An exploration of alcohol use severity and route of drug administration among persons that use heroin and cocaine

Subst Abus. Apr-Jun 2016;37(2):343-8. doi: 10.1080/08897077.2015.1080207. Epub 2015 Nov 13.


Background: Alcohol use is prevalent among populations of persons that use illicit drugs. Problematic alcohol use among persons that use heroin and cocaine has been associated with poor treatment adherence, abstinence maintenance, and mental health concerns. Fully exploring how alcohol use severity interacts with route of administration (ROA) may be of notable importance in development of treatment protocols for persons that use heroin and cocaine.

Methods: Data from a neurological and sociobehavioral assessment of risk factors among injection and noninjection drug users known as the NEURO-HIV Epidemiologic Study was used in the analyses. Participants (N = 551) included those who reported their level of past-30-day alcohol use and past-6-month heroin and cocaine use.

Results: Multiple logistic regression analyses found that both problematic and moderate alcohol users were significantly less likely than abstainers to report injecting heroin and cocaine. Both problematic and moderate alcohol users were significantly more likely than abstainers to snort substances.

Conclusions: Alcohol use may play a role in promoting or impeding the use of substances through certain ROAs. Treatment protocols that transition persons that use injection heroin and cocaine to noninjection use of these substances may be used in conjunction with treatments that reduce alcohol consumption as a means to reduce noninjection drug use.

Keywords: Alcohol; cocaine; heroin; route of administration.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / psychology*
  • Alcohol-Related Disorders / complications
  • Alcohol-Related Disorders / diagnosis*
  • Baltimore / epidemiology
  • Cocaine / administration & dosage*
  • Cocaine-Related Disorders / complications
  • Cocaine-Related Disorders / epidemiology
  • Cocaine-Related Disorders / psychology*
  • Drug Users / psychology*
  • Female
  • Heroin / administration & dosage*
  • Heroin Dependence / complications
  • Heroin Dependence / epidemiology
  • Heroin Dependence / psychology*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / psychology*
  • Young Adult


  • Heroin
  • Cocaine