Treatment outcome of cocaine-alcohol dependent patients (original) (raw)
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Treatment Outcome of Alcoholics with and without Cocaine Disorders
Alcoholism: Clinical and Experimental Research, 1994
The treatment outcome literature suggests that alcoholics with coexisting drug dependence have worse prognoses. We compared three groups of inpatients treated on the same hospital unit for disorders of alcohol only ( n = 51), cocaine only ( n = 27), or both disorders (dual group, n = 27). At follow-up, we contacted 105 (8lY0) of 129 patients at a mean of 13.4 & 4.1 months after discharge. The three groups significantly and equivalently decreased their consumption of substances at follow-up, and they also had equivalent improvements in employment and in medical and psychiatric wellbeing. A nonsignificant trend existed for greater abstinence in the alcohol group (53%) than in the dual group (SSYO), and with regression analysis diagnostic group and stable residence predicted abstinence in the past 30 days. Elapsed time before using alcohol was equivalent for the two alcohol groups, and relapse to alcohol preceded relapse to cocaine by 1 month on average. In sum, outcomes were more similar than different for the three groups. Although specific treatments to enhance abstinence for cocaine users are indicated, clinicians should approach cocaine-using alcoholics with equal optimism for improvement as with other alcoholics.
Alcohol Use Affects the Outcome of Treatment for Cocaine Abuse
American Journal on Addictions, 2002
A lcohol and cocaine interact both behaviorally and biologically, and there is a high rate of comorbidity for abuse of both substances. 1-3 In most treatment settings, abstinence from all drugs including alcohol is encouraged. It is not clear, however, whether concurrent alcohol use affects baseline clinical characteristics and treatment outcome for cocaine abuse. Carroll and colleagues have reported an association between concurrent alcohol abuse and more severe cocaine dependence and increased polysubstance abuse. 4 Other studies have found an association between comorbid alcohol and cocaine use and higher baseline scores on the family and alcohol sub-scales of the Addiction Severity Index, along with higher scores on baseline depression and global severity measures. 1,5,6 Research also indicates concurrent cocaine and alcohol use results in a prolonged euphoria and increased heart rate. Both the euphoria and increased heart rate may be associated with cocaethylene, a metabolite formed from combined cocaine and alcohol ingestion. 2 Higgins
Co-Occurring Alcohol and Cocaine Dependence: Recent Findings From Clinical and Field Studies
Alcoholism: Clinical and Experimental Research, 2004
This article represents the proceedings of a symposium held at the 2003 annual meeting of the Research Society on Alcoholism in Ft. Lauderdale, FL. The organizer and chair was Barbara A. Flannery, and the discussant was Raye Z. Litten. The presentations were (1) Examining treatment trajectories of alcohol and cocaine dependent patients, by Jon Morgenstern; (2) Outcomes of alcoholics with and without cocaine dependence in a continuing care study, by James R. McKay; (3) Characteristics of non-treatment seeking cocaine and alcohol dependent African Americans, by Barbara A. Flannery; and (4) Cocaine and alcohol use among sex workers in South Africa, by Wendee M. Wechsberg.
The American journal of psychiatry, 1998
The authors investigated the theoretical and clinical role of depression among cocaine abusers in treatment. Eighty-nine cocaine-abusing patients underwent 2 weeks of substance abuse treatment. Posttreatment major depressive disorder, depressive symptoms before and after substance abuse treatment, and alcohol diagnoses were assessed and their relation to pretreatment substance use, cravings in high-risk situations, and 3-month follow-up status was examined. High rates of major depressive disorder were found but were unrelated to pretreatment substance use. The decrease in depressive symptoms during treatment was independent of major depressive disorder or alcohol diagnoses and predicted treatment attrition. Higher levels of depressive symptoms during treatment were associated with greater urge to use cocaine, alcohol, and other drugs in high-risk situations. Concurrent major depressive disorder and depressive symptoms did not predict cocaine use at follow-up. However, patients who h...