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Escalation of drug use in persons dually diagnosed with opioid and cocaine dependence: Gender comparison and dimensional predictors
- Source :
- Drug Alcohol Depend
- Publication Year :
- 2019
-
Abstract
- Background Persons dually diagnosed with opioid and cocaine dependence (OD + CD) present a clinical challenge and are at risk of morbidity and mortality. The time of escalation of heroin and cocaine exposure in persons with OD + CD remain understudied, and the influence of gender and other variables have not been examined. This observational study focused on the time of escalation of heroin and cocaine in volunteers with OD + CD, examining gender and exposure to other drugs (e.g., cannabis or alcohol) as predictors. Ages of first use and of onset of heaviest use of each drug were collected (in whole years). Time of escalation was defined as the interval between age of first use and onset of heaviest use. Volunteers sequentially ascertained adult volunteers recruited from the New York Metropolitan area, of which n = 297 were diagnosed with OD + CD. Methods Instruments administered were the SCID-I diagnostic interview (DSM-IV criteria), BIS-11 impulsiveness scale, and KMSK scales, dimensional measures of maximal exposure to specific drugs. Results In volunteers with OD + CD, ages of onset of heaviest use of cannabis (median age = 15) and alcohol (median age = 19) were in adolescence or emerging adulthood and preceded those for heroin and cocaine (median ages = 26 and 25, respectively). Maximal levels of cannabis and alcohol exposure were high, in volunteers with OD + CD. In adjusted Cox regressions, gender was not a significant predictor of time of heroin or cocaine escalation. However, more rapid time of alcohol escalation was a predictor of more rapid time of escalation of both heroin and cocaine, in volunteers with OD + CD.
- Subjects :
- Drug
Adult
Male
medicine.medical_specialty
Adolescent
media_common.quotation_subject
Diagnostic interview
Toxicology
Article
Cocaine dependence
Heroin
03 medical and health sciences
Cocaine-Related Disorders
Young Adult
0302 clinical medicine
Sex Factors
Internal medicine
Medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Gender comparison
media_common
Pharmacology
biology
business.industry
Middle Aged
medicine.disease
biology.organism_classification
Opioid-Related Disorders
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry and Mental health
Opioid
Observational study
Female
New York City
Cannabis
business
030217 neurology & neurosurgery
medicine.drug
Forecasting
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Drug Alcohol Depend
- Accession number :
- edsair.doi.dedup.....3b5427f58e9513a364bbc6de2968973c