Correlates of Stimulant Use among People Who Use Heroin Undergoing Treatment in Out-Patient Facilities in France, 2010–2020

Bibliographic Data

ID21646463
AuthorsEric Janssen (0000-0002-3820-9657, French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et des Tendances Addictives - OFDT), corresponding author), Michael Vuolo (Department of Sociology, Ohio State University)
Year2024
Volume59
Issue3
Pages353-361
Publication date2024-02-23
Open AccessNo
TypeARTICLE
VenueSubstance Use & Misuse (JOURNAL)
Journal identifiersISSN: 1082-6084 • E-ISSN: 1532-2491
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10826084.2023.2270682
PMID37859423
OpenAlexW4387798439
LanguageEN
References cited39

Background: Polydrug use has been implicated in driving a “fourth wave” of the overdose crisis in North America, specifically through concurrent use of stimulants and opioids, especially fentanyl. In France, however, heroin has historically been and remains the easiest-to-access opioid, accounting for most drug treatment demand. Whether similar polydrug use is increasing in Western Europe remains understudied, despite severe health implications and potential inadequate public health responses.Methods: We take advantage of a nation-wide dataset containing information on all patients serviced in treatment centers in France from 2010 to 2020. We conduct Poisson regression to determine the main predictors of stimulant use among people who use heroin (PWUH) and opioids (PWUO) generally.Results: Heroin remains the primary opioid within drug treatment in France. A decreasing number of out-patients seeking treatment for heroin use has been accompanied by an increasing trend of stimulant use over time, most commonly with powder cocaine. Our results suggest a significant increase of crack cocaine use among the most vulnerable PWUH. Concurrent use of stimulants among PWUH was positively associated with use of alcohol, cannabis, unprescribed psychotropics and hallucinogens, and negatively with tobacco. Similar results were found for all in-treatment PWUO.Conclusions: Our results uncover heterogeneity in the profiles of PWUH that should be fully acknowledged to ensure better efficiency in substance use clinical practices and policy, while simultaneously drawing attention to trends in concurrent opioid-stimulant use outside North America. We advocate for an extension of the generalized risk framework and its implementation in prevention programs

Addiction · Cannabis · Drug · Environmental health · Heroin · Opioid · Poisson regression · Polysubstance dependence · Population · Psychiatry · Public health · Stimulant · Substance abuse · Forensic Toxicology and Drug Analysis · Medicine · Opioid Use Disorder Treatment · Substance Abuse Treatment and Outcomes · Internal Medicine

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