in a pilot sample. Forty cannabis users were recruited (>18 years old, living in Spain, cannabis use at least once during the last 12 months) between December 2018 and January 2019. Participants answered an online survey (mental health, organic harm and injury) and an ad hoc questionnaire to assess accessibility, feasibility, satisfaction, design and content appropriateness. Of the participants, 93.23% (n = 37.3) were satisfied with the design, 94.92% (n = 38.2) were satisfied with the content, and 94.73% (n = 37.0) were satisfied with the accessibility of the survey; only minor changes were required to improve feasibility and accessibility. Participants used a median of 1.0 Standard Joint Unit per day (Interquartile Range [IQR] 1.0-2.0). Of the sample, 92.5% reported at least one related harm and suffers a median of 4.0 disorders (IQR, 1.25-5.0). The present study allows for designing a feasible online survey to conduct a cross-sectional study with a larger sample.

Spain is one of the countries of the European Union in which alcohol consumption has decreased in the past decades. The aim of this paper is to distinguish different phases of the level of alcohol consumption in Spain since 1990. Adult alcohol consumption per capita data between 1990 and 2019 were analysed for temporal trends using the Joinpoint regression model. An additional analysis using interrupted time-series between 1962 and 2016 was performed using data from Global Information System on Alcohol and Health. Data from the survey on alcohol and other drugs in Spain were collected and a narrative review was conducted to identify possible reasons for the trends found. Five point changes were identified on the timeline between 1990 and 2019, including: a decrease of 3.2% per year from 1990 to 1995, an increase of 1.1% per year from 1995 to 2000, a period of stability from 2000 to 2006, a decrease of 4.5% per year from 2006 to 2011, and a period of stability from 2011 onwards. These changes can largely be explained by the different public health measures carried out by the Spanish government, as well as the change in the pattern of consumption in society, which shifted its alcoholic beverage preference from wine to beer, and increased its binge-drinking behaviour. Further studies such as interrupted time-series analyses should test if indeed the hypothesized measures on public health have been effective; this could inform future policies in Spain and in other countries.

Worldwide, as well as in Spain, the use of illegal drugs is among the major contributors to the global burden of disease. Quantifying the costs that illegal drugs impose on society is key in terms of decision-making. The objective of this paper is to estimate the social cost of illicit drug consumption in Catalonia for a specific year, and to establish a methodology to be able to replicate such estimations regularly and monitor properly the impact of national plans. To do that, a cost of illness study was performed. For the estimation of mortality and morbidity costs, we relied on the Attributable Fraction approach. Only public sector costs were included: healthcare and non-healthcare costs. The cost of illegal drug consumption in Catalonia in 2011 was estimated at €326.39 million (0.16% of the Catalan GDP in 2011; 0.15% in 2018). Of the total cost, 82% corresponded to direct costs. Among direct costs, 30.32% corresponded to the penal system, 15.99% to hospitalizations, 13.48% to the police force, 17.19% to pharmacy, 8.34% to treatment in specialized centres, and 5.74% to therapeutic communities, among others. Indirect costs represented 18% of total costs, mostly lost income due to drug-related death. This study has been an opportunity to systematically collect data and think about the potential economic returns that could be achieved from effective policies and programs aimed at reducing the consumption of illegal drugs.

Adolescence is a critical period in the development of addictive behaviors. In particular, the age at which adolescents start drinking is not a trivial matter, given the important consequences that it has. However, relatively little is known about what it is that causes them to start drinking at an ever earlier age. The aim of this paper is to collect new empirical data about the implications of an early age of onset and, at the same time, to identify possible associated variables. Furthermore, the mean age of onset of the different substances is updated by expanding the sample frame of the ESTUDES (14-18 years) to incorporate adolescents aged 12 and 13. The results obtained with a sample of 3,419 adolescents from the Autonomous Community of Galicia (M = 14.57 and SD = 1.76) reveal that at 13.4 years of age, the age at which adolescents tend to start drinking is lower than suggested by ESTUDES 2016-2017. In addition, those who start drinking earlier are more likely to use other substances, their rates of high-risk consumption are 3 times higher and they are more involved in potentially dangerous practices. Finally, variables such as risk perception and expectations of use yield very limited explanatory capacity, especially if they are compared with those related to drinking within the family or peer group. The results reinforce the need to delay the age of alcohol onset as one of the strategic objectives of prevention policies.

