ARTÍCULOS ORIGINALES
Consumption of Psychoactive Substances in
Educational Institutions: an Inquiry into the State of
Affairs in the Schools of Córdoba.
Lucchese MSM, Burrone MS, Enders JE, Fernández AR.
Revista Facultad de Ciencias Medicas 2014; 71(1):36-42
Admission Department, School
of Medical Sciences - Universidad Nacional de
Córdoba.Córdoba. Argentina. Enrique Barros s/n- Ciudad
Universitaria. admision@fcm.unc.edu.ar
Introduction
The illegal consumption of psychoactive
substances is an important psychosocial phenomenon.
According to Luengo, Kulis, Marsiglia, Romero, Gómez-
Fraguela, Villar and Nieri, consumption of substances by
adolescents is a public health problem with personal and
social implications(1). Against this background,
educational institutions constitute a place that fosters the
development of their higher psychological functions by
providing them with symbolic resources to build their
perception of the social world and of themselves as
individuals(2,3). EchavaríaGrajales states that
the school constitutes the scene where the manners of
thinking, feeling and inhabiting the world are shaped, and
where a universe of cultures and identities is framed. For
adolescents, schools are an important part of the changes in
the process of development of their autonomy. The
socialization processes that adolescents establish at school
may include drug consumption; school attendance is important
as a protection factor in contexts of vulnerability(4).
It is important to determine the relationship between
substance consumption, school environment and the school
standing of the students. As a result of these
considerations, the following questions arise: is it true
that state night-shift coeducational schools, with low
academic demands and lax discipline, foster drug
consumption? Is it true that adolescents with behavior
problems and low attendance rates are potential consumers of
illegal substances? Is it true that schools with high
academic and disciplinary standards, with clearly stated
behavior norms, do not facilitate the consumption of
psychoactive substances?
Objectives
Materials and Methods
Two approaches were used to carry out this
study. The quantitative approach was used for the first
stage, using the data gathered by the Second National Survey
of Secondary School Students carried out in Córdoba city in
2005. For the second stage, a qualitative approach was used.
The quantitative approach involved a correlational and
observational analysis. The work was performed on the data
recorded by the Second National Survey of Secondary School
Students, using a multistage probabilistic sample drawn from
a universe consisting of the entire population of students
of the schools included in the Córdoba Province School
Census of 2004. The sample was representative of students of
the Córdoba Province aged 13, 15 and 17 years, comprising
4593 students in all. The questionnaire employed was the one
designed and validated by SEDRONAR for secondary school
students, consisting of 97 closed questions, and this study
focused on 13 questions, grouped according to: school,
school standing of the student, and psychoactive substances
consumption by students.
To assess the school characteristics, the
following aspects were taken into account: type of school
(state, private, and other), shift (morning, afternoon, and
night), level of academic demand (high, fairly high,
somewhat high, and low). As regards student school standing:
sex (male, female), age (13, 15 and 17 years), grade (8th,
10th, and 12th), number of grade
repetitions (none, one, two, or more), existence of behavior
problems (often, sometimes, and never), and frequent absence
from school (yes, no). As regards psychoactive substances
consumption: whether the student did or did not consume
psychoactive substances. The analysis comprised summary
measurements and multivariate and factorial multiple
correspondence analysis. Statistical processing of data was
carried out as bivariate analysis, through categorical data
(chi-squared test, Mantel Haenzel or Fisher’s test), in
order to determine the risk ratio and confidence intervals (CIs)
for each variable under study. In all cases a significance
level of p < 0.05 was established.
The second stage consisted of an ethnographic
study. The schools (both state and privately managed
state-supervised, “private” for short henceforward) were
chosen by an intentional, cumulative and sequential sampling
method until a point of data saturation was reached. This
stage began once the results of the quantitative had been
obtained. Ten in-depth interviews were carried out, with
school principals, deputy principals, regents, and members
of the schools technical staffs. The questions were adapted
to the various situations of the educational institutions as
regards consumption, school, and school standing of the
students. The qualitative data thus gathered was analyzed
using the Glaser and Strauss’ comparative constant method.
Validation was done by means of inter-method triangulation(5).
Results
The National Survey in Córdoba comprised 4593
students. The mean age of students in the sample was 14.91 ±
0.03, with a range going from 11 to 22 years. 42.85% of
students were male and 57.15%, female. When comparing the
mean age of the groups stratified by sex, it was detected
that male mean age was higher than female mean age, namely
14.96 ± 0.04 vs 14.87 ± 0.03 respectively (p < 0.01). As for
the type of school, it was found that 54.45% of students
attended state schools, the remaining being at privately
managed schools, and that 73.74% of the total student
population was in the morning shift.
For the relationships between school shift,
sex, school academic demand, and school discipline demand,
the results were as follows.
