LUCIO GARCIA DE OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina
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- In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern(2018) CASTALDELLI-MAIA, Joao Mauricio; NICASTRI, Sergio; CERDA, Magdalena; KIM, June H.; OLIVEIRA, Lucio Garcia de; ANDRADE, Arthur Guerra de; MARTINS, Silvia S.Introduction and AimsGiven a scenario of intense discussion about the legal situation of cannabis users worldwide, this paper aims to investigate the role of cannabis within a drug use sequencing pattern. Design and MethodsData came from a representative sample of college students from 27 Brazilian capitals (n=12711). We analysed the patterns of transition from/to the first use of cannabis to/from the first use of alcohol, tobacco and seven other illegal drugs. Survival analysis methods were used to analyse age of onset data on all potential drug pairs. Drugs that were not specified as the target drug pair tested in each survival model were included as time-varying covariates in all models. ResultsWe found significant transitions from alcohol [adjusted hazard ratio (aHR)=1.41, 95% confidence interval (CI) 1.15-1.73, P<0.001] and inhalants (aHR=1.56, 95% CI 1.26-1.93, P<0.001) to cannabis. Moreover, we found significant transitions from cannabis to alcohol (aHR=2.40, 95% CI 1.47-3.91, P<0.001), cocaine (aHR=7.47, 95% CI=4.26-13.09, P<0.001), prescription opioids (aHR=2.16, 95% CI 1.29-3.63, P<0.01) and tranquilisers (aHR=1.51, 95% CI 1.11-2.06, P<0.01). Discussion and ConclusionsOverall, our findings point to a strategic role of cannabis within drug first use sequence pattern. We had an important and unexpected findingthe bi-directional relationship between alcohol and cannabis. In addition, the first use of cannabis still precedes the first use of cocaine and non-medical use of tranquilisers and prescription opioids. [Castaldelli-Maia JM, Nicastri S, Cerda M, Kim JH, Oliveira LG, Andrade AG, Martins, SS. In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern. Drug Alcohol Rev 2017;00:000-000]
- Comparação do uso de drogas entre universitários brasileiros, norte-americanos e jovens da população geral brasileira(2013) ECKSCHMIDT, Frederico; ANDRADE, Arthur Guerra de; OLIVEIRA, Lúcio Garcia deOBJECTIVE: To compare drug use between college students and the general Brazilian population, as well as with American college students' drug use, identifying possible usage differences related to cultural interference. METHODS: To compare lifetime drug use between target populations, public data collected from statistical surveys conducted with Brazilian college students and the general population were used, as well as surveys conducted with American college students. The surveys' confidence intervals (95% CI) were subjects of comparison. RESULTS: Drug use is more frequent among American college students, who use more tobacco, tranquilizers, marijuana, ecstasy, hallucinogens, cocaine, crack cocaine and heroin than Brazilian college students. In contrast, Brazilian college students use nearly the double of inhalants than American college students. This pattern of use is repeated in the analysis of intra-gender differences. Add to this that Brazilian college students seem to engage more frequently in drinking alcoholic beverages and using marijuana, tranquilizers, inhalants, hallucinogens and amphetamines than their peers in the general Brazilian population. CONCLUSIONS: Knowing the particularities of drug use among college students is of paramount importance for the early detection of consumption. Investments in this segment and gender differences should be considered in preventive policies, as well as developing strategies of consumption reduction and control, such as screening programs and brief intervention, due to better cost-effectiveness.
- The role of drug use sequencing pattern in further problematic use of alcohol, tobacco, cannabis, and other drugs(2015) CASTALDELLI-MAIA, Joao Mauricio; MARTINS, Silvia S.; OLIVEIRA, Lucio Garcia de; ANDRADE, Arthur Guerra de; NICASTRI, SergioBackground: There has been considerable debate regarding what typically occurs after experimentation with drugs throughout the life of young people who used various drugs. Aims: To evaluate the clinical importance of the most common sequence for the first use of a drug by two models (the ""gateway model'' and the ""alternative model'', which is the most popular sequence for Brazilian university students according to a previous study) regarding the problematic use of alcohol, tobacco, cannabis and other illegal drugs, assessed by ASSIST. Method: People who had already experimented with three or more drugs across different stages of the two models were selected from a representative sample of university students from 27 Brazilian capitals (n = 12 711). Findings: There were no differences regarding the problematic use of the most consumed drugs in Brazil (alcohol, tobacco and cannabis) between the models. Multiple drug seekers and violators had more problematic use of illegal drugs other than cannabis than individuals in the model sequence. However, in the case of violators, this was only evident in the alternative model. Conclusions: Multiple drug seekers and violators deserve special attention due to their increased risk of problematic use of other illegal drugs.
