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Alcohol and Cocaine Abuse

A Comparison of Epidemiology and Clinical Characteristics
  • Mary H. Closser
  • Thomas R. Kosten
Part of the Recent Developments in Alcoholism book series (RDIA, volume 10)

Abstract

Increasing numbers of persons presenting for substance abuse treatment are multiple-substance users and their predominant drugs of choice are cocaine and alcohol. There are similarities in the treatment of alcohol and cocaine abuse, but important clinical differences need to be acknowledged. This chapter compares and contrasts the most recent epidemiology and clinical characteristics of both alcohol and cocaine abusers. First, use and abuse trends in the United States for both substances are described. The clinical characteristics of dependence on either substance are contrasted in detail, and finally, treatments are briefly described. Treatment for both disorders can be accomplished in the same setting if important demographic and pharmacological differences are addressed. In either disorder, comorbid psychopathology is frequent and appropriate treatment matching based on diagnosis is imperative.

Keywords

Antisocial Personality Disorder Fetal Alcohol Syndrome Cocaine Abuser Cocaine Dependence Prenatal Alcohol Exposure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Vaillant GE: The Natural History of Alcoholism. Cambridge, MA, Harvard University Press, 1983.Google Scholar
  2. 2.
    Gawin FH, Ellinwood EH: Cocaine and other stimulants. N Engl J Med 318:1173–1182, 1988.PubMedCrossRefGoogle Scholar
  3. 3.
    Gawin FH, Kleber HD: Evolving conceptualizations of cocaine dependence. Yale Biol Med 61:123–136, 1988.Google Scholar
  4. 4.
    Kosten TA, Kosten TR: The dependence syndrome concept as applied to alcohol and other substances of abuse, in Galanter, M (ed): Recent Developments in Alcoholism: Combined Alcohol and Other Drug Dependence. New York, Plenum Press, 1990.Google Scholar
  5. 5.
    Clayton RR: Cocaine use in the United States: in a blizzard or just being snowed, in Adams NJ (ed): Cocaine Use in America: Epidemiologic and Clinical Perspectives, NIDA Monograph 61. Rockville, MD, National Institute on Drug Abuse, 1985.Google Scholar
  6. 6.
    Rotmsaville BJ: Epidemiology of drug use and abuse in adults, in Cavenar JS (ed): Psychiatry. New York, Basic Books, 1985.Google Scholar
  7. 7.
    Steffans RA, Stinson FS, Freel CG, Clem D: Apparent Per Capita Alcohol Consumption: National, State, and Regional Trends, 1977–1986. Rockville MD, National Institute on Alcohol Abuse and Alcoholism, 1988.Google Scholar
  8. 8.
    US Department of Health and Human Services: National Household Survey on Drug Abuse Population Estimates 1990 NIDA Publication # ADM91-1732. Washington, DC, Superintendent of Documents, US Government Printing Office, 1990.Google Scholar
  9. 9.
    US Department of Health and Human Services: Seventh Special Report to the U.S. Congress on Alcohol and Health, DHHS Pub. No. (ADM)-90-1656. Washington, DC, Superintendent of Documents, US Government Printing Office, 1990.Google Scholar
  10. 10.
    Siegel RK: New patterns of cocaine use: changing doses and routes, in Adams NJ (ed): Cocaine Use in America: Epidemiologic and Clinical Perspectives, NIDA Monograph 61. Rockville, MD, National Institute on Drug Abuse, 1985.Google Scholar
  11. 11.
    Regier DA, Boyd JH, Burke JD, et al.: One-month prevalence of mental disorders in the United States. Arch Gen Psychiatry 45:977–986, 1988.PubMedCrossRefGoogle Scholar
  12. 12.
    Clarren SK, Smith DW: The fetal alcohol syndrome: a review of the world literature. N Engl J Med 298:1063–1067, 1978.PubMedCrossRefGoogle Scholar
  13. 13.
    Abel EL, Sokol RJ: Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug Alcohol Depend 19:51–70, 1987.PubMedCrossRefGoogle Scholar
  14. 14.
    Streissguth AR, Martin DC, Martin JC, et al.: The Seattle longitudinal prospective study on alcohol and pregnancy. Neurobehav Toxicol Teratol 3:223–233, 1981.PubMedGoogle Scholar
  15. 15.
    Streissguth AR, Barr HM, Sampson PD, et al.: Attention, distraction and reaction time at age 7 years and prenatal alcohol exposure. Neurobehav Toxicol Teratol 8:717–725, 1986.PubMedGoogle Scholar
  16. 16.
    Chasnoff IJ: Alcohol use in pregnancy, in Chasnoff, IJ (ed): Drug Use in Pregnancy: Mother and Child. Norwell, MA, MTP Press, 1986, pp 75–80.CrossRefGoogle Scholar
  17. 17.
    Chasnoff IJ, Griffith DR, MacGregor S, et al.: Temporal patterns of cocaine use in pregnancy. JAMA 261:1741–1744, 1989.PubMedCrossRefGoogle Scholar
  18. 18.
    Amaro J, Zuckerman B, Cabrai H: Drug use among adolescent mothers: profile of risk. Pediatrics 84:144–151, 1989.PubMedGoogle Scholar
  19. 19.
    Erickson PG, Murray GF: Sex differences in cocaine use and experiences: a double standard revived? Am J Drug Alcohol Abuse 15:135–152, 1989.PubMedCrossRefGoogle Scholar
