Frequent medical visits by cocaine-using subjects in a Canadian community: an invisible problem for health practitioners?

The purpose of this study was to examine the frequency of medical visits by cocaine-using subjects in a Canadian community. A sample of 100 subjects reporting cocaine use at least 10 times in the previous 12 months were recruited in an urban setting in Canada and interviewed in a structured manner to address aspects of their use of cocaine and their responses to those agents. The respondents reported a total of 488 medical visits in the 12 months prior to interview. The frequency of visits correlated with the use of cocaine, barbiturates, hallucinogens, narcotics, and amphetamines. Medical visits also varied with the frequency with which the subjects reported certain adverse reactions to cocaine. Logistic regression modeling was used to assign subjects into a higher medical contact group (three or more medical visits per 12 months) and a lower medical contact group (two or fewer medical visits per 12 months). Membership in the higher or lower contact group was differentiated by a simple model in which the classifying variables were whether or not the subjects reported using crack cocaine in the previous year, whether or not they reported using hallucinogens in the previous year, and whether or not they reported experiencing aggressive reactions with the use of cocaine. Thus, users of cocaine report frequent visits to physicians. Medical visits are more likely if they also used crack cocaine, if they experienced aggressive reactions to cocaine, and if other substances were also used. Recognition of this behavior may facilitate earlier intervention by primary care physicians.