Factors associated with cocaine use disorder: Results from the French nationwide repeated cross-sectional OPPIDUM study (2019-2023) (2026)

Cocaine use has increased both globally and nationally. This trend is accompanied by a rise in clinical complications. The objective of our study was to identify factors observed to be associated with cocaine use disorder, using data from the OPPIDUM program, collecting information directly from patients with substance use disorders recruiting in care or harm reduction facilities. Cocaine users were divided into two groups: cocaine use disorder and simple use. A univariate analysis was performed to compare the groups, followed by a multivariate analysis to identify factors associated with cocaine use disorder. Between 2019 and 2023, 6863 cocaine users (28% of all OPPIDUM participants) from 116 addiction treatment centers were included. Several factors were found to be significantly associated with cocaine use disorder: extreme precariousness (OR = 1.34, 95% CI [1.12-1.61], p = 0.002), cocaine-only use (OR = 1.90, 95% CI [1.45-2.50], p < 0.0001), alcohol dependence (OR = 1.48, 95% CI [1.30-1.68], p < 0.0001), and use of antidepressants and antipsychotics (OR = 2.08, 95% CI [1.37-3.16], p = 0.001; OR = 1.94, 95% CI [1.40-2.69], p < 0.001). These findings highlight several key factors associated with cocaine use disorder and their clinical implications. The study has limitations: potential selection bias, repeated inclusion of the same users across years, multiple modes of cocaine use, and the exploratory nature of the analyses due to uncontrolled alpha risk. Nevertheless, these insights can help healthcare professionals better understand patient profiles and provide more tailored care and prevention strategies. [Author's abstract]