Stimulant use, religiosity, and the odds of developing or maintaining an alcohol use disorder over time

Little is known about whether cocaine or methamphetamine use, particularly among stimulant users residing in rural areas, is associated with increased odds of developing or maintaining an alcohol use disorder (AUD) over time. One factor that may help to protect some users against the development of an AUD is religiosity. This study examined how stimulant use and religiosity are associated longitudinally with the odds of an AUD among a rural population-based cohort of stimulant users.

Recent stimulant users (N = 710) were recruited via respondent-driven sampling and were interviewed every 6 months over a 3-year period. Concurrent and lagged generalized estimating equations analyses were conducted to estimate how past-30- day crack cocaine, powder cocaine, and methamphetamine use; religiosity; and other covariates were associated with the odds of an AUD.

At baseline, 56% of the participants met AUD criteria. The odds of an AUD declined significantly over time in the concurrent, but not the lagged, model. Crack cocaine use was associated with increased odds of an AUD in both models, although the strength of the concurrent association between an AUD and crack cocaine use declined over time. Powder cocaine use and more frequent church attendance also were concurrently associated with decreased odds of an AUD.

Rural stimulant users, especially those using cocaine, could potentially benefit from treatment for both alcohol use and stimulant use. In addition, our findings suggest that greater frequency of church attendance may be related to lower odds of the development or maintenance of an AUD.