Factors associated with adverse reactions to cocaine among a sample of long-term,high dose users in São Paulo,Brazil
Cleusa P. Ferri , John Dunn , Michael Gossop;and Ronaldo Laranjeira
Aim. To investigate the frequency of adverse cocaine reactions and associated factors among regular cocaine misusers. Design, setting and participants. A cross-sectional survey with 332 cocaine misusers from a range of treatment and non-treatment settings in São Paulo, Brazil. Measurements. An interview schedule was translated from English into Portuguese incorporating the Severity of Dependence Scale, the GHQ-28, CAGE and an 8-item questionnaire investigating the frequency of specific adverse cocaine reactions. Findings. Patients reported a median of 4.5 different adverse reactions to cocaine. The most commonly described reactions were feeling very hot (84%), shaking uncontrollably (76%) and feeling ill (75%). The least common and most severe symptoms were convulsions or fits (18%) and passing out (21%). Frequency of adverse reactions to cocaine was positively associated with out-of-treatment status, severity of cocaine dependence, ever having injected cocaine, using tranquillisers with cocaine, and GHQ score. Conclusions. Adverse reactions to cocaine are common among regular cocaine users. Some of the adverse effects, especially those on the heart and central nervous system, are potentially fatal. Preventive strategies should be developed to reduce the risk of adverse cocaine reactions. The findings are discussed in relation to the type of interventions that might be developed and lines of future research.