Comparison of Substance Use Milestones in Cannabis- and Cocaine-Dependent Patients

Division on Substance Abuse, New York Psychiatric Institute, New York, New York 10022, USA.
Journal of Addictive Diseases (Impact Factor: 1.46). 01/2012; 31(1):60-6. DOI: 10.1080/10550887.2011.642753
Source: PubMed


To compare the progression of substance use milestones between cocaine- and cannabis-dependent patients.
Using data gathered from two separate clinical studies for treatment of cocaine dependence and cannabis dependence, 130 cannabis-dependent and 112 cocaine-dependent individuals were compared on milestones related to their substance use.
In cannabis- vs. cocaine-dependent patients, the mean age of first use, regular use and first treatment contact differed significantly. No statistically significant differences were found between the two groups for other measured milestones.
These results differ from most epidemiologic studies that suggest cocaine users progress more rapidly to regular use and treatment contact.

Download full-text


Available from: Adam Bisaga
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examines sociodemographic and clinical characteristics, as a function of primary substance of abuse, among clients approached, screened, and assessed for eligibility in a 10-site effectiveness trial of a Web-based psychosocial intervention for substance use disorders. Consistent with the design of effectiveness trials, eligibility criteria were broad and exclusion criteria minimal; thus, the recruited sample may be viewed as relatively representative of patients seeking treatment throughout the United States. χ tests for categorical variables and F tests for continuous variables were used to analyze demographic, substance use, physical and mental health, and sexual risk data collected at screening and baseline; pairwise comparisons between primary substance subgroups for baseline data were conducted if the test statistic P value was 0.01 or less. Few participants expressed disinterest in the study at screening because of the computer-assisted intervention. A diverse sample of substance users completed baseline and were enrolled: 22.9% marijuana; 21.7% opiates; 20.9% alcohol; 20.5% cocaine; and 13.9% stimulants users. Marijuana users demonstrated the greatest differences across primary substances: they were younger, less likely to be married or attend 12-step meetings, and more likely to be in treatment as a result of criminal justice involvement. All patients, even marijuana users, reported comparable rates of co-occurring mental health disorders and sexual risk and substantial rates of polysubstance use disorders. Primary substance of abuse may be a less important indicator of overall severity compared with co-occurring disorders and other factors common across treatment seekers, further demonstrating the need for integrated treatment services and care and comprehensive pretreatment assessment.
    No preview · Article · Sep 2013 · Journal of Addiction Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Adolescence is a developmental period that coincides with the onset of tobacco use. Teen smokers are also more likely to abuse other drugs compared to nonsmokers. Previous studies with rats have shown that low-dose nicotine pretreatment enhances initial acquisition of cocaine self-administration when given during early adolescence, but not at later ages. The aim of the present study was to determine whether these nicotine pretreatment effects extend to extinction and reinstatement of reward-seeking behavior. Adolescent [postnatal day (P)28] and adult rats (P86) were pretreated for 4 days with nicotine (60 μg/kg, i.v.) or saline. Following pretreatment, rats were allowed to nose poke for cocaine (500 μg/kg/infusion) or sucrose pellets for at least 12 days or until meeting acquisition criterion. Responding was then extinguished for at least 7 days or until extinction criterion was met. The following day, the rats were reinstated with either a priming injection of cocaine (10 mg/kg, i.p.) or sucrose pellets. Nicotine markedly enhanced extinction of cocaine self-administration in adolescent rats, but not adults. Pretreatment also enhanced the acquisition of cocaine self-administration in adolescents, while reducing discrimination for the reinforced hole in adults. There were no pretreatment or age effects on cocaine-induced reinstatement. In contrast, nicotine induced only minor enhancement of sucrose-taking behavior in adolescents, with no significant impact on extinction or reinstatement at either age. Nicotine pretreatment affects reward-related behavior in both an age- and reward-dependent manner. These findings show that brief nicotine exposure during early adolescence enhances drug-related learning.
    No preview · Article · Sep 2013 · Psychopharmacology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Marijuana (cannabis) remains a controversial drug in the twenty-first century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis (pot) use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed as the twenty-first century matures. However, potential dangerous adverse effects from smoking marijuana are well known and should be clearly taught to a public that is often confused by a media-driven, though false message and promise of benign pot consumption.
    Full-text · Article · Oct 2013 · Frontiers in Public Health
Show more