Abstracts of Distinction: The Co-Occurrence of Violence and Substance Use Among Mexican Adolescents

The rise and spread of violence in Mexico is an urgent concern given its unsettling, widespread and accelerating impact on communities. Experiencing violence as a perpetrator, victim, or witness is a complex and interconnected phenomenon. Youth in the U.S. who experience any type of violence (perpetrator, victim, or witness) are at higher risk of substance use. However, it remains unknown how this co-occurrence of violence and substance use impacts Mexican adolescents’ vulnerability to using substances and the effectiveness of strategies to prevent or resist substance use.

This study draws on nine focus groups with 103 7^th and 9^th grade adolescents (n=47 males; n=56 females) living in the three largest cities in Mexico – Mexico City, Guadalajara, and Monterrey. Following the same protocols across cities, adolescents were asked about scenarios where alcohol and drugs were present, situations where they were offered drugs, and strategies they used to resist using substances. Data were analyzed by a bi-national team of researchers who coded responses, identified themes, reached agreements, and validated themes. The findings will be integrated into a planned cultural adaptation of a US developed and tested efficacious prevention intervention called keepin’it REAL.

Violence co-occurring with substance use emerged as a major theme with four sub-themes. (1) Violence both inside and outside the home. Outside threats of violence and intimidation were often used by those offering drugs as a strategy for getting others to take drugs. Inside violence occurred within the family setting with family members using drugs, including from parents to substance using adolescents. (2) Violence as a self-defense measure against drug offers. Aggression came when adolescents felt frustrated that saying “no” to the offer had not worked multiple times. As a result, adolescents (both boys and girls) described hitting, kicking, or slapping the drug offerors. (3) Violence to intervene with friends’ drug use. Adolescents got into physical fights with their friends if they saw them using drugs. (4) Violence as a result of substance use. Adolescents used violence and other delinquent acts to pay for the cost of the drugs owed to dealers and gangs.

The context for drug offers in these Mexican areas lends itself to a strong connection between drug offers and violence. Specifically, drug offerors are aggressive and do not stop easily. They use intimidation to threaten and sometimes physically overpower teenagers to initiate drug use. In culturally adapting the intervention as Mantente REAL, considerations need to be made for new resistance strategies to handle the intensity of drug risk in this context. The program adaptation should address what to do when offers turn to intimidation and how do adolescents stand up for themselves with both bravery and safety.