A 2.5-Year Follow-up of Depression, Life Crises, and Treatment Effects on Abstinence Among Opioid Addicts

doi:10.1001/archpsyc.1986.01800080019003

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Vol. 43 No. 8, August 1986

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A 2.5-Year Follow-up of Depression, Life Crises, and Treatment Effects on Abstinence Among Opioid Addicts

Thomas R. Kosten, MD; Bruce J. Rounsaville, MD; Herbert D. Kleber, MD

Arch Gen Psychiatry. 1986;43(8):733-738.

Abstract

• Follow-up studies have suggested that treatment increasesaddicts' likelihood of remaining abstinent and that depressionand life crises are associated with decreased abstinence. Animportant issue is to what extent receiving treatment can amelioratepsychosocial risk factors such as life crises and depressionand decrease ex-addicts' vulnerability to continued drug abuse.In our 2.5-year follow-up of 268 opiate addicts, drug abusetreatment was generally associated with increased abstinence,and life crises and depression were significant risk factorsfor continued drug abuse. The impact of these risk factors,however, was ameliorated by drug abuse treatment. Although lifecrises had a greater impact than depression, these two riskfactors had additive effects in increasing the risk for continueddrug abuse. Among the types of life crises, arguments and losses("exits") had very strong additive effects with depression aspredictors of drug abuse.

Author Affiliations

From the Department of Psychiatry, Connecticut Mental Health Center, and the APT Foundation, Yale University School of Medicine, New Haven.

Footnotes

Accepted for publication Nov 6, 1985.

Reprint requests to APT Foundation, Suite 1A, 904 Howard Ave,New Haven, CT 06511 (Dr Kosten).

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