- Polydrug use among college students in Brazil: a nationwide survey(2013) OLIVEIRA, Lucio Garcia de; ALBERGHINI, Denis Guilherme; SANTOS, Bernardo dos; ANDRADE, Arthur Guerra deObjective: To estimate the frequency of polydrug use (alcohol and illicit drugs) among college students and its associations with gender and age group. Methods: A nationwide sample of 12,544 college students was asked to complete a questionnaire on their use of drugs according to three time parameters (lifetime, past 12 months, and last 30 days). The co-use of drugs was investigated as concurrent polydrug use (CPU) and simultaneous polydrug use (SPU), a subcategory of CPU that involves the use of drugs at the same time or in close temporal proximity. Results: Almost 26% of college students reported having engaged in CPU in the past 12 months. Among these students, 37% had engaged in SPU. In the past 30 days, 17% college students had engaged in CPU. Among these, 35% had engaged in SPU. Marijuana was the illicit drug mostly frequently used with alcohol (either as CPU or SPU), especially among males. Among females, the most commonly reported combination was alcohol and prescribed medications. Conclusions: A high proportion of Brazilian college students may be engaging in polydrug use. College administrators should keep themselves informed to be able to identify such use and to develop educational interventions to prevent such behavior.
- Use of alcohol and other drugs among Brazilian college students: effects of gender and age(2012) ANDRADE, Arthur Guerra de; DUARTE, Paulina do Carmo Arruda Vieira; BARROSO, Lucia Pereira; NISHIMURA, Raphael; ALBERGHINI, Denis Guilherme; OLIVEIRA, Lucio Garcia deObjective: To assess the frequency of drug use among Brazilian college students and its relationship to gender and age. Methods: A nationwide sample of 12,721 college students completed a questionnaire concerning the use of drugs and other behaviors. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-WHO) criteria were used to assess were used to assess hazardous drug use. A multivariate logistic regression model tested the associations of ASSIST-WHO scores with gender and age. The same analyses were carried out to measure drug use in the last 30 days. Results: After controlling for other sociodemographic, academic and administrative variables, men were found to be more likely to use and engage in the hazardous use of anabolic androgenic steroids than women across all age ranges. Conversely, women older than 34 years of age were more likely to use and engage in the hazardous use of amphetamines. Conclusions: These findings are consistent with results that have been reported for the general Brazilian population. Therefore, these findings should be taken into consideration when developing strategies at the prevention of drug use and the early identification of drug abuse among college students.
- The association between low alcohol use and traffic risk behaviors among Brazilian college students(2012) GONCALVES, Priscila Dib; CUNHA, Paulo Jannuzzi; MALBERGIER, Andre; AMARAL, Ricardo Abrantes do; OLIVEIRA, Lucio Garcia de; YANG, Jasmine J.; ANDRADE, Arthur Guerra deAlthough there are a large number of studies focused on binge drinking and traffic risk behaviors (TRB), little is known regarding low levels of alcohol consumption and its association to TRB. The aim of this cross-sectional study is to examine the association of low to moderate alcohol intake pattern and TRB in college students in Brazil. 7037 students from a National representative sample were selected under rigorous inclusion criteria. All study participants voluntarily fulfilled a structured, anonymous, and self-questionnaire regarding alcohol and drug use, social-demographic data, and TRB. Alcohol was assessed according to the average number of alcoholic units consumed on standard occasions over the past 12 months. The associations between alcohol intake and TRB were summarized with odds ratio and their confidence interval obtained from logistic regression. Compared with abstainers students who consumed only one alcohol unit had the risk of being a passenger in a car driven by a drunk driver increased by almost four times, students who reported using five or more units were increased by almost five times the risk of being involved in a car crash. Compared with students who consumed one alcohol unit, the risk of driving under the influence of alcohol increased four times in students using three alcohol units. Age group, use of illicit drugs, employment status, gender, and marital status significantly influenced occurrence of TRB among college students. Our study highlights the potential detrimental effects of low and moderate pattern of alcohol consumption and its relation to riding with an intoxicated driver and other TRB. These data suggest that targeted interventions should be implemented in order to prevent negative consequences due to alcohol use in this population.
- Religion as a protective factor against drug use among Brazilian university students: a national survey(2013) GOMES, Fernanda Carolina; ANDRADE, Arthur Guerra de; IZBICKI, Rafael; ALMEIDA, Alexander Moreira; OLIVEIRA, Lucio Garcia deObjective: To investigate the relationship between religiosity and drug use among Brazilian university students. Methods: This manuscript is part of the ""First Nationwide Survey on the Use of Alcohol, Tobacco and Other Drugs among College Students in the 27 Brazilian State Capitals"". In this study, 12,595 university students were divided into two groups according to their attendance at religious services: frequent attenders (FR; 39.1%) and non-frequent attenders (NFR; 60.8%). Subsequently, we analyzed their responses to a structured, anonymous questionnaire on drug use and other behaviors. Individual multivariate logistic regression models tested the association between religiosity and drug use (alcohol, tobacco, marijuana and at least one illicit drug). Results: Drug use over the last 30 days was higher among NFR students even after controlling for demographic variables. NFR students were more likely to use alcohol OR = 2.52; 95% CI: 2.08-3.06, tobacco (2.83; 2.09-3.83), marijuana (2.09; 1.39-3.11) and at least one illicit drug (1.42; 1.12-1.79) compared to FR students. Conclusion: Religiosity was found to be a strongly protective factor against drug use among Brazilian university students. However, more studies are needed to identify the mechanisms by which religiosity exerts this protective influence.
