The countries and territories comprising the English-speaking Caribbean (ESC) have made some strides in the development of mental health policy, services and systems with the expenditure in mental health as a percentage of health budgets ranging from 1% to 7%. The ESC countries have well developed primary healthcare systems. However, mental health legislations in many countries are in need of reform. Some countries have developed an innovative community based, secondary care treatment model: treatment in the medical wards of general hospitals. These countries have made progress in integrating mental health into primary healthcare and have made psychotropic medication widely available at the primary care level. Notwithstanding the progress in some countries, greater effort is required in phasing out mental hospitals and integrating mental health into primary care in other ESC countries.

ABSTRACT

Objective: Cigarettes, alcohol, cannabis, inhalants and cocaine are the most commonly used substances among high school students in Jamaica. However, there is limited evidence on their co-use and whether the use of one drug predicts the use of the others (multiple substance use). This study aimed to determine whether cannabis use predicts the co-use of the other substances. Methods: We analysed data from the National Secondary School Survey 2013, Jamaica, using inferential statistics to determine associations. Results: Lifetime cannabis use was significantly associated with lifetime cigarette use for males (X 2 = 282.72, p = 0.000) and females (X 2 = 434.32, p = 0.000). Similarly, it was significantly associated with: (a) lifetime use of alcohol for males (X 2 = 88.62, p = 0.000) and females (X 2 = 99.48, p = 0.000); (b) lifetime use of inhalants for males (X 2 = 13.28, p = 0.00) and females (X 2 = 49.56, p = 0.00); and (c) lifetime cocaine use for males (X 2 = 9.78, p = 0.00) and females (X 2 = 64.54, p = 0.00). Past-month (recent) use of cannabis was significantly associated with past-month use of cigarettes and alcohol, but not inhalants, for males and females. Logistic regression results showed that lifetime cannabis use was a risk factor for lifetime use of cigarettes (adjusted odds ratio [AOR]: 11.38; 95% confidence interval [CI]: 9.02, 14.37) and alcohol (AOR: 5.84; 95% CI: 4.11, 8.30), but a strong protective factor against lifetime use of inhalants and cocaine. Past-month use of cannabis was a strong protective factor against pastmonth use of cigarettes and alcohol. Conclusion: Lifetime cannabis use was significantly associated with multiple substance use and was shown to be a risk factor for lifetime use of cigarettes and of alcohol. However, adolescents who reported recent (past-month) use of cannabis were less likely to report recent use of alcohol and cigarettes. These findings suggest the need for research to further explore the role cannabis plays in multiple drug use and offer more concrete explanations for its role.

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ABSTRACT:This study sought to explore the simultaneous polydrug use pattern across genders of 1 st and 2 nd year undergraduate students in one university in Kingston, Jamaica. There were 295 study participants (58 males and 237 females) from the faculty of Medical Sciences at a local university. The study used a self administered questionnaire which addressed various aspects of drug use and simultaneous polydrug use. Unadjusted results revealed a significantly higher simultaneous polydrug use among males than females 40.9% and 14.3% respectively in the last 12 months (χ 2 , p=0.009) and in the last 30 days 8.9% vs. 1.7% (χ 2 , p=0.014). These results suggest a prominence of simultaneous polydrug use behaviour among male undergraduate students in this population compared with females, although further research is required. DESCRIPTORS:Students. Street drugs. Behaviour addictive. Substance-Related disorders. Risk factors. DIFERENCIAS DE GÉNERO EN EL POLICONSUMO SIMULTÁNEO DE DROGAS ENTRE ESTUDIANTES DE PREGRADO EN UNA UNIVERSIDAD, KINGSTON -JAMAICA RESUMEN:Este estudio tuvo como objetivo explorar el patrón comparativo de policonsumo simultáneo de drogas entre géneros, en estudiantes de 1º y 2º año de pregrado en una universidad en Kingston, Jamaica. Hubo 295 participantes en el estudio (58 hombres y 237 mujeres) de la Facultad de Ciencias Médicas de esta universidad local. El estudio utilizó un cuestionario auto-administrado en el que se abordaron diversos aspectos del consumo y poli-consumo simultáneo de drogas. Los resultados no-ajustados revelaron un significativo mayor nivel de policonsumo simultaneo en hombres que en mujeres 40,9% y 14,3% respectivamente en los últimos 12 meses (χ 2 , p=0,009) y en los últimos 30 días 8,9% vs. 1,7% (χ 2 , p=0,014). Estos resultados sugieren un predominio en el comportamiento de policonsumo simultáneo de drogas entre hombres estudiantes de pregrado en esta población comparado con mujeres, aunque se refiere investigación adicional. DESCRIPTORES:Estudiantes. Drogas ilícitas. Conducta adictiva. Transtornos relacionados com substancias. Factores de riesgo. DIFERENÇAS DE GÊNERO NO POLICONSUMO SIMULTÂNEO DE DROGAS ENTRE ESTUDANTES DE GRADUAÇÃO EM