title: Illicit drug use in young adults and subsequent decline in general health: the Coronary Artery Risk Development in Young Adults (CARDIA) Study.
abstract: BACKGROUND
  The long-term health consequences of drug use among healthy young adults in the general population are not well described. We assessed whether drug use predicted decline in general self-rated health (GSRH) in a community-based cohort, healthy at baseline.
  
  
  METHODS
  A prospective cohort of 3124 young adults (20-32 years old) from four US cities, the Coronary Artery Risk Development in Young Adults Study, was followed from 1987/1988 to 2000/2001. All reported "Good" or better GSRH at baseline, with reassessment in 2000/2001. Drug use in 1987/1988 was as follows: 812 participants were Never Users; 1554 Past Users Only; 503 Current Marijuana Users Only; 255 Current Hard Drug Users (e.g. cocaine, amphetamines, opiates). Analyses measured the association of drug use (1987/1988) with decline to "Fair" or "Poor" GSRH in 2000/2001, adjusting for biological and psychosocial covariates.
  
  
  RESULTS
  Reporting health decline were: 7.2% of Never Users; 6.5%, Past Use Only; 7.0%, Current Marijuana Only; 12.6%, Current Hard Drugs (p<0.01). After multivariable adjustment, Current Hard Drug Use in 1987/1988 remained associated with health decline (Odds Ratio (OR), referent Never Use: 1.83, 95% confidence interval (CI) 1.07-3.12). The health decline associated with Current Hard Drugs appeared to be partly mediated by tobacco smoking in 2000/2001, which independently predicted health decline (OR 1.66, 95% CI 1.08-2.50) and weakened the apparent effect of Current Hard Drugs (OR 1.21, 95% CI 0.62-2.36).
  
  
  CONCLUSIONS
  Hard drug use in healthy young adults, even when hard drug use stops, is associated with a subsequent decrease in general self-rated health that may be partially explained by persistent tobacco use.
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, 1530 3rd Ave South, MT608, Birmingham, AL 35294-4410, USA. skertesz@uab.edu
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Kertesz
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pletcher
authors.forename: Monika
authors.initials: M
authors.lastname: Safford
authors.forename: Jewell
authors.initials: J
authors.lastname: Halanych
authors.forename: Katharine
authors.initials: K
authors.lastname: Kirk
authors.forename: Joseph
authors.initials: J
authors.lastname: Schumacher
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
authors.forename: Catarina I
authors.initials: CI
authors.lastname: Kiefe
mesh_terms: D000328:Adult; D000407:Alabama; D044383:Black People; D002140:California; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D015999:Multivariate Analysis; D018570:Risk Assessment; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology; D044465:White People; D001741:Black or African American
chemical_list: D013287:Illicit Drugs