From the XXth Century to the third millennium. Addictions and public health: Drugs, alcohol and society

Social changes observed in the last decades, -derived from variations in th e demographic structure of the population with an increase in the absolute numbers of adolescents and persons from the third age with special vulnerab ilities for substance abuse; recurrent economical crisis where problems der ived from the increasing level of drug abuse among this group are added to those that result from poverty and lack of opportunities, and modernization and globalization as well- have affected the lives of persons in the indiv idual, familial and social areas where drug abuse is immersed. To the tradi tional problem of alcohol abuse among middle-aged males, no-v females and a dolescents are abusing alcohol imitating adult models where drinking anti d runkenness are often to linked. In spite of the change in social perception that associates tobacco use with health risks, Mexican adolescents, specia lly females, are smoking more. To the traditional problem of inhalation of solvents with psychotropic effects among children and adolescents and of ma rihuana among youth and some groups of the adult population, an increasing use of cocaine is observed, a trend that includes children and the poor sec tor of the population. An increasing use of IV drug use, an epidemic outbre ak of heroin in selected cities bordering the United States, and the emerge nce of new drugs such as met-ampheramines, are now part of the drug subcult ure. The article describes some recent trends in drug use and changes obser ved from the 1970's, and discusses the perspectives for the future regardin g the social contest. The relation between drug use, sexual risk behavior a nd delinquency is discussed. The association with accidents and different f orms of violence, including suicide and intrafamily violence, is also analy zed. The macro determinants of the problem and their relation to drug use ( globalization, economical development and inequalities, migration, changes in gender roles and family composition) are reviewed. The article finishes with an overview of the challenges for the future and research need.