Mental health of heroin users with differing injection drug use histories: A non-treatment sample of Mexican American young adult men

Background: While the comorbidity of mental health and injecting heroin has been documented, current research is limited by describing the mental health of people who inject drugs without a comparison group and by the lack of research on nontreatment samples in the United States, particularly among Hispanics. The purpose of this study was to examine the association of injecting history (never, former, occasional, and daily) and multiple outcomes of global and mental health using a sample of U.S.-based Latinos not currently in treatment. Methods: Data are from a sample of street-recruited Mexican American young adult men (n = 275) in San Antonio, TX. Multiple logistic regression and structural equation modeling were used. Results: Overall 54% of men reported lifetime injecting drug use (20.7% former users, 11.1% occasional users, and 21.9% daily users). We found varying prevalence rates of global and mental health status among different histories of injecting. After covariate adjustment, daily injecting remained strongly associated with all four outcomes: perceived poor health status (AOR = 4.39; p <= 0.001), psychological distress (AOR = 2.78; p <= 0.05), depression (AOR = 4.37; p <= 0.001), and suicidal ideation (OR = 4.75; p <= 0.001). Acculturation, gang membership, and incarceration history also emerged as important factors. Conclusion: This study provides new information about the relationship between mental health and injecting heroin use. Findings: Support the need to consider mental health states among people who inject drugs, and to examine varying histories of injecting with socially and culturally relevant factors.