Drug use opportunities as opportunities for drug use prevention: Bogotá, Colombia a case in point

Background: As drugs become more ubiquitous and fewer resources are available for drug prevention and treatment, understanding the early stages of drug use involvement becomes increasingly important for prevention efforts. This study aims to explore the concept of drug use opportunity, and to disentangle, from a socio-ecological perspective, the factors associated with experiencing a drug use opportunity. Methods: Data from 2279 standardized questionnaires administered in 23 schools in Bogotá was analyzed. Schools were selected in a multistage probability cluster sample. Multilevel logistic regression modeling estimated the effects of multiple level factors on the likelihood of having experienced an opportunity to use illicit drugs or inhalants. Results: One-third of respondents (32.1%) reported having had an opportunity to use drugs. Even among those who perceived drugs to be readily available and/or expressed intentions to use drugs in the near future, most reported never having experienced an opportunity to use drugs. For most of the drugs assessed, peer drug use, cigarette smoking, alcohol drinking, problematic behavior, and degree of school safety were the strongest correlates of having had a drug use opportunity. Conclusions: Despite living in an environment of high drug availability, most adolescents do not experience opportunities to use drugs. The likelihood of experiencing an opportunity is influenced by multiple interacting individual and macro-social factors, just as drug use is. Drug use opportunities were mainly promoted by friends, suggesting the need to consider their role within close social networks, alongside that of drug suppliers, in the design of intervention activities and drug policy development.