[Predictive model for cocaine use in prisons in Rio de Janeiro, Brazil].
OBJECTIVE
To identify predictors of and groups vulnerable to cocaine use in prison.


METHODS
We selected 376 inmates with history of cocaine use in prison (cases) and 938 inmates with no history of drug use (controls) serving sentences in the Rio de Janeiro State prison system in 1998. The analysis included exposure variables divided into three hierarchical levels: distal, intermediate, and proximal. We performed bivariate analysis using logistic regression and multivariate analysis using hierarchized regression; results are given in odds ratios.


RESULTS
Variables associated with cocaine use in prison in the proximal level were use of alcohol and marijuana and duration of imprisonment in years. The effect of social vulnerability variables (distal level) was intermediated by variables in the next levels. Considering only the distal and intermediate levels, use of marijuana prior to imprisonment (OR=4.50; 95% CI: 3.17-6.41) and offence in order to obtain drugs (OR=2.96; 95% CI: 1.79-4.90) showed the strongest association with the outcome. For every additional year spent in prison, the odds of cocaine use increase by 13% (OR=1.13; 95% CI: 1.06-1.21).


CONCLUSIONS
Considering the distal and intermediate levels, use of marijuana prior to imprisonment and perpetration of offence in order to obtain drugs were the variables with greatest predictive value. The final model showed alcohol and marijuana use in prison and duration of imprisonment as important predictors of the outcome. The prison environment appears as a factor stimulating drug use.
Carvalho
Márcia Lazaro de
ML
Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fiocruz, Rio de Janeiro, RJ, Brazil. marcialc@ensp.fiocruz.br
Valente
Joaquim Gonçalves
JG
Assis
Simone Gonçalves de
SG
Vasconcelos
Ana Glória Godoi
AG
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D011330:Prisons / Q000706:statistics & numerical data*