Differences among out-of-treatment drug injectors who use stimulants only,opiates only or both: implications for treatment entry

The goal of this study was to compare drug and alcohol use, psychological s ymptoms and substance abuse treatment entry among 583 street-recruited, out -of-treatment injection drug users (IDUs) who used stimulants only, opiates only or both stimulant and opiate. Data analyzed from structured interview s indicated that stimulant-only users had the most severe alcohol problems and the highest psychological symptom scores for hostility, paranoia and ps ychoticism. In the 2 months following their interview only 3% of the stimul ant-only users entered substance abuse treatment, as compared to nearly hal f of the participants in the other two groups. Even after controlling for v ariables that differed among the groups by logistic regression analysis, st imulant only users were still 24-25 times less likely than opiate only or b oth stimulant and opiate users to enter treatment. Researchers and clinicia ns are challenged to better understand and address the unique needs of stim ulant users, including potential psychological problems and alcohol abuse, in order to attract them to treatment and serve them through a comprehensiv e treatment approach. (C) 2001 Elsevier Science Ireland Ltd. All rights res erved.