Modelo preditivo do uso de cocaína em prisões do Estado do Rio de Janeiro

Abstract

ObjectiveTo identify predictors of and groups vulnerable to cocaine use in prison. MethodsWe selected 376 inmates with history of cocaine use in prison (cases) and 938 inmates with no history of drug use (controls) serving sentences in the Rio de Janeiro State prison system in 1998. The analysis included exposure variables divided into three hierarchical levels: distal, intermediate, and proximal. We performed bivariate analysis using logistic regression and multivariate analysis using hierarchized regression; results are given in odds ratios. ResultsVariables associated with cocaine use in prison in the proximal level were use of alcohol and marijuana and duration of imprisonment in years. The effect of social vulnerability variables (distal level) was intermediated by variables in the next levels. Considering only the distal and intermediate levels, use of marijuana prior to imprisonment (OR=4.50; 95% CI: 3.17-6.41) and offence in order to obtain drugs (OR=2.96; 95% CI: 1.79-4.90) showed the strongest association with the outcome. For every additional year spent in prison, the odds of cocaine use increase by 13% (OR=1.13; 95% CI: 1.06-1.21). Conclusions Considering the distal and intermediate levels, use of marijuana prior to imprisonment and perpetration of offence in order to obtain drugs were the variables with greatest predictive value. The final model showed alcohol and marijuana use in prison and duration of imprisonment as important predictors of the outcome. The prison environment appears as a factor stimulating drug use.Data from the Rio de Janeiro Child and Youth Court (Segunda Vara da Infância e Juventude) show that, of all illegal acts perpetrated by youths in the last five years, 13.4% are classified as possession/use of illegal drugs and 22.2% as drug dealing, according to Statute no. 6.368/76.The boundary between use and dealing is not always clear-cut in practice. In 1997, drug dealing accounted for 14.8% of sentences and ranked third in terms of the frequency of crimes committed.* In the Rev Saúde Pública 2005;39(5)

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