Identifying adolescent drug users: results of a national survey on adolescent health in Switzerland (1995)

FRANÇAIS :
L'objectif de cette étude est de déterminer les caractéristiques et la proportion des adolescents usagers de drogue en Suisse, grâce à l'étude d'un échantillon représentatif de jeunes, menée entre 1992 et 1993. Les résultats mettent en évidence que le taux d'usagers de drogues illicites parmi les adolescents suisses est élevé par rapport à d'autres pays européens. L'examen des paramètres suivants : âge, sexe, nationalité, type d'éducation, pensées suicidaires, dépendance tabagique et usage de cannabis - est pertinent pour la réalisation d'un profil type du consommateur d'héroïne ou de cocaïne. Enfin, bien que cette population ait de fréquents contacts avec les services de soins généralistes, elle accède peu à la prise en charge spécialisée en toxicomanie et ne consulte pas pour ses problèmes de dépendance. La prévention devrait donc s'exercer de préférence dans les milieux généralistes et les médecins être sensibilisés aux problèmes rencontrés par les adolescents.
ENGLISH :
Objective: To explore the proportion and characteristics of adolescents who use illicit drugs and contrast them with adolescents who do not use such drugs in Switzerland. To facilitate the detection of adolescents with drug related difficulties.
Methods: We used data from a national survey on adolescent health in Switzerland (N = 9,273) conducted in 1992 and 1993. The survey is based on self-administered questionnaires among a representative sample of adolescents enrolled in schools and apprenticeship programs. We used exploratory analysis for identifying characteristics which set the drug user apart from non-users and performed confirmatory multivariate logistic regression analysis to examine which variables remain independently associated with heroin or cocaine use.
Results: In Switzerland, 3.1% of adolescents have taken heroin or cocaine at least once in their life, and 27.7% have already used cannabis. Analysis of lifestyles and health of adolescents shows that young drug users present difficulties in integrating in society, have health problems and difficulties in relationships, situations which tend to be less common among other adolescents. Yet, they also display marked similarities, most notably in that over 70% had seen a physician in the past year. However, while 40% of the drug users expressed a need for help with drug related problems, only 6% had actually talked about them with a physician. Characteristics that remained independently associated with heroin and cocaine use after controlling for confounding factors were age, sex, nationality, type of education, feelings of suicide, past and present smoking, and use of cannabis.
Conclusion: The level of illicit drug use among Swiss adolescents is high compared to other European countries but lower than the United States. Drug-using adolescents display a constellation of characteristics which should make it possible to identify them and offer help. Yet, even though they may have frequent contact with the health services, their drug problems are generally not recognized by the gatekeepers of the health services and no specific aid is available to them. Drug prevention must be intensified and medical doctors sensitized to the drug problems which adolescents may face.