BACKGROUND: Effective public health programs aimed at problematic cocaine users are challenged by the fact that they can have complex patterns of drug use with respect to polysubstance use and routes of drug administration. This study was carried out to explore the presence of subgroups of cocaine users on the basis of their concurrent use of opioids and their routes of cocaine and opioid administration, and to determine if subgroups could be differentiated in terms of sociodemographic factors and risk behaviours. METHODS: Regular cocaine users (≥1 per week) were recruited in low-threshold services located in the Montréal downtown area. The following variables were examined: demographic characteristics, types of drug used, routes of drug administration, and condom use with occasional or commercial sexual partners. Latent class analysis and multinomial logistic regression modeling were carried out. RESULTS: 886 cocaine users were recruited (83.5% male: mean age 35.38 years). A 5-class model was identified: (1) "cocaine smokers" (CSs) (n = 161; membership probability (MP) = 0.183); (2) "cocaine smokers/sniffers" (CSSs) (n = 201; MP = 0.218); (3) "cocaine injectors" (CIs) (n = 207; MP = 0.231); (4) "cocaine-opioid injectors" (COIs) (n = 277; MP = 0.291); (5) "cocaine-opioid polyroute users" (COPs) (n = 40; MP = 0.077). Compared with COIs, other subtypes were significantly different in terms of either age, duration of cocaine use, ethnic background, homelessness, polydrug use or condom use. CONCLUSION: The heterogeneity of consumption patterns supports the importance of offering an array of interventions aimed at problematic cocaine users. These should include the provision of clean injecting and smoking material, the promotion of safe sexual behaviours and the prevention of initiation to drug injection. In the absence of specific treatment, cocaine users should have access to primary health care services and addiction treatment based on innovative behavioural and pharmacological approaches.
BACKGROUND: Effective public health programs aimed at problematic cocaine users are challenged by the fact that they can have complex patterns of drug use with respect to polysubstance use and routes of drug administration. This study was carried out to explore the presence of subgroups of cocaine users on the basis of their concurrent use of opioids and their routes of cocaine and opioid administration, and to determine if subgroups could be differentiated in terms of sociodemographic factors and risk behaviours. METHODS: Regular cocaine users (≥1 per week) were recruited in low-threshold services located in the Montréal downtown area. The following variables were examined: demographic characteristics, types of drug used, routes of drug administration, and condom use with occasional or commercial sexual partners. Latent class analysis and multinomial logistic regression modeling were carried out. RESULTS: 886 cocaine users were recruited (83.5% male: mean age 35.38 years). A 5-class model was identified: (1) "cocaine smokers" (CSs) (n = 161; membership probability (MP) = 0.183); (2) "cocaine smokers/sniffers" (CSSs) (n = 201; MP = 0.218); (3) "cocaine injectors" (CIs) (n = 207; MP = 0.231); (4) "cocaine-opioid injectors" (COIs) (n = 277; MP = 0.291); (5) "cocaine-opioid polyroute users" (COPs) (n = 40; MP = 0.077). Compared with COIs, other subtypes were significantly different in terms of either age, duration of cocaine use, ethnic background, homelessness, polydrug use or condom use. CONCLUSION: The heterogeneity of consumption patterns supports the importance of offering an array of interventions aimed at problematic cocaine users. These should include the provision of clean injecting and smoking material, the promotion of safe sexual behaviours and the prevention of initiation to drug injection. In the absence of specific treatment, cocaine users should have access to primary health care services and addiction treatment based on innovative behavioural and pharmacological approaches.
Authors: B Jacka; B C Bray; T L Applegate; B D L Marshall; V D Lima; K Hayashi; K DeBeck; J Raghwani; P R Harrigan; M Krajden; J S G Montaner; J Grebely Journal: J Viral Hepat Date: 2017-09-04 Impact factor: 3.728
Authors: Meredith C Meacham; Scott C Roesch; Steffanie A Strathdee; Suzanne Lindsay; Patricia Gonzalez-Zuniga; Tommi L Gaines Journal: Drug Alcohol Rev Date: 2017-03-24
Authors: Linwei Wang; Jeong Eun Min; Emanuel Krebs; Elizabeth Evans; David Huang; Lei Liu; Yih-Ing Hser; Bohdan Nosyk Journal: Int J Drug Policy Date: 2017-09-06
Authors: Dane Hautala; Roberto Abadie; Courtney Thrash; Juan Carlos Reyes; Kirk Dombrowski Journal: J Rural Health Date: 2017-09-07 Impact factor: 4.333
Authors: Meredith C Meacham; Abby E Rudolph; Steffanie A Strathdee; Melanie L Rusch; Kimberly C Brouwer; Thomas L Patterson; Alicia Vera; Gudelia Rangel; Scott C Roesch Journal: Subst Use Misuse Date: 2015-10-07 Impact factor: 2.164