The CRAFFT Substance Abuse Screening Instrument, developed by the Center for Adolescents Substance Abuse Research (CeASAR) (Knight et al., 1999), is a screening tool for high-risk alcohol and drug risk consumption designed for use with adolescents. Since its publication it has been the subject of translations and validations in different countries, populations and contexts that have demonstrated its enormous potential. However, there is still no empirical validation study that would ensure its good psychometric performance in Spain. The aim of this paper is to develop an adapted version of the CRAFFT in Spanish and to analyze its psychometric properties in a sample of Spanish adolescents. For this purpose an individual interview was conducted on 312 adolescents aged between 12 and 18 years of age (M = 15.01; SD = 1.83) from the Galician community. The interview included a part of the Adolescent Diagnostic Interview (ADI) and the Problem Oriented Screening Instrument for Teenagers (POSIT). The results obtained, similar to those found in other countries, allow us to report that the Spanish version of the CRAFFT has a good psychometric behaviorproperties. It was found to have a satisfactory internal consistency with a Cronbach’s alpha value of .74. In terms of sensitivity and specificity, values of 74.4% and 96.4% respectively, were obtained and the area under the ROC curve was .946. The Spanish version of the CRAFFT is made available to researchers and professionals in the field of addictive behaviors, so that it can be used with the necessary psychometric guarantees.

Introduction: This paper describes the presence of alcohol in the public space, assessing establishments that offer it, its advertising, and signs of consumption, as factors that may influence its consumption., Method: Descriptive observational study based on cluster sampling with two-step selection. Results are described, and the spatial association between variables is assessed., Results: In the 20 census tracts studied, 306 premises were identified that offered alcoholic beverages: 204 were on-premises and 102 were off-premises, mainly supermarkets and food retail stores. Their spatial distribution was uneven, concentrated in two central districts. We identified 72 publicity items, mostly sponsorship of musical events. There were many promotional items linked to on- premises, especially in their terraces. Five people were detected promoting consumption or selling alcohol in the Old Town. In each time slot, between 39 and 51 signs of consumption on the public space were observed (mostly abandoned beer cans), more frequent at night and in the Old Town. There is an association between the presence of establishments that offer alcohol and advertising. There is no relationship between these variables and signs of consumption in the public space; these are concentrated in the Old Town, which has greater presence of tourism., Conclusions: The urban environment is characterized by elements that stimulate alcohol use and its distribution is uneven, with a strong influence of tourism-related activities. Further regulation of alcohol promotion, availability and consumption in the public space may change its social image and decrease its use.

Introduction: Cannabis is the illicit drug mostly widely consumed by adolescents in Spain. The understanding of consumption motives is an important factor for intervention. In Spain, there are no available instruments for their evaluation, hence, the goal of this paper is to study the psychometric properties of the Marihuana Motives Measure (MMM) in a sample of adolescent consumers., Material and Method: Firstly, translation and back-translation was performed. A total of 228 adolescent consumers of cannabis were evaluated. Factorial analysis was conducted, and the reliability of the total scores and of each scale of the questionnaire was studied through Cronbach's alpha. Test-retest reliability was analyzed through interclass correlations. Validity evidence of the MMM was examined through correlations between current cannabis use, subjective consumption effects measured with the Addiction Research Center Inventory (ARCI), and personality measured with the Millon Adolescent Clinical Inventory (MACI)., Results: High reliability was observed in total score of the MMM (Cronbach α = .86), and high and moderate reliability for each of the five factors obtained in the factorial analysis of the MMM, Social = .82, Enhancement = .72, Coping = .83, Expansion = .74, and Conformity = .64. Significant correlations were also observed between cannabis consumption motives and subjective effects, and between consumption motives and personality., Conclusion: The Spanish version of the MMM shows a similar factorial structure as the one obtained by the original author, and its measures are reliable and valid for the study of cannabis consumption motives in adolescent consumer population.

