Tranquilizer misuse among active cocaine users: Predictors of initiation

Area of Science:

• Public Health
• Epidemiology
• Addiction Medicine

Background:

• Tranquilizer use is linked to adverse health outcomes in people who use drugs.
• Understanding tranquilizer misuse (TM) initiation and its predictors is crucial for harm reduction.

Purpose of the Study:

• To estimate the incidence rate of tranquilizer misuse initiation among cocaine users.
• To identify predictors associated with initiating and sustaining tranquilizer misuse.

Main Methods:

• Prospective cohort study in Montreal, Canada, with 3-month follow-up interviews.
• Defined initiation as first-time tranquilizer misuse; 'lasting-initiation' as continued use.
• Used Cox proportional hazard regression to analyze predictors of TM initiation.

Main Results:

• High incidence rate of TM initiation (40.49 per 100 person-years) among 245 cocaine users.
• A significant proportion (35.7%) experienced 'lasting-initiation' (14.70 per 100 person-years).
• Independent predictors for initiation and 'lasting-initiation' included criminal activity as income source, recent substance use disorder treatment, and non-medical prescription opioid use.

Conclusions:

• The incidence of tranquilizer misuse initiation is notably high in this cocaine-using population.
• Problematic drug use patterns, including polydrug use, involvement in the illicit economy, and prior SUD treatment, predict initiation.
• Findings inform targeted prevention and harm reduction strategies for vulnerable populations.