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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 increases addicts' likelihood of remaining abstinent and that depression and life crises are associated with decreased abstinence. An important issue is to what extent receiving treatment can ameliorate psychosocial risk factors such as life crises and depression and decrease ex-addicts' vulnerability to continued drug abuse. In our 2.5-year follow-up of 268 opiate addicts, drug abuse treatment was generally associated with increased abstinence, and life crises and depression were significant risk factors for continued drug abuse. The impact of these risk factors, however, was ameliorated by drug abuse treatment. Although life crises had a greater impact than depression, these two risk factors had additive effects in increasing the risk for continued drug abuse. Among the types of life crises, arguments and losses ("exits") had very strong additive effects with depression as predictors 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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