First, this paper estimates the dimensions of the market for cannabis in Spain using data on the extent of consumption and the main patterns of use of consumers. Then the paper reviews the hypothetical production and distribution costs of these drugs in different production regimes under different legal conditions. The review shows that current prices of cannabis in the illegal market could be notably reduced if production and distribution of cannabis were decriminalized and even more if they were performed by legal enterprises. Thirdly, we examine the relationship between prices and consumption levels by analysing the price elasticity of demand. A fall in the prices of cannabis products will likely result in an increase in the number of users and in the total amount consumed. Lastly we consider several alternatives for the taxation of cannabis derivatives to counteract the likely fall in prices, and their pros and cons.

This paper aims to examine the socio-economic determinants of alcohol-impaired drinking in Spanish adolescents. In particular, we are interested in analysing the impact of the family and school environment. To do it, we used the Spanish Survey on Drug Use in the School Population for the year 2008, carried out by the Spanish Government’s Delegation for the National Plan on Drugs. This survey with 30,183 students between 14 and 18 years of age (M = 15.6; SD = 1.17) constitutes a representative sample of the Spanish student population. Of these, 6.7% reported having driven under the influence of alcohol, this behaviour being more frequent among boys (10.6%) than girls (2.9%). Logistic regressions reveal that informative campaigns at school could significantly reduce the likelihood of alcohol-impaired driving (OR = 0.82), especially among males (OR = 0.73) and among younger students (OR = 0.66). Our results also suggest that although parents’ education has no significant impact, parent’s alcohol abuse increase notably the probability of driving after drinking (OR = 2.22 for mothers and OR = 2.81 for fathers).

A descriptive retrospective study of acute intoxication cases registered at the Complexo Hospitalario de Pontevedra (CHOP) between January 2005 and December 2008 was performed to find out the number and types of poisoning cases treated, their distribution according to patient's sex and age, chronology, type of toxic agents involved, intentionality, history, symptoms, clinical development, treatment and toxicological analysis used for diagnosis. Data were recorded using Clinica and IANUS software and consulting all paper records of patients with symptoms of poisoning. Data from a total of 1893 patients with a mean age of 35.6 ± 17.6 years (66% men) were included. Highest rates of poisoning were recorded on Saturdays and Sundays during the summer months (June, July and August). Drugs of abuse were the most common toxic agents (70.4%), ethyl alcohol accounting for 61% of these cases, which often involved males and with people with high degrees of dependency. In second place was poisoning resulting from the abuse of medical drugs, more commonly associated with females, and involving benzodiazepines in 73.2% of cases. The majority of these intoxications were intentional, and suicide attempts accounted for 18.8%. The problems most commonly resulting from the poisoning were neurological, and mortality rate was just 0.2%.

Introduction: Monitoring health-related behaviors in adolescence requires instruments capable of providing valid data The objective of this paper is to review and assess existing information sources on smoking and alcohol and cannabis use by age and sex among adolescents in Spain., Methods: A search was carried out for studies with repeated observations over time, and their methods and characteristics reviewed. For each study, the number of surveys, their frequency and their sample size are assessed, as well as the instrument used, the available indicators, and the availability, accessibility and comparability of the information., Results: Five sources of information providing data over extended periods of time with accessible data are identified: the National survey on drug use in secondary-school children (Encuesta estatal sobre uso de drogas en estudiantes de secundaria; ESTUDES); the Health behavior in school-aged children study (ECERSHBSC); the Monitoring system for risk factors associated with non-transmissible diseases in young people (Sistema de Vigilancia de Factores de Riesgo Asociados a Enfermedades No Transmisibles dirigido a poblacion juvenil; SIVFRENT-J); the Study of risk factors in secondary school children (Estudio de factores de riesgo en estudiantes de secundaria; FRESC); and the Monitoring study of health behaviors in adolescents (Estudio de monitorizacion de las conductas de salud de los adolescents; EMCSAT). Two of the surveys cover the whole of Spain, one is regional, and two are city-specific. All use solid methods and representative sampling techniques. In some, changes have occurred that make comparison of the evolution of some indicators difficult. Report accessibility is variable; comparability is limited for some surveys. Some provide almost no stratified data., Conclusions: There are valuable sources of data, but all have shortcomings. Changing the measurement instrument in a survey for comparison with others raises dilemmas as to the internal comparability of series.

