Solvent use as a precursor to intravenous drug abuse.

Intravenous drug abuse (IVDA) is a significant public health threat, and ways of identifying individuals at high risk for IVDA are needed to plan strategies for intervention and treatment. Previous work had identified similarities in psychiatric diagnosis and patterns of drug use in IVDAs and solvent users. Using the same population, we found that 59 of 179 IVDAs (33.0%) reported a history of solvent use, which preceded the onset of IVDA in 41 of the 59. IVDAs with a history of solvent use were more likely to receive diagnoses of alcoholism and antisocial personality disorder (ASP) than IVDAs without solvent use. Even allowing for these coexisting psychiatric disorders, a reported history of solvent use increased the likelihood of also reporting IVDA by a factor of 3.2. Although the magnitude of risk is likely to differ in other populations, a history of solvent use may indicate individuals at high risk for IVDA, and youths who have used solvents should be considered at high risk for severe drug abuse, including IVDA.