A 2.5-Year Follow-up of Cocaine Use Among Treated Opioid Addicts: Have Our Treatments Helped?

doi:10.1001/archpsyc.1987.01800150101012

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Vol. 44 No. 3, March 1987

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A 2.5-Year Follow-up of Cocaine Use Among Treated Opioid Addicts

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 majorproblem through 1983. Cocaine abuse had only minimally declinedduring the follow-up period despite treatment, and the numberof opioid addicts with at least weekly cocaine abuse had doubled.The clear effect of methadone maintenance treatment in reducingopioid abuse was not evident for cocaine abuse. During the follow-upperiod, more cocaine use was reported by the methadone-treatedsubjects than by those undergoing detoxification only. Prognostically,cocaine users were more likely to be nonwhites and men. Subjectswho increased their cocaine use during the follow-up periodwere more likely to have depressive disorders and more likelyto be found among methadone- and "drug-free"—treated subjectsthan among detoxification subjects. Thus, among methadoneanddrug-free—treated subjects, depression appeared to bea risk factor for escalating cocaine abuse; this risk factormay 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).

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