- The Role of First Use of Inhalants Within Sequencing Pattern of First Use of Drugs Among Brazilian University Students(2014) CASTALDELLI-MAIA, Joao Mauricio; NICASTRI, Sergio; OLIVEIRA, Lucio Garcia de; ANDRADE, Arthur Guerra de; MARTINS, Silvia S.The present study investigated the role of first use of inhalants within a first drug sequencing pattern. In a representative sample of university students from 27 Brazilian capitals (n = 12,711), we analyzed the patterns of transition from/to first use of inhalants to/from the first use of alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, amphetamines, prescription opioids, and tranquilizers. Cox proportional hazards models were used to analyze data. Drugs that were not specified as the pair of drugs tested in each model were included as time-varying covariates in all models. In this sample, first use of inhalants was preceded only by the first use of alcohol and tobacco. However, first use of inhalants preceded first use of cannabis, amphetamines, cocaine, and tranquilizers. First use of inhalants preceded the first use of prescription opioids, and vice versa. This study highlights the need to intervene early with youths who are at risk of or just beginning to use inhalants, because this class of drugs seems to be the first illegal drug in Brazil to be experimented by respondents in our sample. There is also a call for attention to individuals who have already first used inhalants because of their higher chance to experiment with other drugs such as cannabis, cocaine, and prescription drugs. All these findings show an in-transition culture of drug use, which should be tracked through time, because some classical models (i.e., gateway model) might be outdated and might also not fit within different settings.
- Use transition between illegal drugs among Brazilian university students(2014) CASTALDELLI-MAIA, Joao Mauricio; MARTINS, Silvia S.; OLIVEIRA, Lucio Garcia de; LAAR, Margriet van; ANDRADE, Arthur Guerra de; NICASTRI, SergioPurpose The aim of the present study was to test whether the first use of an illicit drug increases the chance of first use of other illicit drugs. Method The transitions from the first use of a drug to the first use of another drug were analyzed. Comparisons were made between first drug users and non-users. Survival analysis methods were used to compare the cumulative probability of second drug use after adjusting for socio-demographic covariates and the intermediate use of alcohol and/or tobacco. A total of 12,721 Brazilian university students participated in this study. Results Inhalants and marijuana were used prior to the use of several other drugs, whereas the opposite pattern was not found. Ecstasy was used before other drugs in several instances. Other well-examined drugs, such as amphetamines, cocaine and hallucinogens, were used both before and after other illicit drugs without any marked predominance for either of the two roles. Conclusions This study supports the role of the use of marijuana and inhalants almost exclusively before the use of other illicit drugs, whereas the use of ecstasy has an opposite role. These roles could be linked to the prevalence of lifetime use and whether individuals were at an earlier or later age during experimentation.
- Drug use in college students: a 13-year trend(2012) WAGNER, Gabriela Arantes; OLIVEIRA, Lucio Garcia de; BARROSO, Lucia Pereira; NISHIMURA, Raphael; ISHIHARA, Luciana Morita; STEMPLIUK, Vladimir de Andrade; DUARTE, Paulina do Carmo Arruda Vieira; ANDRADE, Arthur Guerra deOBJECTIVE: To analyze drug use trends among college students in 1996, 2001 and 2009. METHODS: A cross-sectional epidemiological study with a multistage stratified cluster sample with 9,974 college students was conducted in the city of Sao Paulo, southeastern Brazil. An anonymous self-administered questionnaire was used to collect information on drug use assessed in lifetime, the preceding 12 months and the preceding 30 days. The Bonferroni correction was used for multiple comparisons of drug use rates between surveys. RESULTS: There were changes in the lifetime use of tobacco and some other drugs (hallucinogens [6.1% to 8.8%], amphetamines [4.6% to 8.7%], and tranquilizers [5.7% to 8.2%]) from 1996 to 2009. Differences in the use of other drugs over the 12 months preceding the survey were also seen: reduced use of inhalants [9.0% to 4.8%] and increased use of amphetamines [2.4% to 4.8%]. There was a reduction in alcohol [72.9% to 62.1%], tobacco [21.3% to 17.2%] and marijuana [15.0% to 11.5%] use and an increase in amphetamine use [1.9% to 3.3%] in the preceeding 30 days. CONCLUSIONS: Over the 13-year study period, there was an increase in lifetime use of tobacco, hallucinogens, amphetamines, and tranquilizers. There was an increase in amphetamine use and a reduction in alcohol use during the preceding 12 months. There was an increase in amphetamine use during the preceding 30 days.