STROKE AND COCAINE OR AMPHETAMINE USE

The association of cocaine and amphetamine use with hemorrhagic and is chemic stroke is based almost solely on data from case series. The lim ited number of epidemiologic studies of stroke and use of cocaine and/ or amphetamine have been done in settings that serve mostly the poor a nd/or minorities. This case control study was conducted in the defined population comprising members of Kaiser Permanente of Northern and So uthern California. We attempted to identify all incident strokes in wo men ages 15-44 years during a 3-year period using hospital admission a nd discharge records, emergency department logs, and payment requests for out-of-plan hospitalizations. We selected controls, matched on age and facility of usual care, at random from healthy members of the hea lth plan. We obtained information in face-re-face interviews. There we re 347 confirmed stroke cases and 1,021 controls. The univariate match ed odds ratio for stroke in women who admitted to using cocaine and/or amphetamine was 8.5 (95% confidence interval = 3.6-20.0). After furth er adjustment for potential confounders, the odds ratio in women who r eported using cocaine and/or amphetamine was 7.0 (95% confidence inter val = 2.8-17.9). The use of cocaine and/or amphetamine is a strong ris k factor for stroke in this socioeconomically heterogeneous, insured u rban population.