Patrón epidemiológico del consumo de droga mediante el análisis de cabello efectuado en el departamento de Madrid del Instituto Nacional de Toxicología y Ciencias Forenses, 2013-2015

Abstract

[ES] El abuso y dependencia de sustancias psicoactivas constituyen un problema prioritario de salud pública que se pone de manifiesto subjetivamente en el hecho de que las drogas se encuentran entre los problemas que más preocupan a la sociedad actual y se confirma mediante los datos epidemiológicos. Las consecuencias del consumo de drogas son graves tanto para el individuo como para la sociedad, tanto en términos sanitarios como socioeconómicos, y las soluciones a este problema se escapan de la capacidad de los individuos afectados, debiendo ser asumidas por la sociedad. Para esta investigación se ha requerido de un enfoque epidemiológico, cuyo objetivo es describir las relaciones entre el problema de salud y las características geográficas básicas como edad, género o localización geográfica. Para esta investigación se han utilizado dos tipos de fuentes de información: - Sistemas basados en registros oficiales - Sistemas basados en datos de entrevistas personales o exámenes realizados a determinada población

[EN]Knowledge of drug use, particularly in Spain, but also in Europe and wolrdwide, comes from epidemiological surveys carried our in general or specific populations more than from objective analytical data. Hair testing enables a retrospective identification of long-term use, thus becoming a routine procedure in Forensic Toxicology. As a result, large datasets of drug tests in hair are available for statistical analysics, which is a very suitable approach to obtain insights about the target population and to improve the interpretation of results. This Doctoral Thesis delves into the knowledge of epidmiological patterns of drug use in the forensic context in a geographical area that comprises nine Spanish Autonomous Communities (Madrid incluede) and more than 19 million inhabitants. The study focuses on a set of more than 5000 tests performed on head hair samples from the Medico-Legal sector at the Madrid Department of the Spanish National Institute of Toxicology and Forensica Sciences during the period 2013-2015. Tests are carried out on judicial request, wht the key aim of assessing the repeated use of drugs (cannabis, cocaine, heroin, ketamine and amphetamine derivatives) and/or substitution treatment drugs (methadone) by people involved in mostly criminal proceedings. the proportion of positivie results and the distribution of quantitativa results are assessed in relation to genter, age, geographical origin, cosmetic treatment and natural pigmentation of hair, and length of the tested sample. Finally, the trends of drug use patterns through the three-year period are evaluated. The study of prevalence of drug use in the forensic field proviedes a systematic approach to the knowledge of high-risk drug use. Epidemiological information revealed through hair analysis for legal purposes is particularly relevant in the case of substances with low prevalence of consumption in general population, as as regarding poly-drug use. Thus Forensic Epidemiology allows the orientation of Forensic Toxicology towards Public Health in order to have a positive impact on national policies and practices of prevention of drug use and minimization of its effects.