Sociodemographic,neighborhood, psychosocial,and substance use correlates of cocaine use among Black adults: Findings from a pooled analysis of national data

ObjectiveCocaine use (CU) is serious a public health issue affecting U.S. adults, including Blacks. Cocaine-related overdose deaths have also trended upwards among this population. However, there remains a lack of research on correlates of CU among a nationally representative sample of Black adults.MethodsThe current study examines the prevalence and correlates of past-year CU among Black adults aged 18 and older (N = 9,821). Data from the National Survey on Drug Use and Health (2015–2016) were used and a weighted logistic regression model was estimated.ResultsFindings showed 2.4% of Black adults reported past-year CU—significantly higher than rates of CU among other assessed racial groups. Opioid use/misuse, encounters with drug dealers, easier access to cocaine, unemployment, and being 35 or older were associated with increased odds of CU. Greater risk perception of CU and religiosity were associated decreased odds of CU.ConclusionResults identified several correlates associated with past-year CU among Black adults. Findings suggest addressing CU among this population will likely require the development of multilevel prevention and intervention strategies and an increased focus on opioid use/misuse as opioids have been recently implicated in cocaine-related overdose deaths.     

Higher smoking prevalence among United States adults with co-occurring affective and drug use diagnoses

IntroductionIndividuals with drug use disorders or affective disorders have higher cigarette smoking prevalence and smoking intensity and are less likely to quit than the general population. We sought to estimate the prevalence of cigarette smoking by drug use and psychiatric diagnoses and to explore to what extent a co-occurring diagnosis was associated with current smoking.MethodsData were derived from the most recent National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III, 2012–2013; n = 36,309). Cigarette smoking status was examined among those with any past-year or lifetime drug use disorders (i.e., alcohol, cannabis, opioid, cocaine) or affective disorders (i.e., mood, anxiety). Diagnoses were assessed using the Diagnostic and Statistical Manual of Mental Disorders criteria (DSM-5).ResultsAdjusting for sociodemographic characteristics, those with drug use disorders (past-year AOR = 3.3, 95% CI: 3.0, 3.6; lifetime AOR = 3.2, 95% CI: 3.0, 3.5) and those with affective disorders (past-year AOR = 1.7; 95%CI: 1.5, 1.8, lifetime AOR = 1.3, 95% CI: 1.2; 1.4), had higher odds of current cigarette smoking compared to individuals with no diagnosis. The odds of current cigarette smoking was significantly higher in individuals with both drug use disorders and affective disorders compared to those with either a drug use or affective disorder or no disorder (past-year AOR = 5.1; 95% CI: 4.3, 5.9, lifetime AOR = 4.3; 95% CI: 3.8, 4.7).ConclusionsApproximately 30% of the population had a past-year drug use or affective disorder, 17% of whom report both. The combination of both diagnoses produced a 1.5 to 3-fold higher correlation with smoking than either alone.