title: "Shotgunning" as an illicit drug smoking practice.
abstract: 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 respiratory pathogens. Three hundred fifty-four drug users (239 from a syringe exchange and 115 from a drug detoxification program) were interviewed about shotgunning and screened for tuberculosis (TB). Fifty-nine (17%; 95% CI 12.9%-20.9%) reported shotgunning while smoking crack cocaine (68%), marijuana (41%), or heroin (2%). In multivariate analysis, age < or = 35 years (OR 2.0, 95% CI 1.05-3.9), white race (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 associated with shotgunning. Shotgunning is a frequent drug smoking practice with 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.
authors.affiliation: Department of Medicine, Beth Israel Medical Center, New York, NY 1003, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Perlman
authors.forename: M P
authors.initials: MP
authors.lastname: Perkins
authors.forename: D
authors.initials: D
authors.lastname: Paone
authors.forename: L
authors.initials: L
authors.lastname: Kochems
authors.forename: N
authors.initials: N
authors.lastname: Salomon
authors.forename: P
authors.initials: P
authors.lastname: Friedmann
authors.forename: D C
authors.initials: DC
authors.lastname: Des Jarlais
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016578:Crack Cocaine; D005260:Female; D003932:Heroin; D006801:Humans; D016015:Logistic Models; D008297:Male; D008385:Marijuana Smoking; D009519:New York City; D016017:Odds Ratio; D012309:Risk-Taking; D012882:Skin Tests; D019966:Substance-Related Disorders / Q000150:complications*; D014376:Tuberculosis / Q000635:transmission*
chemical_list: D016578:Crack Cocaine; D003932:Heroin