title: Co-occurrence of alcohol, drug use, DSM-5 alcohol use disorder, and symptoms of drug use disorder on both sides of the U.S.-Mexico border.
abstract: BACKGROUND
  The U.S.-Mexico border displays elevated rates of hazardous alcohol and drug use. Whether the co-occurrence of alcohol and drug use and disorders is also high in the border area is unknown.
  
  
  METHODS
  Data are from the U.S.-Mexico Study on Alcohol and Related Conditions, a cross-sectional survey of randomly selected respondents interviewed from 2011 to 2013. Participants included 1,690 Mexican Americans from Texas (572 in an off-border city and 1,118 from 3 border cities) and 1,293 Mexicans from Nuevo Leon and Tamaulipas (415 in an off-border city and 878 from 3 Mexican cities bordering Texas) who reported drinking in the last 12 months. Participants were interviewed regarding the prevalence of and risk factors for: (i) co-occurring hazardous alcohol use (5+/4+ at least monthly) and drug use (medical and illicit) and (ii) co-occurring presence of a DSM-5 alcohol use disorder (AUD) and 2 symptoms (hazardous use and quit/control) of drug use disorder (DUD symptoms).
  
  
  RESULTS
  Co-occurring hazardous alcohol and drug use was more common in the U.S. border cities (14.7%) than off-border (7.2%), but similar for Mexican border (1.2%) and off-border (1.4%) cities. Co-occurrence of AUD and DUD symptoms was likewise more common at the U.S. border (6.8%) than off-border (3.3%), as well as at the Mexican border (1.3%), compared to off-border (0.6%), but not statistically significant for Mexico. In models adjusting for demographics, mobility factors and exposure to the U.S. culture, border residence in both countries related to a nearly twofold increase in prevalence ratios (PRs) of co-occurring AUD and DUD symptoms (PR = 1.97, 95% CI = 1.36 to 2.85).
  
  
  CONCLUSIONS
  Increased rates of co-occurring AUDs and DUDs suggest an added negative impact on already difficult conditions of the border population.
authors.affiliation: Dirección de Investigaciones Epidemiológicas y Psicosociales and Universidad Autónoma Metropolitana , Instituto Nacional de Psiquiatría Ramón de la Fuente, Mexico City, Mexico.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.forename: Sarah
authors.initials: S
authors.lastname: Zemore
authors.forename: Ricardo
authors.initials: R
authors.lastname: Orozco
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Cherpitel
authors.forename: Yu
authors.initials: Y
authors.lastname: Ye
authors.forename: Jason
authors.initials: J
authors.lastname: Bond
authors.forename: Jane Carlisle
authors.initials: JC
authors.lastname: Maxwell
authors.forename: Lynn
authors.initials: L
authors.lastname: Wallisch
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol Use; Co-Occurrence; DSM-5; Drug Use; U.S.-Mexico Border
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