An exploration of alcohol use severity and route of drug administration among persons that use heroin and cocaine

ABSTRACT

Background: Alcohol use is prevalent among populations of persons that use illicit drugs. Problematic alcohol use among persons that use heroin and cocaine has been associated with poor treatment adherence, abstinence maintenance, and mental health concerns. Fully exploring how alcohol use severity interacts with route of administration (ROA) may be of notable importance in development of treatment protocols for persons that use heroin and cocaine. Methods: Data from a neurological and sociobehavioral assessment of risk factors among injection and noninjection drug users known as the NEURO-HIV Epidemiologic Study was used in the analyses. Participants (N = 551) included those who reported their level of past-30-day alcohol use and past-6-month heroin and cocaine use. Results: Multiple logistic regression analyses found that both problematic and moderate alcohol users were significantly less likely than abstainers to report injecting heroin and cocaine. Both problematic and moderate alcohol users were significantly more likely than abstainers to snort substances. Conclusions: Alcohol use may play a role in promoting or impeding the use of substances through certain ROAs. Treatment protocols that transition persons that use injection heroin and cocaine to noninjection use of these substances may be used in conjunction with treatments that reduce alcohol consumption as a means to reduce noninjection drug use.

KEYWORDS:

• Alcohol
• cocaine
• heroin
• route of administration

Author contributions

Michael Scherer conceived the idea for the current study, developed the study design, analyzed the results, and was responsible for a majority of writing and editing on the manuscript. Paul T. Harrell made contributions to the introduction section and analysis of data. Rebecca C. Trenz contributed to the introduction section and prepared and revised the manuscript for the special edition. Sarah Canham provided writing and editing support. William W. Latimer is the principal investigator on this project. Dr. Latimer provided consistent guidance and support on the formulation of the analyses and final version of the manuscript.

Funding

This study was fully supported by NIDA grants R01DA014498 (Randomized Trial of IFCBT-HIVPI To Prevent HIV Among Non-Injection Drug Users) and T32DA007292 (NIDA Epidemiology Training Program). Grant funding was used to conduct this study, including collection, management, analysis, and interpretation of the data and preparation of the manuscript.