title: Mexicans' use of illicit drugs in an era of drug reform: national comparative analysis by migrant status.
abstract: BACKGROUND
  Although rates of illicit drug use are considerably lower in Mexico than in the United States, rates in Mexico have risen significantly. This increase has particular implications for Mexican women and US migrants, who are considered at increased risk of drug use. Due to drug reforms enacted in Mexico in 2008, it is critical to evaluate patterns of drug use among migrants who reside in both regions.
  
  
  METHODS
  We analysed a sample of Mexicans (N=16,249) surveyed during a national household survey in 2011, the Encuesta Nacional de Adicciones (National Survey of Addictions). Comparative analyses based on Mexicans' migrant status - (1) never in the United States, (2) visited the United States, or (3) lived in the United States (transnationals) - featured analysis of variance and Chi-square global tests. Two multilevel regressions were conducted to determine the relationships among migrant status, women, and illicit drug use.
  
  
  RESULTS
  Comparative findings showed significant differences in type and number of drugs used among Mexicans by migrant status. The regression models showed that compared with Mexicans who had never visited the United States, Mexican transnationals were more likely to report having used drugs (OR=2.453, 95% CI=1.933, 3.113) and using more illicit drugs (IRR=2.061, 95% CI=1.626, 2.613). Women were less likely than men to report having used drugs (OR=0.187, 95% CI=0.146, 0.239) and using more illicit drugs (IRR=0.153, 95% CI=0.116, 0.202).
  
  
  CONCLUSIONS
  Overall, the findings support further exploration of risk factors for illicit drug use among Mexican transnationals, who exhibit greater drug use behaviours than Mexicans never in the United States. Because drug reform mandates referrals to treatment for those with recurrent issues of drug use, it is critical for the Mexican government and civic society to develop the capacity to offer evidence-based substance abuse treatment for returning migrants with high-risk drug behaviours.
authors.affiliation: School of Social Work, University of Southern California, 655 West 34th Street, Los Angeles, CA 90089, United States. Electronic address: erickgue@usc.edu.
authors.forename: Erick G
authors.initials: EG
authors.lastname: Guerrero
authors.affiliation: Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, 14370 Cuidad de México, Distrito Federal, Mexico. Electronic address: ameth@imp.edu.mx.
authors.forename: Jorge Ameth
authors.initials: JA
authors.lastname: Villatoro
authors.affiliation: School of Social Work, University of Southern California, 655 West 34th Street, Los Angeles, CA 90089, United States. Electronic address: yinfeik@usc.edu.
authors.forename: Yinfei
authors.initials: Y
authors.lastname: Kong
authors.affiliation: Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, 14370 Cuidad de México, Distrito Federal, Mexico. Electronic address: marcarment@imp.edu.mx.
authors.forename: Marycarmen Bustos
authors.initials: MB
authors.lastname: Gamiño
authors.affiliation: School of Social Work, University of Southern California, 655 West 34th Street, Los Angeles, CA 90089, United States. Electronic address: williaav@usc.edu.
authors.forename: William A
authors.initials: WA
authors.lastname: Vega
authors.affiliation: Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco 101, San Lorenzo Huipulco, 14370 Cuidad de México, Distrito Federal, Mexico. Electronic address: medinam@imp.edu.mx.
authors.forename: Maria Elena Medina
authors.initials: ME
authors.lastname: Mora
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003625:Data Collection; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
chemical_list: D013287:Illicit Drugs
keywords: Drug reform; Gender; Illicit drug use; Mexicans; Migrant status