  20. 20.
    Blume SB: Women and alcohol: a review. JAMA 256:1467–1470, 1986.PubMedCrossRefGoogle Scholar
  21. 21.
    Griffin ML, Weiss RD, Mirin SM, et al.: A comparison of male and female cocaine abusers. Arch Gen Psychiatry 46:122–126, 1989.PubMedCrossRefGoogle Scholar
  22. 22.
    Schnoll SH, Karrigan J, Kitchen SB, et al.: Characteristics of cocaine abusers presenting for treatment, in Adams NJ (ed): Cocaine Use in America: Epidemiologic and Clinical Perspectives, NIDA Monograph 61. Rockville, MD, National Institute on Drug Abuse, 1985.Google Scholar
  23. 23.
    Gawin FH, Kleber HD: Cocaine use in a treatment population: patterns and diagnostic distinctions, in Adams, NJ (ed): Cocaine Use in America: Epidemiologie and Clinical Perspectives, NIDA Monograph 61. Rockville, MD, National Institute on Drug Abuse, 1985.Google Scholar
  24. 24.
    Washton, AM: Structured outpatient treatment of alcohol vs. drug dependencies, in Galanter M (ed): Recent Developments in Alcoholism: Combined Alcohol and Other Drug Dependence. New York, Plenum Press, 1990.Google Scholar
  25. 25.
    Liskow BI, Goodwin DW: Pharmacological treatment of alcohol intoxication, withdrawal and dependence: a critical review, J Stud Alcohol 48:356–370, 1987.PubMedGoogle Scholar
  26. 26.
    Brower KJ, Maddahian E, Blow FC, et al.: A comparison of self-reported symptoms and DSM-III-R criteria for cocaine withdrawal. Am J Drug Alcohol Abuse 14:347–356, 1988.PubMedCrossRefGoogle Scholar
  27. 27.
    Gawin FH, Kleber HD: Abstinence symptomatology and psychiatric diagnosis in chronic cocaine abusers. Arch Gen Psychiatry 43:107–113, 1986.PubMedCrossRefGoogle Scholar
  28. 28.
    Begleiter H, Porjesz B: Persistence of a “subacute” withdrawal syndrome following chronic ethanol intake. Drug Alcohol Depend 4:353–357, 1979.PubMedCrossRefGoogle Scholar
  29. 29.
    Grant I, Reed R, Adams KM: Diagnosis of intermediate-duration and subacute organic mental disorders in abstinent alcoholics. J Clin Psychiatry 48:319–323, 1987.PubMedGoogle Scholar
  30. 30.
    Kleber HD, Gawin FH: The physiology of cocaine craving and “crashing.” Arch Gen Psychiatry 44:299–300, 1987.CrossRefGoogle Scholar
  31. 31.
    Heizer JE, Pryzbeck TR: The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. J Stud Alcohol 49:219–224, 1987.Google Scholar
  32. 32.
    Ross HE, Glaser FB, Germanson T: The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Arch Gen Psychiatry 45:1023–1031, 1988.PubMedCrossRefGoogle Scholar
  33. 33.
    Hesselbrock MN, Meyer RE, Kenner JJ: Psychopathology in hospitalized alcoholics. Arch Gen Psychiatry 42:1050–1055, 1985.PubMedCrossRefGoogle Scholar
  34. 34.
    Weiss RD, Mirin SM, Michael JL: Psychopathology in chronic cocaine abusers. Am J Drug Alcohol Abuse 12:17–29, 1986.PubMedCrossRefGoogle Scholar
  35. 35.
    Weiss RD, Mirin SM, Griffin ML, et al.: Psychopathology in cocaine abusers. J Nerv Ment Dis 176:719–725, 1987.CrossRefGoogle Scholar
  36. 36.
    Rounsaville BJ, Foley S, Carroll K, et al.: Psychiatric diagnosis of treatment seeking cocaine abusers. Arch Gen Psychiatry 8:43–51, 1991.CrossRefGoogle Scholar
  37. 37.
    Bunt G, Galanter M, Lifshutz H, et al.: Cocaine/“crack” dependence among psychiatric inpatients. Am J Psychiatry 147:1542–1546, 1990.PubMedGoogle Scholar
  38. 38.
    Miller NS, Gold MS, Millman RB: The prevalence of alcohol dependence in cocaine dependence in an inpatient population. Ann Clin Psychiatry 1:93–97, 1989.CrossRefGoogle Scholar
  39. 39.
    Gawin FH, Kleber HD, Byck R, et al.: Desipramine facilitation of initial cocaine abstinence. Arch Gen Psychiatry 46:117–121, 1989.PubMedCrossRefGoogle Scholar
  40. 40.
    Gold MS, Washton AM, Dackis CA: Cocaine abuse: neurochemistry, phenomenology, and treatment, in Adams, NJ (ed): Cocaine Use in America: Epidemiologie and Clinical Perspectives, NIDA Monograph 61. Rockville, MD, National Institute on Drug Abuse, 1985.Google Scholar
  41. 41.
    Kosten TR: Pharmacotherapeutic interventions for cocaine abuse: matching patients to treatment. J Nerv Ment Dis 77:379–389, 1989.CrossRefGoogle Scholar
  42. 42.
    Institute of Medicine: Broadening the Base of Treatment for Alcohol Problems. Washington, DC, National Academy Press, 1990.Google Scholar
  43. 43.
    Institute of Medicine: Treating Drug Problems. Washington, DC, National Academy Press, 1990.Google Scholar
  44. 44.
    Washton AM, Gold MS: Cocaine: A Clinician’s Handbook. New York, Guilford Press, 1987.Google Scholar
  45. 45.
    Washton AM: Cocaine Addiction: Treatment, Recovery, and Relapse Prevention. New York, WW Norton, 1989, p 243.Google Scholar

Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Mary H. Closser
    • 1
  • Thomas R. Kosten
    • 1
  1. 1.Substance Abuse Treatment UnitYale University School of MedicineNew HavenUSA

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