Risk and protective factors for heroin use in a nationally representative sample of Ecuadorian youth

Introduction Recent reports from a variety of sources indicate that heroin use among Ecuadorian adolescents is on the rise. In order to design effective prevention and intervention programs, research is needed that quantifies use and assesses risk and protective factors associated with use. Methods: This study analyzed the National Survey of Drug Use, a nationally representative survey of 50,145 adolescents (49.6% female; M age = 14.92 years, SD = 1.74) conducted in Ecuador in 2015. Results: Overall, 2.3% of the sample reported lifetime heroin use. Logistic regression analysis revealed that higher lifetime heroin use was associated with lifetime use of alcohol (Adj OR = .71 CI [.58,.86]), marijuana (Adj OR = 3.79 C1[3.17, 4.52]), and hard drugs (Adj OR = 16.33 CI[13.89, 19.21]), as well as with greater perceived access to heroin (Adj OR = 2.13 CI [1.93, 2.36]) and repeating more school grades (Adj OR = 1.66 CI [1.37, 2.01]). Higher levels of parental involvement (Adj OR = .95 CI [.91,.99]) were associated with a reduced risk of use. Risk and protective factors operated similarly across age and gender. Conclusion: These data suggest that targeting substance use early in adolescence, focusing on school engagement, enhancing parenting skills, and improving family climate may be important approaches to curbing heroin use among Ecuadorian teens. The relative absence of age and gender differences in patterns of risk and protection suggest that a universal prevention approach versus a targeted approach may be most effective.