English

Abstract

states that have legalized medical marijuana also have a greater percentage of adolescents who consider the drug to be less risky (3). The exact nature of this association is to be determined but should impact on the policy decisions related to substance abuse by groups like CARIAD. The evaluation by Reid et al of the effectiveness of CARIAD in meeting its training objectives to educate health and allied professionals about alcohol and drug use, and increase awareness of addiction issues in the Caribbean is included among the articles presented in this special edition of the Journal (4). As the cultural norms of the society change, it will continue to influence drug usage. This will not only be for adolescents but also young adults, particularly those engaged in academic pursuits. Undergraduate students and their substance use are also featured in this issue, where WhitehorneSmith et al investigated the drug use practices of medical/ health students (5). This has added to the empirically based research on drug use in this particular group across the Caribbean and Latin America and indicates that the trend in adolescent substance use continues into adulthood, with alcohol being the most commonly abused substance. The relatively high prevalence of alcohol use among Caribbean adolescents and adults, along with its relationship with emotional anguish, will continue to present a significant public health challenge for lowand middle-income countries. Through organizations such as CARIAD and the National Council on Drug Abuse (NCDA) in Jamaica, contextand culture-specific strategies to decrease the physical availability of alcohol and other drugs need to be implemented to reduce adolescent and young adult drug use (6). Substance abuse has become associated with a myriad of medical, psychiatric, social/family, employment, and legal problems internationally and similarly in Jamaica and the wider Caribbean. In terms of the relationship between substance abuse and violence and offending behaviour, substances not only impact on community violence but also violence in the home and in institutions. Substance use contributes more to the public health burden of the cycle of domestic violence more than any other risk factor (7). Longman-Mills et al have studied the relationship between physical abuse during childhood and experiencing psychological distress and substance abuse among university students (8). The authors were able to identify that experiencing physical abuse increases the likelihood of having higher levels of psychological distress and becoming a From: Department of Community Health and Psychiatry, The University of the West Indies, Kingston 7, Jamaica.