As regards the relationship between
consumption and school shift, the morning shift shows less
consumption than the afternoon and night shifts (62%, 72%,
88.33%, respectively; p < 0,001). Moreover, a difference was
observed in the consumption of both legal and illegal
substances according to school shifts, with adolescents in
the morning shift consuming less than those in the afternoon
and night shifts (p < 0,001). As regards monthly prevalence
of some illegal drug, it was detected that for schools with
a fairly high level of academic demand and discipline (p =
0.0187) students do no consume illegal drugs. Besides, it
was detected that female students consume less than male
students (p = 0.0273). It was also detected that night-shift
schools with low academic and disciplinary demands present a
higher consumption risk. As regards levels of academic
demand, the study shows that adolescent consumption
increases as these levels decrease (p < 0.02). This study
has detected that age is an important variable associated
with consumption (p = 0.0053). Consumption was observed to
increase with age.
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Figure 1:
Multivariate analysis of life prevalence of
consumption of na illegal substance, school shift, academic
demand, discipline demand and sex of student.
Ref: consumption of illegal substance: 0 NO;
100 YES
Sex: 1: male; 2, female
Type of school: 1: state; 2: private
School shift: 1: morning; 2: afternoon; 3:
night
Academic demand: 1: high; 2: fairly high; 3:
somewhat high; 4: low
Discipline demand: 1: high; 2: fairly high;
3: somewhat high; 4: low
Figure 1 shows in the first quadrant the
grouping of state school, male sex, low academic demand, low
discipline demand, and night school shift. The second
quadrant (broken-line ellipse) shows the grouping of high
academic demand, high discipline demand, morning shift and
no consumption of illegal substances. The third quadrant
(continuous line ellipse) shows the grouping of private
school, female sex, and fairly high academic and
disciplinary demand. The last quadrant (rectangle) groups
consumption of some illicit substance, afternoon shift and
low academic and disciplinary demand.
Figure 2, which corresponds to the analysis
of the relationship between type of school (private or
state), school standing of adolescents and drug consumption.
The first quadrant (continuous line ellipse) demonstrates
the grouping of males with frequent behavior problems in
school and consumption of alcoholic beverages and some
illegal substance. The second quadrant (broken-line
ellipse) associates private schools and no repetition, with
high attendance rates and no consumption of illegal
substances. The third quadrant (continuous line rectangle)
shows the association of female sex, no consumption of
alcoholic beverages, and no behavior problems, whereas the
fourth quadrant (broken line rectangle) shows the
relationship among frequent school absenteeism and
repetition of one grade during the course of studies.
Figure 2:
Multivariate analysis of type of school
(private or state), adolescent school standing and
consumption of drugs. (n=4593). Year 2005.
Ref: Sex: 1: male; 2, female
Type of School: 1: state; 2: private
Repetition: 1, none; 2: two; 3, two or more
Behavior problems: 1, often; 2, sometimes; 3,
never
Frequent absence: 1, yes; 2, no
Illegal substance: 0: consumption; 100: no
consumption
Prevalence of alcoholic beverages: 0:
consumption; 100: no consumption
As regards qualitative analysis of substance
consumption by adolescents, through inquiries about what and
when they consume, the following statements were gathered:
“Teenagers get drunk; they pay a price in
order to become part of a group. Boys and girls alike drink
alcohol”
(Interview Nº 1)
“There is consumption, more in teenagers
attending the afternoon shift than in those in the morning
shift. There are some punctual cases, and the remaining ones
consume marijuana. As regards alcohol, it is usual
particularly on weekends, alcohol is accepted as something
natural and so is marijuana”
(Interview Nº 2)
“Marijuana consumption has arrived in school.
There are cases of students who steal pills from their
parents or grandparents”
(Interview Nº 2)
“50% of students smoke cigarettes, between
60% and 70% consume alcohol and 3 or 4 students consume
illegal substances, particularly since 2008”
(Interview Nº 4)
“There is consumption of and dealing in drugs
in the school”
(Interview Nº 8)
“They consume alcohol and arrive in school
already drunk”
(Interview Nº 2)
Alcohol is mainly consumed on weekends; this
consumption is considered as something completely natural,
and it is done to follow the fashion, to imitate the group
peers and for the sake of fun. In two state schools, one
student was reported to have entered the school in a drunken
state, and another one was found in the act of consuming an
illegal substance.
As regards level of academic demand,
interviewees had the perception that it is variable. Some
private institutions perceive themselves as demanding, and
the effects of this demand can be seen in the rate of
admission of their students to university. Some state
schools identify their level of academic demand as normal,
whereas another one declares it to be high; it was also
observed that the demand may depend on the teachers and the
subjects they teach. Moreover, coeducational morning-shift
schools were detected to have higher academic demands than
those of the afternoon and night-shifts, which is related to
consumption of substances, and coincides with the
quantitative results of this study.
As regards levels of disciplinary demands,
the following statements were identified:
“Lack of discipline does not affect the
majority of students”
(Interview Nº 1).
“Public policies tend to do all that is
necessary to retain students; for instance, if they are
absent for a total of 45 days, nothing is done (…)”
(Interview Nº 2).
