Intentional Use of Both Opioids and Cocaine in the United States

People who use opioids or cocaine commonly choose to use the other. Among the 167,444 responders, 817(0.49%) reported use of opioids on a regular or daily basis. Of these, 28% used cocaine ≥1 of prior 30 days, 11% >1 day. Of 332 who used cocaine on a regular/daily basis, 48% used opioids ≥1 of prior 30 days, 25% >1 day. People with serious psychological distress were >6 times as likely to use both opioids and cocaine regularly/daily and people who have never been married were 4 times as likely. Compared to those living in a small metropolitan region, people living in a large metropolitan region were >3 times as likely and the unemployed were twice as likely. People with post-high school education were 53% less likely to use opioids and cocaine at least occasionally. Knowing the characteristics of those most likely to use both should guide interventions for prevention and harm reduction.