title: Use of synthetic cathinones and cannabimimetics among injection drug users in San Diego, California.
abstract: BACKGROUND
  Use of synthetic cathinones (SC) and cannabimimetics (i.e., "THC homologues" [TH]) is associated with adverse health effects. We investigated the epidemiology of synthetic drug use among a cohort of injection drug users (IDUs) in San Diego, California.
  
  
  METHODS
  We used logistic regression analysis to identify correlates of SC and TH use among 485 IDUs enrolled from June 2012 to September 2013.
  
  
  RESULTS
  Seven percent of participants reported ever using SC and 30% reported ever using TH. In multivariate logistic regression, age and recent hospitalization were significantly associated with odds of SC use (Adjusted Odds Ratio [AOR] 0.93, 95% Confidence Interval [C.I.] 0.90, 0.97; and AOR 2.34 95% C.I. 1.00, 5.49, respectively) and TH use (AOR 0.96, 95% C.I. 0.94, 0.98; and AOR 2.62, 95% C.I. 1.47, 4.68, respectively). Use of methamphetamine (AOR 9.35, 95% C.I. 1.20, 72.79) and club drugs in the past six months (AOR 3.38, 95% C.I. 1.17, 9.76) were significantly associated with SC use. Being on probation/parole (AOR 2.42, 95% C.I. 1.44, 4.07), initiating injection drug use with stimulants (AOR 1.89 95% C.I. 1.13, 3.16), and past six-month marijuana (AOR 9.22, 95% C.I. 4.49, 18.96) and prescription drug use (AOR 1.98, 95% C.I. 1.20, 3.27) were significantly associated with TH use.
  
  
  CONCLUSIONS
  A considerable proportion of IDU use synthetic drugs and may experience harms associated with their use. Findings have implications for criminal justice system management. Prevention efforts should emphasize the risks associated with rapidly changing synthetic formulations, and the potential harms associated with polydrug use.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive MC 0849, La Jolla, CA 92093, United States. Electronic address: kdwagner@ucsd.edu.
authors.forename: Karla D
authors.initials: KD
authors.lastname: Wagner
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive MC 0849, La Jolla, CA 92093, United States.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Armenta
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive MC 0849, La Jolla, CA 92093, United States.
authors.forename: Alexis M
authors.initials: AM
authors.lastname: Roth
authors.affiliation: The Center for Social Work Research, School of Social Work, The University of Texas at Austin, 1 University Station D3510, Austin, TX 78712, United States.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Maxwell
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive MC 0849, La Jolla, CA 92093, United States.
authors.forename: Jazmine
authors.initials: J
authors.lastname: Cuevas-Mota
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive MC 0849, La Jolla, CA 92093, United States.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Garfein
mesh_terms: D000328:Adult; D000470:Alkaloids / Q000008:administration & dosage*; D002140:California; D002186:Cannabinoids / Q000008:administration & dosage*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D055030:Drug Users; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
chemical_list: D000470:Alkaloids; D002186:Cannabinoids; D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; C023665:cathinone
keywords: Cannabimimetics; Cathinones; Injection drug use; Synthetic drugs