Illicit Drug Use and Sociodemographic Correlates Among Adolescents in a Brazilian Metropolitan Region: A School-Based Cross-Sectional Study.

(1) Introduction: Drug use among adolescents remains persistent, including in school settings, thus requiring attention. This study analyzed the prevalence of drug experimentation and current use among high school students and their associated factors. (2) Methods: An analytical cross-sectional study was conducted in 2023 with 4610 students from public and private high schools in the Metropolitan Region of Grande Vitória, Brazil. Data were collected using tablets and a questionnaire. Sociodemographic variables were considered. Bivariate analyses and Poisson regression were used. (3) Results: Drug experimentation was reported by 22% of students (23.5% girls; 19.8% boys), and current use by 8.7% (9.2% girls; 8.0% boys). Higher lifetime use was observed among older adolescents (RP: 1.44) and those from higher socioeconomic classes (RP: 1.24). Statistically significant associations were found in LGBTQIAPN+ students (RP: 1.54 experimentation; RP: 1.76 current use) and Black students (RP: 1.33; 1.59). Being in a relationship (RP: 1.41; 1.42), currently working (RP: 1.36; 1.62), and having separated parents (RP: 1.29; 1.37) were also associated. (4) Conclusions: The high prevalence of drug use among adolescents highlights the need for targeted public policies, especially school-based actions promoting mental health, diversity, and racial equity. This study identifies vulnerable subgroups at greater risk.