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Onset of Cocaine Use: Associated Alcohol Intoxication and Psychosocial Characteristics Among Adolescents in Substance Abuse Treatment

Apantaku-Olajide, Tunde MD, MRCPsych; Darker, Catherine D. PhD; Smyth, Bobby P. MRCPsych

doi: 10.1097/ADM.0b013e318288daa2
Original Research

Objectives: Cocaine abuse is widespread in Europe, and Ireland ranks among the leading countries for prevalence of cocaine use among adolescents. This study aimed to examine demographic and substance use correlates of lifetime cocaine use among adolescents with substance use disorder, and to explore the relationship between alcohol intoxication and cocaine initiation.

Methods: Data from a cross-sectional study of 171 adolescents presenting to an outpatient substance abuse treatment program in the Dublin metropolitan area were analyzed. Bivariate and multivariate analyses were conducted.

Results: Approximately 64% of the participants reported ever used cocaine: 70% reported the first use of cocaine was while alcohol intoxicated and 96% reported the onset of cocaine use was preceded by cannabis use. Later age at treatment entry, unstable accommodation, nonengagement in educational/vocational functions, and greater frequency of alcohol and cannabis use had robust associations with lifetime cocaine use. Male gender was significantly associated with first use of cocaine while alcohol intoxicated.

Conclusions: Alcohol frequently plays a central role in cocaine initiation in Irish adolescents. Efforts to delay, avoid, or reduce adolescent drinking may yield benefits in terms of reducing cocaine use initiation in this population.

From the Department of Psychiatry, Dalhousie University (Dalhousie Medicine New Brunswick), Saint John, NB, Canada (TAO); Department of Psychiatry (New Brunswick), Memorial University of Newfoundland, Canada (TAO); Department of Public Health and Primary Care, Trinity College Dublin, Ireland (CDD, BPS); and The Drug Treatment Centre Board (DTCB), Dublin, Ireland (BPS).

Send correspondence and reprint requests to Tunde Apantaku-Olajide, MD, MRCPsych, Addictions and Mental Health Services, 55 Union Street, Saint John, NB E2L 5B7, Canada. E-mail:

The authors declare no conflicts of interest.

Received July 10, 2012

Accepted January 20, 2013

© 2013 American Society of Addiction Medicine