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]
- 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.
- 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.
- Uso prescrito de cloridrato de metilfenidato e correlatos entre estudantes universitários brasileiros(2012) CESAR, Eduardo Luiz da Rocha; WAGNER, Gabriela Arantes; CASTALDELLI-MAIA, Joao Mauricio; SILVEIRA, Camila Magalhaes; ANDRADE, Arthur Guerra de; OLIVEIRA, Lucio Garcia deBackground: The prevalence of prescribed use of methylphenidate (MPH) and its correlates are not well-known in Brazil. Objective: To estimate the prevalence of prescribed use of MPH and its correlates in a sample of Brazilian college students. Methods: Twelve-thousand seven hundred and eleven college students filled out a drug use questionnaire. They were divided into two groups based on the lifetime use of MPH: MPH users (MPHU) and MPH non-users (MPHNU). Quasi-binomial regression models were carried out in order to evaluate the correlation among MPHU and other variables. Results: A lifetime use of MPH was reported from 0.9% of college students (MPHU). Being from the Midwest (PR = 4.8, p < 0.01) and South (PR = 5.2, p < 0.05), living in students housing (PR = 5.8, p < 0.001), prescribed use of amphetamines (PR = 8.9, p < 0.001) and benzodiazepines (< 3 weeks: PR = 4.4, p < 0.001; >= 3 weeks: PR = 6.7, p < 0.001), and harmful use of alcohol (PR = 4.0, p < 0.05) were correlated with MPHU. Discussion: The association of alcohol and drug use with prescribed use of MPH among college students suggests the importance of screening drinking patterns and use of other drugs among students with ADHD symptoms.