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Objective: Crack cocaine use has increased rapidly throughout Mexico, along with rising HIV and hepatitis C virus (HCV) infections among vulnerable groups. The Tirando Esquina: Interviniendo Muros de Salud (TE:IMS) project uses projection-mapping technology and is the first of its kind to reach and provide health education at an individual and community level to at-risk crack smoking populations in Mexico City. Setting: This intervention project took place in Mexico City. Design: A single-arm design was utilised. Method: The TE:IMS intervention used projection mapping, a community-based art form wherein 3-dimensional (3-D) images, videos and graphics are projected onto buildings in the community. A total of nine projection mapping episodes were projected and health promoters engaged individuals on the street to reinforce messaging and distribute safer crack kits. A sample of persons who use crack (n = 58) were recruited prior to the intervention to complete pretest–posttest evaluation questionnaires. Results: Findings provide evidence of initial effectiveness. Decreases pre- to posttest were found in weekly crack use (p <.05), sharing of paraphernalia (p =.002) and use of cans as pipes (p =.008), while increases were observed in the usage of Pyrex pipes (p =.002). While quantitative HIV knowledge assessments did not increase significantly, qualitative data suggest the intervention made a substantial impact on perceptions and knowledge of HIV among those who interacted with the health promoters and saw the projections. Conclusions: TE: IMS was successful in providing health education and harm reduction strategies at a community level to at-risk crack smoking populations in Mexico City. These findings provide evidence for the initial effectiveness of innovative education and harm reduction efforts in this population. [ABSTRACT FROM AUTHOR]

BackgroundQUIT is the only primary care-based brief intervention that has previously shown efficacy for reducing risky drug use in the United States (Gelberg et al., 2015). This pilot study replicated the QUIT protocol in one of the five original QUIT clinics primarily serving Latinos.DesignSingle-blind, two-arm, randomized controlled trial of patients enrolled from March-October 2013 with 3-month follow-up.SettingPrimary care waiting room of a federally qualified health center (FQHC) in East Los Angeles.ParticipantsAdult patients with risky drug use (4-26 on the computerized WHO ASSIST): 65 patients (32 intervention, 33 control); 51 (78%) completed follow-up; mean age 30.8 years; 59% male; 94% Latino.Interventions and measuresIntervention patients received: 1) brief (typically 3-4 minutes) clinician advice to quit/reduce their risky drug use, 2) video doctor message reinforcing the clinician's advice, 3) health education booklet, and 4) up to two 20-30 minute follow-up telephone drug use reduction coaching sessions. Control patients received usual care and cancer screening information. Primary outcome was reduction in number of days of drug use in past 30days of the highest scoring drug (HSD) on the baseline ASSIST, from baseline to 3-month follow-up.ResultsControls reported unchanged HSD use between baseline and 3-month follow-up whereas Intervention patients reported reducing their use by 40% (p

BACKGROUND: Given the increased use of psychoactive substances on the United States-Mexico border, a binational study (Tijuana, Mexico-Los Angeles, USA) was conducted to identify the prevalence of substance use in primary care settings. OBJECTIVES: To compare the prevalence and characteristics of patients at risk for substance use disorders in Tijuana and East Los Angeles (LA) community clinics with special attention paid to drug use. METHODS: This was an observational, cross-sectional, analytical study, comparing substance use screening results from patients in Tijuana and LA. The settings were 2 community clinics in LA and 6 in Tijuana. Participants were 2,507 adult patients in LA and 2,890 in Tijuana eligible for WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screening during March-October 2013. Patients anonymously self-administered the WHO ASSIST on a tablet PC in the clinic waiting rooms. RESULTS: Of eligible patients, 96.4% completed the ASSIST in Tijuana and 88.7% in LA (mean 1.34 minutes and 4.20 minutes, respectively). The prevalence of patients with moderate-to-high substance use was higher in LA than Tijuana for each substance: drugs 19.4% vs. 5.7%, alcohol 15.2% vs. 6.5%, tobacco 20.4% vs. 16.2%. LA patients born in Mexico had 2x the odds and LA patients born in the United States had 6x the odds of being a moderate-to-high drug user compared to Tijuana patients born in Mexico. CONCLUSIONS: Moderate-to-high drug use is higher in LA than in Tijuana but rates are sufficiently high in both to suggest that screening for drug use (along with alcohol and tobacco use) should be integrated into routine primary care of community clinics in both cities.

