Association between stressful life events and psychoactive substance use in adolescents and young adults from Argentina, Colombia and Peru

BACKGROUND: Substance use is a common problem among young people in Latin America and has significant consequences for their mental health. One of the variables associated with the use of psychoactive substances is stressful life events (SLEs). SLEs can include traumatic experiences, significant losses, interpersonal conflicts, financial difficulties, among others. OBJECTIVE: To explore the association between the number of SLEs and psychoactive substance use in adolescents and young adults from deprived urban settings. METHODS: In this cross-sectional study, adolescents and young adults were recruited from disadvantaged urban environments in Buenos Aires, Bogota and Lima. Data were collected between April 2021 and November 2022. The number of SLEs experienced in lifetime until a year ago was assessed using an adaptation of the Adolescent Appropriate Life Events Scale, which asks about 30 SLEs. Psychoactive substance use in the last three months was self-rated and six outcomes were analyzed: alcohol, tobacco, marijuana, tranquilizers, other drugs, and use of three or more substances. Crude and adjusted prevalence ratios (PRs) were estimated using generalized linear models of the Poisson family with log link and robust variances for each outcome. RESULTS: 2378 participants' data were analyzed. Participants experiencing between 10 and 22 SLEs more than a year ago had higher prevalence rates of psychoactive substance use than participants between 0 and 5 SLEs in four of six outcomes: tobacco (PR: 1.69, 95% CI 1.37-2.08), alcohol (PR: 1.23, 95% CI 1.13-1.35), marijuana (PR: 1.75, 95% CI 1.35-2.26), and three or more psychoactive substances (PR: 1.85, 95% CI 1.35-2.53) in the last three months. CONCLUSION: Experiencing a higher number of SLEs was associated with the use of tobacco, alcohol, marijuana, and three or more psychoactive substances in adolescents and young adults from disadvantaged urban areas of Bogota, Buenos Aires, and Lima. Recognizing young people who have gone through multiple stressful life events at an early stage is essential, so that interventions can be implemented to prevent them from turning to psychoactive substances. CLINICAL TRIAL NUMBER: Not applicable.