Outcomes of patients with cocaine use disorders after admissions to treatment.

Background: Cocaine Use Disorder (CUD) has been associated with cardiovascular, neurological and mental health comorbidities, as well as risk of accidents and premature death. We aimed to analyze health care utilization, complications and long-term outcomes of patients seeking treatment of CUD.

Methods: longitudinal study among patients starting treatment of CUD in an Addiction Unit between 2001 and 2018. Drug use characteristics, clinical and laboratory parameters were collected at admission. Follow-up was ascertained through regular visits and electronic medical records.

Results: 175 patients (77.7% M) were included. Median age at first admission was 35 years [interquartile range (IQR): 30-41 years]; 53% snorted cocaine, 36% injected, and 11% inhaled. Almost 25% had co-occurring alcohol use disorder, 39% were cannabis users and 9% opiate users. Prevalence of HIV and Hepatitis C virus infection was 26% and 47%, respectively.

A total of 168/175 (96%) of patients were followed-up during 1.713 person-years with median follow-up of 10.5 years (IQR: 7.4-14.1 years). At the end of study there were 1.481 episodes of hospitalization, median of 8 admission episodes per patient [IQR: 3-1 episodes]; 63% of admissions were in Emergency Room Departments (ERD), 15% in Psychiatry/addiction units, and 13% in Internal Medicine/specialty departments. The cumulated mortality was 14% (24 patients) with a mortality rate of 1.4 x 100 p-y.

Conclusion: re-admissions to health care facilities including ERD seem to be frequent in the course of chronic CUD and may suggest poor retention in the continuum of care.