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Cocaine use among drug users in Methadone treatment: results from the Amsterdam cohort study

Feng, Lili
http://rave.ohiolink.edu/etdc/view?acc_num=osu1406728675

Abstract Details

2001, Master of Public Health, Ohio State University, Public Health.
Drug abuse is a worldwide public health concern because it is generally associated with high rates of morbidity, mortality, and hospitalization. In particular, injecting drug use plays an important role in the spread of HIV/AIDS and other blood-borne infections. Since the early 1980s, methadone treatment as one of the strategies of the harm reduction approach has proven effective in suppressing the use of short-acting opioid drugs (i.e. heroin); sustaining good treatment retention; and in reducing illicit drug use, criminal behavior and the spread of HIV infection. However, methadone treatment seems to confer no similar benefit for clients who are addicted to stimulants such as cocaine. Cocaine dependence is a widespread problem for patients undergoing methadone treatment. A substantial number of studies have explored the effectiveness of methadone treatment on cocaine use, but the findings are inconsistent. The present study examines the association of cocaine use with levels of methadone dosage among 465 clients who participated in the Amsterdam Cohort Study from 1992 to 2001. The entire study group was in methadone treatment. The data are from the self- reported questionnaires filled out by clients during intake, and include demographic characteristics, types of drugs used, history and behavior of drug use, sexual behavior and methadone treatment modalities. Descriptive statistics and logistic regression were applied to the data analysis. A predictive model of cocaine use, a multivariate model for the confounding effects between cocaine use and methadone dosage, and a bivariate model to examine the confounders of methadone dosage in relation to cocaine use were built with the significance criterion at 0.10, and the 10% change of OR for methadone dosage as indicators of the confounding effect. The results of the study indicate that cocaine use among the clients was as high as 71%, and that there was a strong positive correlation between heroin use and cocaine use. Due to the high risk of drug use behavior, the HIV positive rate was 16%. Because cocaine has become more popular in recent years in Amsterdam, the more recently clients came to the intake, the more likely they used cocaine (OR=6.650 in 1999-2001 compared with 1992-1994). Ethnicity, calendar year of intake, condom use with casual sexual partners, and heroin use are factors confounding the association of cocaine use with levels of methadone dosage. Contrary to the findings of some studies, the present study demonstrates that cocaine use is lower among injecting drug users, and clients who take methadone above 60mg daily are more likely to abuse cocaine than those who take methadone at a lower level. Because the study is cross-sectional, no causal link between cocaine use and other independent variables could be established. Generalizability of the study is only for those low-threshold methadone treatment clients in places where the harm reduction approach is well-accepted. Recommendations for cocaine reduction emphasize behavioral interventions addressing social, psychological and physiological problems among cocaine users in methadone treatment.
Randi Love (Advisor)
n/a Moeschberger (Committee Member)
67 p.
Public Health

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Citations

  • Feng, L. (2001). Cocaine use among drug users in Methadone treatment: results from the Amsterdam cohort study [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1406728675

    APA Style (7th edition)

  • Feng, Lili. Cocaine use among drug users in Methadone treatment: results from the Amsterdam cohort study. 2001. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1406728675.

    MLA Style (8th edition)

  • Feng, Lili. "Cocaine use among drug users in Methadone treatment: results from the Amsterdam cohort study." Master's thesis, Ohio State University, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=osu1406728675

    Chicago Manual of Style (17th edition)

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© 2001, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.