Differences in factors associated with first treatment entry and treatment re-entry among cocaine users

FRANÇAIS :
L'étude de 313 usagers en traitement au Brézil, montre que le fait de consommer des doses élevées de drogues, d'avoir un problème d'alcoolisme et une prise de conscience de ses problèmes sont des facteurs favorisant la première entrée en traitement. En revanche, une plus grande gravité de la dépendance, l'implication dans le crime et le soutien social amènent à rentrer à nouveau en traitement après rechute. Ces différences soulignent la nécessité de distinguer dans la prise en charge le premier contact avec le traitement et les entrées ultérieures.
ENGLISH :
Aims. To investigate factors associated with first entry to treatment and with treatment re-entry among cocaine users. Design. Cross-sectional study. Setting participants. Cocaine users (n = 313) recruited from community and treatment settings in Brazil. Measurements. Structured questionnaire including selected items from the addiction severity index (ASI), general health questionnaire, version 28 (GHQ-28), CAGE and the severity of dependence scale (SDS). Findings. Higher dose use, being a problematic drinker and increased awareness of their problem were associated with increased odds of making first contact with an agency. Greater severity of dependence, being involved in acquisitive crime and social support increased the chance of treatment re-entry. Being involved in acquisitive crimes and concerns about confidentiality were associated with decreased odds of first treatment contact. Being a problematic drinker was associated with decreased odds of re-entry treatment. Conclusions. These findings suggest that the distinction between first treatment contact and subsequent entry to treatment is useful, clinically relevant and deserving of further investigation. (Author' s abstract)