This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Have Our Treatments Helped?

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

Arch Gen Psychiatry. 1987;44(3):281-284.

Abstract
• During a 2.5-year follow-up study of opioid addicts, we found that cocaine abuse had become an increasing and major problem through 1983. Cocaine abuse had only minimally declined during the follow-up period despite treatment, and the number of opioid addicts with at least weekly cocaine abuse had doubled. The clear effect of methadone maintenance treatment in reducing opioid abuse was not evident for cocaine abuse. During the follow-up period, more cocaine use was reported by the methadone-treated subjects than by those undergoing detoxification only. Prognostically, cocaine users were more likely to be nonwhites and men. Subjects who increased their cocaine use during the follow-up period were more likely to have depressive disorders and more likely to be found among methadone- and "drug-free"—treated subjects than among detoxification subjects. Thus, among methadoneand drug-free—treated subjects, depression appeared to be a risk factor for escalating cocaine abuse; this risk factor may benefit from specific interventions.

Author Affiliations
From the Substance Abuse Treatment Unit, APT Foundation, and the Department of Psychiatry, Connecticut Mental Health Center, Yale University School of Medicine, New Haven, Conn.

Footnotes
Accepted for publication Dec 18, 1986.

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

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cocaine use and dependence in clients attending a drug treatment centre in Dublin
Thula
Psychiatr. Bull. 2009;33:88-91.
ABSTRACT | FULL TEXT  

Six-Month Trial of Bupropion With Contingency Management for Cocaine Dependence in a Methadone-Maintained Population
Poling et al.
Arch Gen Psychiatry 2006;63:219-228.
ABSTRACT | FULL TEXT  

Methadone Versus Buprenorphine With Contingency Management or Performance Feedback for Cocaine and Opioid Dependence
Schottenfeld et al.
Am. J. Psychiatry 2005;162:340-349.
ABSTRACT | FULL TEXT  

Cocaine and Other Indirect-Acting Monoamine Agonists Differentially Attenuate a Naltrexone Discriminative Stimulus in Morphine-Treated Rhesus Monkeys
McMahon et al.
J. Pharmacol. Exp. Ther. 2004;308:111-119.
ABSTRACT | FULL TEXT  

Evaluation of a Minimal Services Treatment Track for Noncompliant Patients in Opioid Substitution Treatment
Calsyn et al.
AJPH 2003;93:1086-1088.
FULL TEXT  

A Review of Temporal Effects and Outcome Predictors in Substance Abuse Treatment Studies With Long-Term Follow-Ups: Preliminary Results and Methodological Issues
McKay and Weiss
Eval Rev 2001;25:113-161.
ABSTRACT  

Methadone Clients, Crime, and Substance Use
Patterson et al.
Int J Offender Ther Comp Criminol 2000;44:667-680.
ABSTRACT  

Association of Depressive Symptoms During Abstinence With the Subjective High Produced by Cocaine
Uslaner et al.
Am. J. Psychiatry 1999;156:1444-1446.
ABSTRACT | FULL TEXT  

Desipramine in Opioid-Dependent Cocaine Abusers Maintained on Buprenorphine vs Methadone
Oliveto et al.
Arch Gen Psychiatry 1999;56:812-820.
ABSTRACT | FULL TEXT  

Synergistic Elevations in Nucleus Accumbens Extracellular Dopamine Concentrations during Self-Administration of Cocaine/Heroin Combinations (Speedball) in Rats
Hemby et al.
J. Pharmacol. Exp. Ther. 1999;288:274-280.
ABSTRACT | FULL TEXT  

Discriminative Stimulus Effects of a Cocaine/Heroin "Speedball" Combination in Rhesus Monkeys
Negus et al.
J. Pharmacol. Exp. Ther. 1998;285:1123-1136.
ABSTRACT | FULL TEXT  

Imipramine Treatment of Opiate-Dependent Patients With Depressive Disorders: A Placebo-Controlled Trial
Nunes et al.
Arch Gen Psychiatry 1998;55:153-160.
ABSTRACT | FULL TEXT  

Buprenorphine vs Methadone Maintenance Treatment for Concurrent Opioid Dependence and Cocaine Abuse
Schottenfeld et al.
Arch Gen Psychiatry 1997;54:713-720.
ABSTRACT  

Desipramine Treatment of Cocaine Dependence in Methadone-Maintained Patients
Arndt et al.
Arch Gen Psychiatry 1992;49:888-893.
ABSTRACT  

Pharmacotherapy for Cocaine-Abusing Methadone-Maintained Patients Using Amantadine or Desipramine
Kosten et al.
Arch Gen Psychiatry 1992;49:894-898.
ABSTRACT  

New Pharmacotherapies for Cocaine Dependence... Revisited
Meyer
Arch Gen Psychiatry 1992;49:900-904.
ABSTRACT  

Ensuring Success in Interventions with Drug-Using Offenders
ANGLIN and MAUGH
The ANNALS of the American Academy of Political and Social Science 1992;521:66-90.
ABSTRACT  

Psychiatric Diagnoses of Treatment-Seeking Cocaine Abusers
Rounsaville et al.
Arch Gen Psychiatry 1991;48:43-51.
ABSTRACT  

Bupropion Reduces Cocaine Abuse in Methadone-Maintained Patients
Margolin et al.
Arch Gen Psychiatry 1991;48:87-87.
ABSTRACT  

Buprenorphine suppresses cocaine self-administration by rhesus monkeys
Mello et al.
Science 1989;245:859-862.
ABSTRACT  

Cocaine Use and HIV Infection in Intravenous Drug Users in San Francisco
Chaisson et al.
JAMA 1989;261:561-565.
ABSTRACT