High rates of substance abuse among long-term travelers to the tropics: an interventional study

Background: Drug abuse constitutes a worldwide problem. The purpose of this study was to investigate the characteristics of illicit drug use during long-term travel to the tropics, and to estimate the effects of antidrug brochures provided before travel on the use of drugs during travel. Methods: An interventional study was done on 1,000 travelers to the tropics aged 18 to 30 years. Pretravel brochures explaining the hazards of drug abuse were provided to 500 of them. A control group of 500 travelers did not receive the brochures. Questionnaires exploring drug abuse habits were sent to all travelers after their return. Results: Among 223 travelers (108 and 115 of the intervention and control groups, respectively) who returned their questionnaires, 82 (36.8%, 95% CI 30.5-43.5%) had experienced illicit drug use during their trip, whereas only 52 of them had tried drugs before (p < 0.01). More travelers had used drugs in the Far East (43.3%) than in South America (25.6%, p < 0.01). The strongest predictors of drug abuse were: the compound of female gender and travel to Asia (odds ratio (OR), 4.3), education less than or equal to12 school years (OR 3.5), age less than or equal to25 years (OR 2.7), and no malaria prophylaxis (OR 2.6). The brochures failed to decrease the rate of drug abuse (38.9% vs. 34.8% in the control group, p = NS). Conclusions: More than one-third of young Israelis who travel to the tropics use illicit drugs. For many, the trip was their first encounter. Brochures as a sole agent are inadequate, and further means are needed to reduce this alarming trend.