title: Psychotic symptoms of cocaine self-injectors in a harm reduction program.
abstract: BACKGROUND
  Psychotic symptoms are common among cocaine users.
  
  
  METHODS
  An observational naturalistic study on the effects and events of intravenous cocaine use in a drug consumption room was carried out; the patients were diagnosed of cocaine dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision).
  
  
  RESULTS
  Twenty-one patients, 81% men self-injected cocaine 375 times. Psychotic symptoms were observed in 62% of the patients and 21% of the self-injections; delusions were observed in 9.3%, psychotic self-reference with insight in 9.1%, illusions in 6.4%, and hallucinations in 5.3%. A higher presence of psychotic symptoms was noted with cannabis used in the previous month (76.9% versus 44.4%; P = .001) (no psychotic symptoms group); also, a greater use of benzodiazepines was observed: 75.6% versus 63.6% (P = .046). Lower use of methadone in the group with psychosis was observed: 75.6% versus 97.3% (P = .001). Motor alterations were tremor 58%, stereotyped movements 24%, and behaviour alteration 6%, significantly more frequent in the psychotic group.
  
  
  CONCLUSIONS
  Thus, there was a high frequency of psychotic symptoms after intravenous cocaine use; patients with psychotic symptoms reported higher use of cannabis and benzodiazepines in the previous month and lower use of methadone. More tremors and stereotyped movements were observed in the group with psychotic symptoms. It is necessary to give a special approach to cocaine intravenous users.
authors.affiliation: Outpatient Drug Clinic Vall Hebron, Department of Psychiatry, University Hospital Vall Hebron-ASPB, Barcelona, Spain. croncero@vhebron.net
authors.forename: Carlos
authors.initials: C
authors.lastname: Roncero
authors.forename: Nieves
authors.initials: N
authors.lastname: Martínez-Luna
authors.forename: Constanza
authors.initials: C
authors.lastname: Daigre
authors.forename: Lara
authors.initials: L
authors.lastname: Grau-López
authors.forename: Begoña
authors.initials: B
authors.lastname: Gonzalvo
authors.forename: Jesús
authors.initials: J
authors.lastname: Pérez-Pazos
authors.forename: Miguel
authors.initials: M
authors.lastname: Casas
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications; D005260:Female; D040261:Harm Reduction / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011605:Psychoses, Substance-Induced / Q000150:complications / Q000175:diagnosis*; D012651:Self Medication
chemical_list: D003042:Cocaine