Abstract
A survey of 1220 street-recruited crack cocaine smokers revealed that crack smokers may turn to drug injection to ease crack withdrawal. Crack smokers who later injected tended to smoke crack more heavily and for longer periods than those who did not inject. The initiation of injection was significantly associated with ever snorting heroin (prevalence ratio [PR] = 3.4, 95% confidence interval [CI] = 2.0-5.9) or snorting heroin specifically while smoking crack (PR = 2.3, 95% CI = 1.3-4.0), suggesting that snorted heroin use may mediate the transition to injection among crack smokers. Programs to prevent and treat crack dependence may prevent later injection and injection-related infections including HIV.
Publication types
-
Multicenter Study
-
Research Support, U.S. Gov't, P.H.S.
MeSH terms
-
Adolescent
-
Adult
-
Comorbidity
-
Crack Cocaine* / adverse effects
-
Female
-
HIV Infections / prevention & control
-
HIV Infections / psychology
-
HIV Infections / transmission*
-
Heroin Dependence / epidemiology
-
Heroin Dependence / psychology
-
Heroin Dependence / rehabilitation
-
Humans
-
Male
-
Opioid-Related Disorders / epidemiology*
-
Opioid-Related Disorders / psychology
-
Opioid-Related Disorders / rehabilitation
-
Risk Factors
-
Substance Abuse, Intravenous / epidemiology*
-
Substance Abuse, Intravenous / psychology
-
Substance Abuse, Intravenous / rehabilitation
-
Substance Withdrawal Syndrome / epidemiology
-
Substance Withdrawal Syndrome / prevention & control
-
United States / epidemiology