ID: 473

Type of submission: Oral

Conference track: Research

Topics: Harm Reduction for Non-Injectors and/or Stimulant Users; Innovative Harm Reduction Programmes

Presenting author: Maria Eugenia Socias

Presenting author biography:

Eugenia, MD, MSc, is a Postdoctoral Fellow at the University of British Columbia. Her research focuses on understanding barriers and facilitators to healthcare among people who use drugs, particularly in the role that optimization of addiction care might play in mitigating the burden of substance use disorders and related comorbidities.

Intentional use of cannabis to reduce crack cocaine use among people who use drugs in a Canadian setting: a longitudinal analysis

Maria Eugenia Socias, Thomas Kerr, Evan Wood, Huiru Dong, Stephanie Lake, Kanna Hayashi, Kora DeBeck, Didier Jutras-Asward, M-J Milloy

Background: No effective pharmacotherapies exist for the treatment of crack cocaine use disorders. Emerging data suggests that cannabinoids may be effective in reducing cocaine-related craving symptoms. This study investigated the intentional use of cannabis to reduce crack use among people who use illicit drugs (PWUD).

Methods: Data was drawn from three prospective cohorts of PWUD in Vancouver, Canada. Using data from participants reporting intentional cannabis use to control crack use, we used generalized linear mixed-effects modeling to estimate the independent effect of three pre-defined intentional cannabis use periods (i.e., before, during and after first reported intentional use to reduce crack use) on frequency of crack use.

Results: Between 2012 and 2015, 124 participants reported using cannabis to reduce crack use, contributing a total of 632 observations. In adjusted analyses, compared to before periods, after periods were associated with reduced frequency of crack use (Adjusted Odds Ratio [AOR] = 1.93, 95% Confidence Interval [CI]: 1.05–3.55), but not the intentional use periods (AOR= 0.79, 95% CI: 0.48–1.31). Frequency of cannabis use in the after periods was higher than in the before periods (AOR = 2.99, 95% CI: 1.38–6.48) and similar to the intentional cannabis use periods (AOR = 0.63, 95% CI: 0.35–1.11).

Conclusions: A period of intentional cannabis use to reduce crack use was associated with decreased frequency of crack use in subsequent periods among PWUD. Further clinical research to assess the potential of cannabinoids for the treatment of crack use disorders is warranted.