Psychological Distress Increases Needle Sharing among Cocaine users: Results from the COSMO Study
|Annie Lévesque1,2,3, Julie Bruneau1,3, Didier Jutras-Aswad1,4, Karine Bertrand5, Florence Chanut4,6, Magali Dufour5,
François Lespérance1,4, Michel Perreault7,8, Éric Vaillancourt5 and Élise Roy5,9*
|1Research Center, Centre Hospitalier de l’Université de Montréal (CRCHUM), Canada|
|2Department of Experimental Medicine, McGill University, Canada|
|3Department of Family Medicine, Université de Montréal, Canada|
|4Department of Psychiatry, Université de Montréal, Canada|
|5Department of Community Health Sciences, Université de Sherbrooke, Canada|
|6Hôpital du Sacré-Coeur de Montréal, Canada|
|7Douglas Mental Health Institute, Canada|
|8Department of Psychiatry, McGill University, Canada|
|9Montreal Public Health Department, Agence de la santé et des Services sociaux de Montréal, Canada|
|Corresponding Author :||Elise Roy
Addiction Research and Study Program
Faculty of Medicine and Health Sciences
Université de Sherbrooke, 150, Place Charles-Le Moyne
bureau 200, Longueuil, QC J4K 0A8, Canada
Tel: +1 (450) 463-1835
E-mail: [email protected]
|Received January 19, 2014; Accepted April 28, 2014; Published April 30, 2014|
|Citation: Roy E, Levesque A, Bruneau J, Jutras-Aswad D, Bertrand K, et al. (2014) Psychological Distress Increases Needle Sharing among Cocaine users: Results from the COSMO Study . J Addict Res Ther S10:003. doi:10.4172/2155-6105.S10-003|
|Copyright: © 2014 Roy E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License Canada, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: Cocaine use and mental health disorders have both been separately identified as risk factors for blood borne virus infection. However, the contribution of specific underlying aspects of mental health to risks is not well documented. The aim of this study was to examine the association between psychological distress and risk behaviors for HIV and Hepatitis C infection among cocaine users.
Methods: Individuals who either smoked or injected cocaine were recruited in community-based and addiction treatment programs located in downtown Montreal. Participants were asked to complete an interviewer-administered questionnaire assessing psychological distress based on the Kessler scale (K10). Three-month risk behaviors outcomes included drug injection material sharing (needle, dilution water, cooker, filters, backloading, frontloading or wash), and smoking equipment sharing. Socio-demographic data, severity of cocaine dependence and other substances use information were also collected. Statistical analyses were conducted using logistic regression.
Results: Severe psychological distress was reported by 202 (34.3%) out of 589 participants (86.2% male; 76.6% ≥ 30y.o.). The prevalence of sharing was: 14.8% for needles, 24.9% for other injection equipment (378 injectors) and 68.3% for smoking material (508 smokers). Multivariate analysis showed that injectors with severe psychological distress were more likely to report needle sharing (Adjusted Odds Ratio (AOR): 2.1, 95% CI: 1.1-3.8). No significant association was found between K10 score and sharing of other paraphernalia.
Conclusion: Severe psychological distress increases the risk of needle sharing, a major risk factor for HIV and HCV infection, but not sharing of other paraphernalia. These results suggest differential psychological mechanisms according to sharing practices. They also support the importance of screening for psychological distress in order to implement adequate preventive interventions aimed at cocaine users.