Brief alcohol advice offered to patients was shown to be a clinically- and cost-effective intervention to prevent and manage alcohol-related health harm. However, this intervention is not yet optimally implemented in practice. A suggested strategy to improve the implementation of brief alcohol advice is through community actions which would enhance the environment in which primary healthcare providers must deliver the intervention. However, there has been scarce research conducted to date regarding which community actions have most influence on the adoption and implementation of brief alcohol advice. The current protocol presents the development of a package of community actions to be implemented in three Latin American municipalities, in Colombia, Mexico and Peru. The community actions were based on the Institute for Health Care Improvement's framework for going to full scale, and include: (i) involvement of a Community Advisory Board, (ii) involvement of a project champion, (iii) adoption mechanisms, (iv) support systems and (v) a communication campaign. By presenting a protocol for developing community actions with input from local stakeholders, this article contributes to advancing the public health field of alcohol prevention by potentially stimulating the sustainable adoption and implementation of brief alcohol advice in routine practice. [ABSTRACT FROM AUTHOR]

In this article, the authors comment on the contribution of the Alcohol, Drugs and the Family research group to draw public and scientific attention to the suffering and needs of families coping with addiction problems. The article also describes the impact of the stress-strain-coping-support model and the 5-Step Method on the research, intervention and education domains in Mexico. Some of the limitations to positively influence public policy are underscored; these include the nature of the sociocultural context which favors the view of addictions as private problems that must be solved within the family. The experience of delivering the 5-Step Method to Mexican urban population and its adaptation to indigenous communities and web-based format are discussed as well. Overall, the development and implementation of the 5-Step Method in Mexico has been positive, as demonstrated particularly by a cost-effectiveness study carried out with indigenous communities. Based on this review, the scope and challenges for family intervention in Mexico are outlined considering: (1) the dissemination of the 5-Step Method in both the rural and urban contexts; (2) extensive training of family counsellors; and finally (3) policy making to fulfil the needs of families facing addictive problems. (Contains 1 note.)

OBJETIVO: Evaluar el riesgo para el uso excesivo de etanol en personas con historia familiar positiva de consumo de alcohol (HF+). MATERIAL Y MÉTODOS: Los datos corresponden a una muestra de población general (n= 8 890) y fueron recopilados a partir de una encuesta nacional de adicciones en población urbana de México, realizada en 1988. Se determinaron medidas epidemiológicas de frecuencia y asociación considerando los antecedentes de HF+ como factor de exposición. RESULTADOS: La prevalencia actual del consumo consuetudinario de alcohol fue de 13.7% para los hombres y 0.6% para las mujeres, las cifras para el síndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces más probabilidad de desarrollar el síndrome de dependencia que aquellos con HF-. La razón de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisión de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del síndrome de dependencia de los hijos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

Background During the COVID-19 pandemic, an increase of heavy alcohol use has been reported in several high-income countries. We examined changes in alcohol use during the pandemic among primary health care (PHC) patients in two middle income countries, Colombia and Mexico. Methods Data were collected during routine consultations in 34 PHC centres as part of a large-scale implementation study. Providers measured patients' alcohol consumption with the three item 'Alcohol Use Disorders Identification Test' (AUDIT-C). Generalized linear mixed models were performed to examine changes in two dependent variables over time (pre-pandemic and during pandemic): 1) the AUDIT-C score and 2) the proportion of heavy drinking patients (8+ on AUDIT-C). Results Over a period of more than 600 days, data from N = 17 273 patients were collected. During the pandemic, the number of patients with their alcohol consumption measured decreased in Colombia and Mexico. Each month into the pandemic was associated with a 1.5% and 1.9% reduction in the mean AUDIT-C score in Colombia and Mexico, respectively. The proportion of heavy drinking patients declined during the pandemic in Colombia (pre-pandemic: 5.4%, 95% confidence interval (CI) = 4.8% to 6.0%; during the pandemic: 0.8%, 95% CI = 0.6% to 1.1%) but did not change in Mexico. Conclusions Average consumption levels declined and the prevalence of heavy drinking patterns did not increase. In addition to reduced opportunities for social drinking during the pandemic, changes in the population seeking PHC and restrictions in alcohol availability and affordability are likely drivers for lower levels of alcohol use by patients in this study. [ABSTRACT FROM AUTHOR]

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