摘要：Objectives. We examined the association between substance use disorders and migration to the United States in a nationally representative sample of the Mexican population. Methods. We used the World Mental Health version of the Composite International Diagnostic Interview to conduct structured, computer-assisted, face-to-face interviews with a cross-sectional sample of household residents aged 18 to 65 years who lived in Mexico in cities with a population of at least 2500 people in 2001 and 2002. The response rate was 76.6%, with 5826 respondents interviewed. Results. Respondents who had migrated to the United States and respondents who had family members who migrated in the United States were more likely to have used alcohol, marijuana, or cocaine at least once in their lifetime; to develop a substance use disorder; and to have a current (in the past 12 months) substance use disorder than were other Mexicans. Conclusions. International migration appears to play a large role in transforming substance use norms and pathology in Mexico. Future studies should examine how networks extending over international boundaries influence substance use. Epidemiological studies have found that among immigrants in general 1 and Mexican immigrants in particular, 2 , 3 longer duration of residence in the United States is associated with higher risk for substance use disorders. Transnational migration is likely to have an effect on substance use disorders among Mexican immigrants in native and destination countries. This is particularly important for Mexico because of the large number of Mexican citizens who migrate to work in the United States and subsequently return to Mexico and the even larger proportion of Mexicans who benefit from financial remittances sent home by family members working in the United States. 4 In the United States, Mexican migrants have greater access to alcohol and drugs and exposure to more liberal norms of substance use. Those who remain in Mexico and receive remittances have indirect exposure to US norms of substance use through their family members as well as increased access to alcohol and drugs because of the increase in household income. Studies of patients in treatment for drug use disorders in Mexico have found that those with migration experiences consumed a greater quantity and variety of drugs than did patients without migration experience. 5 However, to date, no studies have examined the effect that migration from Mexico to the United States has on substance use disorders in the Mexican general population. We used data from a national survey of psychiatric disorders in the Mexican general population to examine differences in alcohol and illicit drug use and abuse across 3 groups with different migration experiences. The first group consisted of respondents who had traveled to the United States for work and stayed for at least 3 months. The second group consisted of respondents who currently had a member of their immediate family in the United States. The third group consisted of respondents with no history of migration and no family member currently in the United States.
