Cocaine, polysubstance abuse, and oral health outcomes, NHANES 2009 to 2014

Abstract

BackgroundCocaine is the second most abused illicit drug in the United States. To date, no study has examined the association between cocaine use and oral health with a nationally representative sample. Our study examined the association between cocaine use—singly and with other substances—and oral health outcomes, including periodontitis and untreated caries, among US adults.MethodsData for 11,753 individuals, aged ≥30 years, who completed a periodontal examination, in the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Descriptive analyses and multivariable binary logistic regression analyses were conducted on weighted data.ResultsOverall, 17% (20.5 million) of US adults aged ≥30 years had ever used cocaine, with higher likelihood seen among males, non‐Hispanic whites, and those living in poverty. Current cocaine use prevalence was 2.6% (3.2 million). By number of co‐used substances, the odds of having any periodontitis were higher among cocaine users who consumed ≥3 other substances (adjusted OR = 2.47; 95% CI = 1.15 to 5.30) when compared with solely cocaine users. By type of substance co‐used, odds of having untreated caries were greater among those reporting cigarettes (adjusted OR = 1.94; 95% CI = 1.21 to 3.11) or methamphetamine (adjusted OR = 5.40; 95% CI = 1.92 to 15.14) usage. Odds of any periodontitis were higher among those reported ancillary cigarette use (adjusted OR = 2.84; 95% CI = 1.60 to 5.04) compared with cocaine‐only users.ConclusionsIn addition to a positive association between periodontal disease, dental caries, and cocaine use, select co‐usage elevated the risk of oral disease. Patients should be screened for and counseled regarding substance abuse to facilitate a successful quit.

Illicit drug use and oral health

“…Increased risk of other oral health problems is also reported. Baghaie and colleagues [20] identified 28 primary studies examining oral health problems in illicit drug users and controls, and 10 additional primary studies [21][22][23][24][25][26][27][28][29] were identified from more recent reviews [2,[30][31][32] and further literature searches. These 38 studies were conducted in 16 different countries.…”

The Epidemiology of Cocaine Use Among Hispanic Individuals: Findings From the 2015–2018 National Survey of Drug Use and Health

“…To date, epidemiological research on the use of cocaine solely among Hispanic populations in the United States has been limited. This is of concern, given a recent article estimated that 2.9% of Hispanic adults in the United States are current cocaine users (Bahdila et al, 2020). To our knowledge, this study is the first to present findings estimating the prevalence and correlates of past-year cocaine use among a nationally representative sample of Hispanic young adults between the ages of 18 and 34 in the United States.…”

Oral health status among recreational cannabis (marijuana and hashish) users in the USA: A NHANES-based cross-sectional study

“…In a recent NHANES analysis assessing the association between cocaine use and oral health, Bahdila et al found that cocaine and marijuana co-users exhibited no statistical significant association compared to those exclusively using cocaine. ( Bahdila et al, 2020 )…”