This article examines the analysis of drug use among Secondary Education students in Andalusia from two different studies: the Health Behavior in School-aged Children Study (HBSC), in its 2006 edition, and a study assessing the implementation of the Prevenir para Vivir ("Prevent to Live") drug use prevention program in the education field. To this end, on the one hand the paper analyzes the use of tobacco, alcohol and cannabis among Andalusian adolescents on the HBSC Study, and on the other, selects two groups of adolescents to examine and compare their drug use: a group from the HBSC Study who had not participated in any drug use prevention program and in whose schools the staff had not received training in relation to these issues (called HBSC Control Group), and a group of adolescents who had participated in the Prevenir para Vivir drug use prevention program working with specialized staff (called Prevenir para Vivir Experimental Group). The results indicate, first, higher levels of drug use in older students than in younger ones; and, second, on comparing the two groups, that adolescents who have received drug prevention programs with specialized staff are not always those most likely to present healthier drug use. These results must therefore be interpreted as offering only limited support to drug use prevention programs.

Objectives: The analysis of productivity and disciplinary collaboration patterns for Spanish published scientific research in the field of Substance Abuse (2001-2005)., Methodology: From institutional affiliations we identified and quantified disciplinary participation in papers indexed in the IME/Indice Medico Español, ISOC/Indice Español de Ciencias Sociales y Humanidades, SCI-Expanded/Science Citation Index-Expanded and SSCI/Social Sciences Citation Index databases., Results: A total of 31 disciplines and specialities were identified in ISOC, with 8.6% of documents in collaboration between them; 55 medical specialities were identified in IME, with 10.89% of documents in collaboration between them; and 62 specialities were identified in SCI-Expanded, with 41.68% of documents in collaboration between them., Conclusions: a) Substance Abuse, Psychology, Psychiatry, Epidemiology-Preventive Medicine and Public Health and Pharmacology are the disciplines and specialities that present the highest productivity. To these can be added, in papers published in foreign journals, specialities such as Biochemistry-Molecular Biology, Neurology and Neuroscience; b) Papers published in Spanish journals indexed in SCI-Expanded and in papers published in foreign journals present much higher collaboration indexes between disciplines and specialities; c) The main collaborations between specialities are those between Substance Abuse, Psychiatry and Psychology. To these can be added, in the case of journals indexed in SCI-Expanded, those between these specialities and Pharmacology, Neurology and Neuroscience.

This work pursues two objectives: 1) to analyse time trends in tobacco consumption among Spanish schoolchildren aged 11, 13, 15 and 17 for the period 1986-2002; and 2) to study the evolution of gender differences regarding tobacco consumption in each of these age groups throughout this period. On the basis of a research with a sequential cross-sectional design, data were collected in four nation-wide studies (in 1986, 1990, 1994 and 2002), using representative samples of Spanish schoolchildren. The sub-samples used for this paper add up 14,570 subjects (51.2% girls and 48.8% boys). The analysis of temporal trends has been performed separately for each gender, within each age group. Among 11-year-olds, a growing homogeneity between genders concerning tobacco consumption has been proved, with a general trend to a decrease in the problem. Among 13-year-olds, time trends are very similar to 11-year-olds, except for the period 1994-2002, where there has been an increase in the prevalence of smoking among girls. As for the 15 and 17-year-olds, a growing differentiation between genders has been proved, with a marked rising tendency among girls in all aspects studied. Regarding boys of those ages, the situation is relatively stable since 1990. The spreading of this problem among girls will probably strengthen in the future the current trend toward an increase in tobacco consumption among Spanish adult women.

