title: Increasing prevalence of cocaine as the primary detoxification diagnosis among admissions presenting with current intravenous drug use: a review of detoxification records from northern British Columbia, 1999-2005.
abstract: OBJECTIVE
  This study sought to document the trends in drug use among intravenous drug users (IDUs) in northern British Columbia, and to discuss the public health implications.
  
  
  METHODS
  We conducted a 7-year medical-chart review of all IDU-related admissions (n = 2072) to an inpatient alcohol and drug detoxification centre in Prince George, British Columbia. Primary detoxification diagnosis was modeled onto year of admission using generalized estimating equations (GEE).
  
  
  RESULTS
  Our study demonstrated an increasing prevalence of cocaine as the primary detoxification diagnosis in IDU-related admissions in northern BC, from 32% of all IDU admissions in 1999 to 64% in 2001, and then a relatively steady elevated rate of approximately 60% between 2001-2005.
  
  
  CONCLUSIONS
  Given that needle exchange programs and other harm reduction services for IDUs in British Columbia are not readily available in many northern and rural areas, the risks associated with intravenous cocaine use among northern IDUs represent a serious public health challenge. Tailored harm reduction strategies should take into account the prominence of intravenous cocaine use as an HIV risk factor. In areas without well-established intravenous drug use monitoring programs, such as rural and remote areas, detoxification treatment records may serve as important sentinels for changing drug use patterns among IDUs.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON. Russell_Callaghan@camh.net
authors.forename: Russell C
authors.initials: RC
authors.lastname: Callaghan
authors.forename: Carol
authors.initials: C
authors.lastname: Strike
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Benedikt
authors.initials: B
authors.lastname: Fischer
authors.forename: Jane
authors.initials: J
authors.lastname: Buxton
authors.forename: Emma
authors.initials: E
authors.lastname: Stevens
authors.forename: Lawren
authors.initials: L
authors.lastname: Taylor
authors.forename: J Charles
authors.initials: JC
authors.lastname: Victor
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008658:Inactivation, Metabolic; D007297:Inpatients; D008297:Male; D008485:Medical Audit; D019035:Rural Health Services; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*