Cocaine dependence: 'Side effects' and syndrome formation within 1–12 months after first cocaine use
| Autor: | Madhur Chandra, James C. Anthony |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Side effect Toxicology Cocaine dependence Cocaine-Related Disorders Cocaine Cocaine users Heroin dependence mental disorders Epidemiology medicine Humans Pharmacology (medical) Psychiatry Cocaine powder Pharmacology Heroin Dependence business.industry Incidence Absolute risk reduction Syndrome Middle Aged medicine.disease Health Surveys United States Heroin Psychiatry and Mental health Cocaine use Female Powders business |
| Zdroj: | Drug and Alcohol Dependence. 206:107717 |
| ISSN: | 0376-8716 |
| DOI: | 10.1016/j.drugalcdep.2019.107717 |
| Popis: | This project offers new epidemiological estimates for DSM-IV cocaine dependence among sub-groups of newly incident cocaine users in the United States (US), including estimated attack rates for 21 dependence-related cocaine side effect problems and experiences occurring12 months after onset.In 2002-2016, US National Surveys on Drug Use and Health (NSDUH) sampled, recruited, and assessed cocaine experiences of non-institutionalized civilians. Unweighted estimates for year-pairs (2002-3,…,2015-16) are from 3488 cocaine powder-only initiates and 275 powder-then-crack initiates (all evaluated12 months after onset). Analysis-weighted attack rate estimates are incidence proportions with 95% confidence intervals (CI), summarized via meta-analysis.Evaluated12 months after onset, meta-analysis summaries show 5% of powder-only initiates developed cocaine dependence (95% CI = 4%, 6%) versus 22% of powder-then-crack initiates (95% CI = 17%, 29%). For several cocaine side effect problems and experiences (e.g., 'loss of control' indicators) there is a statistically robust crack-associated excess risk.Three interpretations of observed crack-associated excess risk are especially cogent and deserving of continued inquiry: (1) Powder-then-crack initiates start with heightened dependence risk susceptibilities (i.e., pre-dating onset); (2) Powder-using initiates become cocaine dependent and then start using crack; (3) The cocaine delivery variant of 'crack-smoking' is more toxic than powder insufflation. For powder-then-crack initiates, the cocaine dependence risk (22%) is modestly lower but statistically undifferentiable from a recently estimated risk of heroin dependence12 months after heroin onset (30%). Clinicians can use these side effect estimates in an evidence-based diagnostic workup when patients disclose new onsets of cocaine use. |
| Databáze: | OpenAIRE |
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