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17,6%, el 15,7% y el 17,6% de los estudiantes de 8.º, 10.º y 12.º grado, respectivamente, los han utilizado; su consumo es diario en el 0,2% de los estudiantes de 8.º grado, el 0,1% de los de 10.º grado, y el 0,2% de los de 12.º grado. Consumo de múltiples sustancias Entre los adolescentes que participan en tratamientos por abuso de sustancias, el 96% consume varias, y el 97% también consume alcohol. ETIOLOGÍA Factores genéticos Se ha encontrado que la concordancia para el alcoholis mo es mayor en los gemelos monocigóticos que en los di cigóticos. Los estudios sobre hijos de alcohólicos criados fuera de sus familias biológicas han revelado que estos niños tienen una probabilidad aproximada del 25% de convertirse en alcohólicos. Factores psicosociales Entre los adolescentes, el consumo de sustancias, en particular el de marihuana, viene muy influido por los compañeros y amigos y, en especial en los que dicen con sumirla para relajarse, suele utilizarse para escapar del estrés y como actividad social. No obstante, algunos da tos hacen pensar que el consumo de marihuana se asocia también al trastorno de ansiedad social y a síntomas de depresión. Los datos sugieren que los adolescentes que se inicia ron antes en el consumo de alcohol, tabaco y marihuana a menudo provenían de familias en las que la supervisión y el control parental eran menores. El riesgo más alto de inicio precoz en el consumo de sustancias correspondió a los niños menores de 11 años. Además, una mayor su pervisión por parte de los padres durante la niñez puede disminuir el consumo experimental de alcohol y drogas, y reducir el riesgo futuro de consumo de marihuana, co caína o inhalantes. Discapacidades intelectuales American Association on Intellectual and Developmental Disabilities. Overview of intellectual disability: definition, classifications and sys tems of support. 2010. Arnold LE, Farmer C, Kraemer HC, Davies M, Witwer A, Chuang S, DiSilvestro R, McDougle CJ, McCracken J, Vitello B, Aman M, Sca hill L, Posey DJ, Swiezy NB. Moderators, mediators, and other pre dictors of risperidone response in children with autistic disorder and irritability. J Child Adolesc Psychopharmacol . 2010;20:83–93. Boulet S, Boyle C, Schieve L. Trends in health care utilization and health impact of developmental disabilities, 1997–2005. Arch Pediatr Adolesc Med . 2009;163:19–26. Correia Filho AG, Bodanase R, Silva TL, Alvarez JP, Aman M, Rohde LA. Comparison of risperidone and methylphenidate for reducing ADHD symptoms in children and adolescents with moderate intellec tual disability. J Am Acad Child Adolesc Psychiatry . 2005;44:748. Ellison JW, Rosengeld JA, Shaffer LG. Genetic basis of intellectual disa bility. Annu Rev Med . 2013;64:441–450. Fowler MG, Gable AR, Lampe MA, Etima M, Owor M. Perinatal HIV and its prevention: progress toward an HIV-free generation. Clin Peri natol . 2010;37:699–719. Bibliografía

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