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% Cl 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 ≤12 school years (OR 3.5), age ≤25 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.