“We could say that discipline has not
worsened since 2003/2004, but that it varies according to
the teacher”
(Interview Nº 3).
“An orderly class facilitates the development
of activities. As for discipline, we are very demanding and
fortunately, as a result of the work of monitors, order can
be maintained without coercion”
(Interview Nº 4).
“Monitors are in charge of both
administrative and pedagogical tasks”
(Interview Nº 5).
“Students enter the classroom and leave it at
their will; my class starts at 8:00, but some of them arrive
at 8:40… they just say “I’m coming back in a moment, I’m
going to have breakfast”. “They enter the classroom with pop
music at a very high volume”
(Interview Nº 10).
“There is no discipline demands … there is a
monitoring notebook, but nothing is actually done”
(Interview Nº 9).
These statements of interviewees permit to
detect that discipline has changed as compared to previous
years. Private schools evince a strict discipline which
purports to control the class and to apply penalties in case
of faults; the code of social conduct is recognizable in the
development of daily school activities. State schools
exhibit extremes cases as regards discipline and order,
ranging from the recognition of the value of discipline and
order to a complete laxity. Some schools refer the violation
of norms to their code of social conduct.
Private schools tend to have a more uniform
approach to disciplinary matters, whereas state schools
evince more variation in the application of norms, which may
result, according to the situation, in protection factors or
risk factors. The variety of norms established by different
educational institutions implies different behaviors of the
institutions as such. Some institutions analyze discipline
problems, others tend to expel students, and others
privilege retention of students following ministerial
policies. Flexibility in the matter of interpretation of
norms may be seen in some state schools, but is not found in
private schools.
As regards repetition rates, it ranges
between 5% and 25% in the majority of schools. Only one
school had a repetition rate of 60% from the first to the
third year. Repetition rates are higher in state schools
than in private schools. Re-enrolment as a result of
absenteeism occurs in both types of schools, though in state
schools some cases of three instances of re-enrolment were
recorded for a student in a year. Repetition rates and
re-enrolment are governed by provincial and institutional
policies, and evince different approaches in state and
private institutions. The flexible application of norms is
the result of contingent problems rather than of academic
long-term policies; this may eventually lead to dropping out
of some students because they cannot account for the
educational training they have received. Some educational
policy decisions are not related to levels of academic and
disciplinary demand, as they should be as a result of the
state responsibility and the heterogeneity of the
educational system.
Discussion
With reference to type of school and
attendance shift, this study concluded that adolescents
attending morning-shift schools evince less consumption of
illegal substances than those attending afternoon or night
shifts, a finding that coincides with those of the study
carried out by the ObservatorioHondureño(6). As
regards levels of academic demand, this study concludes that
consumption by students increases as academic demand
decreases, which agrees with the first comparative study on
the use of drugs by the school population in Latin American
countries(7). This also coincides with the
results of the work by AnnelieseDörr and her team, who found
that consumers have a perception of the school as less
demanding than those who do not consume, and that schools
with more lax discipline Foster consumption(8).
Similarly, an article by García del Castillo states that
consumption increases when students perceive the school as
less demanding in matters of discipline(9). These
results are reinforced by a study carried out by CICAD,
which stated that in most Latin American countries the
prevalence of consumption year of any illegal substance
doubles when the school is perceived by students as lax in
disciplinary demands(7).
As regards school standing of adolescents and
its association with consumption of psychoactive substances,
it is observed that frequent absenteeism, behavior problems
and repetition are linked to the consumption of psychoactive
substances. Similarly, a study by VázquezValls and his team
detected a clear relationship between drug consumption and
low academic performance, high absenteeism, dropping out of
school, and low educational expectations(10).
Oliveira and his team detected that the use of psychoactive
substances interferes with lessons and school activities
(11). Another comparative study in Latin America
found that students who get low marks and/or have repeated
some school grade exhibit higher drug consumption rates than
those having a better academic performance(2).
The results of the CICAD study in Latin America indicate
that students who have repeated courses in school show
higher rates of drug consumption in all countries(12,7).
On the other hand, the study by VázquezValls and his team
asserts that adolescents with good marks and high
involvement with their school show a higher self-esteem and
consume less alcohol(13).
CasoNiebla y
HérnandezGuzmán have noted, in a study on a model to explain
low school performance in Mexican adolescents, that
self-esteem has a direct effect on the consumption of
substances, which in turn is related to poor school
performance(14).
Conclusion
It is observed that the differences in the
consumption of legal and illegal substances between the
students surveyed, in relation to the school shift, point to
less consumption in adolescents attending the morning shifts
as compared to those in the afternoon and night shifts.
Repetition and behavior problems were associated to
consumption of some illegal drugs by adolescents, whereas
those schools that are adequately organized towards their
educational goals, and having high levels of academic demand
and clarity of disciplinary norms, become institutions whose
adolescent students do not consume psychoactive substances.
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