“Basuco” Consumption Among Injection Drug Users in Colombia

Epidemiological studies conducted in Colombia during the past 5 years report a growing increase of multiple drug consumption among injecting drug users (IDUs) with a predominant use of heroin with crack showing a similar pattern as documented in other parts of the world. In Latin America, particularly in the Andean region, Basuco (crude extract of coca leaf) has become a first choice for IDUs not only because its’ low price but also because of its strong lasting effects--like crack, Basuco can be smoked though it is not refined or purified making it extremely addictive and highly toxic casing serious neurobiological damage. A few studies on Latin American populations have previously reported that IDUs Basuco consumers are more likely to be promiscuous as they engage in sexual behaviors to access the drugs and are at higher risk for contracting HIV and/or Hepatitis C Virus (HCV); not studies have been conducted on Colombian populations thus far. The current study aimed to identify the demographic characteristics of IDUs basuco consumers and to examine risk factors for drug use and associated outcomes. Data were collected using Respondent Driven-Sampling (RDS) across five cities in Colombia reporting the highest rates of DIUs: Armenia 21.5%, Pereira 19.4%, Cúcuta 19%, Medellín 19%, and Bogotá 17.4%. The total sample included N=1,081 participants ages 18-59 years old (mean=26yrs; 14% females). Almost 75% of IDUs Basuco consumers reported having low socio-economic status and approximately 90% reported having finished some high school. About 57% of IDUs reported injecting drugs 1-3 times a day whereas 43% reported injecting more than 4 times daily; in addition, about 14% reported having had a sexually transmitted infection (STI), about 29% were seropositive for HCV and about 5% for HIV. The highest prevalence of basuco consumption was reported among low-SES IDU males living alone without a sexual stable partner. A comparison between IDUs basuco users vs no basuco users showed a greater risk for those younger than 35 years old, living alone, having low SES and less education. In addition, IDUs basuco users are 2.2 times more likely to inject drugs more than 4 times a day, become HIV and/or HCV seropositive and contract a STI. Results allowed to identify sociodemographic characteristics of IDU basuco consumers and risk factors among Colombian cities reporting the highest concentration of IDUs in the country. Results will be discussed as they related to national public health policies and prevention/intervention efforts.