SHOTGUNNING AS AN ILLICIT DRUG SMOKING PRACTICE

There has been a rise in illicit drug smoking in the United States. '' Shotgunning'' drugs (or ''doing a shotgun'') refers to the practice of inhaling smoke and then exhaling it into another individual's mouth, a practice with the potential for the efficient transmission of respir atory pathogens. Three hundred fifty-four drug users (239 from a syrin ge exchange and 115 from a drug detoxification program) were interview ed about shotgunning and screened for tuberculosis (TB). Fifty-nine (1 7%; 95% CI 12.9%-20.9%) reported shotgunning while smoking crack cocai ne (68%), marijuana (41%), or heroin (2%). In multivariate analysis, a ge less than or equal to 35 years (OR 2.0, 95% CI 1.05-3.9), white rac e (OR 1.2, 95% CI 1.2-4.8), drinking alcohol to intoxication (OR 2.2, 95% CI 1.1-4.3), having engaged in high-risk sex (OR 2.6, 95% CI 1.04- 6.7), and crack use (OR 6.0, 95% CI 3.0-12) were independently associa ted with shotgunning Shotgunning is a frequent drug smoking practice w ith the potential to transmit respiratory pathogens, underscoring the need for education of drug users about the risks of specific drug use practices, and the ongoing need for TB control among active drug users . (C) 1997 Elsevier Science Inc.