“Just another drug” for marginalized users: The risks of using synthetic cathinones among NSP clients in the Czech Republic

ABSTRACT

Background: In several EU countries, synthetic cathinone (SC) use has spread among injecting drug users (IDUs); it has been linked to risk of dependence and HIV/HCV transmission. Aims: To analyze the association between dependence and risky injecting practice with experimental and repeated SC use in the past 12 months among the clients of needle-syringe programs in the Czech Republic. Methods: IDUs in six locations in the Czech Republic were surveyed in 2013 and 2014 (n = 463). Single-predictor multinomial logit models were run to determine SC use upon the Severity of Dependence Scale (SDS) and risky injecting practice; the same predictors were included in the multivariate model with confounders. Findings: SDS score and risky injecting practice were significantly associated with repeated SC use in single-predictor models but not in the multivariate model; SC experimentation was linked to young and male respondents and those who lived in a larger city (>50,000); predictors of repeated SC use were homelessness (AOR = 3.2), co-occurring use of stimulants and opioids (AOR = 4.3), and use of cannabis (AOR = 2.4) in the past month. Conclusions: Repeated SC use was associated with poly-drug use and homelessness; given the rather inferior status of SCs among IDUs, their users face a risk of stigmatization and further marginalization.

Keywords:

• Injecting drug users
• new psychoactive substances
• risky injecting practice
• Severity of Dependence Scale
• synthetic cathinones

Acknowledgments

The authors would like to thank the study participants and the individuals and organization that facilitated data collection (KC and TP Sananim, KC Drop-in Prague, KC Pardubice, KC Ostrava Renarkon, TP Brno and KC Noe Trebic). The authors would also like to acknowledge Dr. Tomas Palenicek for his support in the development of this manuscript. Finally, the authors would like to thank the reviewers for helping to improve the manuscript into its current form.

Funding

Czech Ministry of Health (IGA MZD NT-14064-33), Czech Ministry of Interior (VG20122015075), MICR (VI20172020056), and Project Nr. LO1611 with financial support from the MEYS under the NPU I program.

Additional information

Funding

Czech Ministry of Health (IGA MZD NT-14064-33), Czech Ministry of Interior (VG20122015075), MICR (VI20172020056), and Project Nr. LO1611 with financial support from the MEYS under the NPU I program.