@article{ref1,
title="Why switch? - motivations for self-substitution of illegal drugs",
journal="Substance use and misuse",
year="2021",
author="Shapira, Barak and Berkovitz, Ronny and Rosca, Paola and Lev-Ran, Shaul and Kaptsan, Alexander and Neumark, Yehuda",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Self-substitution is the conscious switch from one drug to another for reasons such as price, availability, desired effect, or perceived benefit of the substitute drug. <br><br>PURPOSE/Objectives: This study aimed to describe drug use patterns and motivations associated with substitution. We examined correlates of lifetime substitution among individuals with substance use disorder. <br><br>METHODS: A cross-sectional study of 771 treatment-enrolled individuals. We used self-report for determining the lifetime prevalence, correlates, and motivations for substitution. <br><br>RESULTS: Of the 771 respondents, 570 (73.9%) reported ever substituting their preferred substance. The main incentives for substitution were availability (23.7%) and curiosity (20.2%). Among heroin or cannabis preferers, improved effects or less adverse effects of the substitute drug, self-medication, and managing withdrawal symptoms were significant substitution incentives. Increased odds for substitution were observed for past 12 months use of cannabis (OR = 1.51, CI = 1.06-4.52), prescription opioids (OR = 2.86, CI = 1.81-4.52), novel psychoactive substances (OR = 2.68, CI = 1.64-4.36), and repeated admission (OR = 1.50, CI = 1.05-2.14). Older age at onset-of-use was negatively associated with substitution (OR = 0.95, CI = 0.93-0.98). <br><br>CONCLUSIONS: Self-substitution of one substance for another is a highly prevalent behavior among treatment-enrolled patients with substance use disorder. Clinicians caring for substance use disorder patients should be aware of substitution patterns involving the use of highly potent substances, which constitutes a risk to patients. <br><br>RESULTS underscore the benefit of substitution patterns analyses, as they reveal important information on the characteristics of persons who use drugs and their motivations.<p /> <p>Language: en</p>",
language="en",
issn="1082-6084",
doi="10.1080/10826084.2021.1887246",
url="http://dx.doi.org/10.1080/10826084.2021.1887246"
}