This paper presents some of the main parameters in the behaviour pattern of young people in their binge drinking practices, seeking to improve the somewhat inaccurate view emerging from field studies. A total of 4083 questionnaires were administered to young people in Valencia aged 14-25 during the academic year 2005/2006, from a random sample of schools and other educational institutions. The survey was conducted in the institutions themselves and participation was anonymous and voluntary. The findings confirm a progressive reduction in the age at which this practice begins, 13 having been the starting age for those adolescents who are currently 14 years old. Likewise, the results contradict the assertion that binge drinking is practised mainly by boys, as it is found to an equal extent in either sex. The European trend towards radicalisation of consumption is also confirmed: a considerable increase in the use of drinks with high alcohol content regardless of age and gender, resulting in mean blood alcohol levels of 1.5 gr. twice a week on average for more than 6 months a year. All of this is commonly combined with a misleading perception of the effects of alcohol consumption, the positive aspects being overestimated. These results underline the need to design selective or even indicated prevention programmes for approximately 20% of the most extreme cases, with a view to overcoming the current constraints of universal prevention. Nor should interventions overlook the issue of parental permissiveness--reflected in aspects such as early age of onset of binge-drinking or lack of controls on the time young people come home after partying.

This paper aims to describe the prevalence of tobacco consumption among pre-adolescent and adolescent school children in Spain at the start of the 21st century. The data were collected within the framework of the "Estilos de Vida de los Adolescentes Escolarizados" (EVAE) project, a nationwide cross-sectional study on the lifestyles of adolescent school children. In this study, a random sample of 8429 students aged from 10 to 18 years old (49.9% boys and 50.1% girls) was selected. The school children filled in an anonymous questionnaire in their classrooms. Among the 12-year-old age group, there are a significantly higher number of boys than girls who have ever smoked tobacco. Figures are higher for girls in the 14-year-old or older age groups. Between the 12 and the 14-year-old age groups, there is an increase of 40 percentage points for girls who have ever smoked tobacco. The prevalence of daily smoking exceeds 10% among the 14-year-old or older age groups, with significantly higher rates for girls than for boys among the 15-year-old group and older students. Among the 17-year-old group, 25% of boys and 35% of girls report that they smoke daily. The recent experience of Spain and other countries shows that it is possible to significantly reduce the prevalence of tobacco consumption among school children within a few years. The primary prevention of tobacco consumption among adolescents can be highly effective and should constitute a priority for the health system, the education system and other sectors involved.

Background and Objective: Concern for encouraging gender equality makes it one of the high priority spheres of action for governments and organisations responsible for instigating scientific policies, with particular importance being placed on including the gender variable in evaluative analyses of scientific and technological activity. A comparative study was made, broken down by gender, of the scientific output of Spanish researchers with a high production in the field of substance abuse., Material and Method: We identified the gender of 338 authors who had published more than four different articles during the period from 1999-2004 and which were indexed in the IME/Indice Médico Español and the SCI/Science Citation Index databases, making a comparative analysis of their output and collaboration patterns, based on the gender variable., Results: In the area of substance abuse, of those with the highest output (> 9 papers), 70% were men compared with 30% women. Among the average producers (5-9 papers), 57% of the authors identified were men and 43% women. Statistically significant differences were observed between men and women with the highest output with regard to the number of published works and those with whom they had collaborated., Conclusions: There is no gender equality in the area of substance abuse, particularly when considering the top researchers. It is essential to make in-depth studies that evaluate scientific output, broken down by gender, in order to adopt the necessary corrective measures to eliminate the disparity between men and women.