Factores de riesgo asociados al consumo de sustancias psicoactivas en adolescentes: estrategias de abordaje desde el primer nivel de atención
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Abstract
El consumo de sustancias psicoactivas en adolescentes constituye un desafío creciente para los sistemas de salud, especialmente en el primer nivel de atención, donde se concentran las principales oportunidades de detección temprana. Este estudio tuvo como objetivo describir las sustancias más consumidas por adolescentes, identificar factores de riesgo asociados, examinar instrumentos validados de tamizaje y proponer un algoritmo clínico aplicable en atención primaria. Se realizó una revisión narrativa de 35 artículos publicados entre 2015 y 2025, seleccionados mediante criterios de calidad metodológica y relevancia temática. Los resultados evidencian que alcohol, tabaco/vapeo y cannabis son las sustancias más prevalentes; que los factores individuales, familiares, escolares y comunitarios influyen de manera multidimensional en el consumo, y que herramientas como CRAFFT y POSIT muestran alta validez para la población adolescente. A partir de estos hallazgos, se propone un algoritmo para estandarizar el tamizaje, intervención breve y referencia oportuna en el primer nivel de atención.
The consumption of psychoactive substances among adolescents constitutes a growing challenge for health systems, particularly within primary care, where the main opportunities for early detection are concentrated. This study aimed to describe the most commonly used substances among adolescents, identify associated risk factors, examine validated screening instruments, and propose a clinical algorithm applicable to primary care settings. A narrative review of 35 articles published between 2015 and 2025 was conducted, selected based on methodological quality and thematic relevance. The results show that alcohol, tobacco/vaping, and cannabis are the most prevalent substances; that individual, family, school, and community factors influence substance use in a multidimensional manner; and that tools such as CRAFFT and POSIT demonstrate high validity for adolescent populations. Based on these findings, an algorithm is proposed to standardize screening, brief intervention, and timely referral within primary care.
The consumption of psychoactive substances among adolescents constitutes a growing challenge for health systems, particularly within primary care, where the main opportunities for early detection are concentrated. This study aimed to describe the most commonly used substances among adolescents, identify associated risk factors, examine validated screening instruments, and propose a clinical algorithm applicable to primary care settings. A narrative review of 35 articles published between 2015 and 2025 was conducted, selected based on methodological quality and thematic relevance. The results show that alcohol, tobacco/vaping, and cannabis are the most prevalent substances; that individual, family, school, and community factors influence substance use in a multidimensional manner; and that tools such as CRAFFT and POSIT demonstrate high validity for adolescent populations. Based on these findings, an algorithm is proposed to standardize screening, brief intervention, and timely referral within primary care.
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Adolescentes, sustancias psicoactivas, factores de riesgo, tamizaje, atención primaria de salud, consumo de sustancias, intervención breve., Adolescents, psychoactive substances, riisk factors, screening, primary health care, substance use, brief intervention.