The relationship of frequency of cocaine use to substance and psychiatric disorders in the U.S. general population.
Abstinence endpoints
Cocaine use disorder
Frequency of use
National survey
Psychiatric disorders
WHO risk drinking categories
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 10 2021
01 10 2021
Historique:
received:
02
02
2021
revised:
21
06
2021
accepted:
23
06
2021
pubmed:
7
8
2021
medline:
4
10
2022
entrez:
6
8
2021
Statut:
ppublish
Résumé
In clinical trials of pharmacotherapy for substance use, abstinence is the primary endpoint accepted by regulatory agencies. However, this endpoint could be overly restrictive, impeding efforts to identify effective medications for cocaine use disorder. To examine non-abstinent gradations in cocaine use as potential indicators of improvement, we investigated the relationship of frequency of cocaine use to clinical correlates in national survey data. Lifetime cocaine users (n = 2501) were interviewed in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) in 2001-2002 and re-interviewed in 2004-2005. Adjusted odds ratios (aORs) indicated associations between heaviest frequency of cocaine use and use of other substances, DSM-IV substance use disorders, psychiatric disorders, and change between 2001-2002 and 2004-2005. The reference category for all aORs was non-users. Greater lifetime cocaine use frequency was associated with lifetime cocaine, alcohol, and cannabis dependence (aOR for a linear trend = 2.80, 1.22, 1.22, respectively) and past-year cocaine, alcohol, and cannabis dependence (aOR = 1.78, 1.13, 1.16, respectively). Greater lifetime cocaine use frequency was associated with past-year depressive, panic, and generalized anxiety disorders (aOR = 1.07, 1.09, 1.12, respectively). Among cocaine users in 2001-2002, compared to the reference group using less than monthly, use ≥1x/week and use 1-3 times a month was associated with cocaine use disorder in 2004-2005 (aOR = 2.13 and aOR = 1.67, respectively). Gradations in risk for dependence on cocaine, other substances and psychiatric disorders by frequency of cocaine use indicates a promising direction for more sensitive outcome measures of treatment effects on cocaine outcomes than binary indicators (e.g., any use vs. none). Study results add to findings suggesting that non-abstinent measures might be useful indicators of treatment efficacy in clinical trials.
Sections du résumé
BACKGROUND
In clinical trials of pharmacotherapy for substance use, abstinence is the primary endpoint accepted by regulatory agencies. However, this endpoint could be overly restrictive, impeding efforts to identify effective medications for cocaine use disorder. To examine non-abstinent gradations in cocaine use as potential indicators of improvement, we investigated the relationship of frequency of cocaine use to clinical correlates in national survey data.
METHODS
Lifetime cocaine users (n = 2501) were interviewed in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) in 2001-2002 and re-interviewed in 2004-2005. Adjusted odds ratios (aORs) indicated associations between heaviest frequency of cocaine use and use of other substances, DSM-IV substance use disorders, psychiatric disorders, and change between 2001-2002 and 2004-2005. The reference category for all aORs was non-users.
RESULTS
Greater lifetime cocaine use frequency was associated with lifetime cocaine, alcohol, and cannabis dependence (aOR for a linear trend = 2.80, 1.22, 1.22, respectively) and past-year cocaine, alcohol, and cannabis dependence (aOR = 1.78, 1.13, 1.16, respectively). Greater lifetime cocaine use frequency was associated with past-year depressive, panic, and generalized anxiety disorders (aOR = 1.07, 1.09, 1.12, respectively). Among cocaine users in 2001-2002, compared to the reference group using less than monthly, use ≥1x/week and use 1-3 times a month was associated with cocaine use disorder in 2004-2005 (aOR = 2.13 and aOR = 1.67, respectively).
CONCLUSION
Gradations in risk for dependence on cocaine, other substances and psychiatric disorders by frequency of cocaine use indicates a promising direction for more sensitive outcome measures of treatment effects on cocaine outcomes than binary indicators (e.g., any use vs. none). Study results add to findings suggesting that non-abstinent measures might be useful indicators of treatment efficacy in clinical trials.
Identifiants
pubmed: 34358768
pii: S0376-8716(21)00428-2
doi: 10.1016/j.drugalcdep.2021.108933
pmc: PMC8464522
mid: NIHMS1730393
pii:
doi:
Substances chimiques
Cocaine
I5Y540LHVR
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
108933Subventions
Organisme : NIDA NIH HHS
ID : R01 DA018652
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Références
Adicciones. 2014;26(1):15-26
pubmed: 24652395
Drug Alcohol Depend. 2008 Jan 1;92(1-3):27-36
pubmed: 17706375
Alcohol Clin Exp Res. 2017 Jan;41(1):179-186
pubmed: 28019652
MMWR Morb Mortal Wkly Rep. 2020 Sep 04;69(35):1189-1197
pubmed: 32881854
Int J Mol Sci. 2019 Jan 29;20(3):
pubmed: 30700023
Arch Gen Psychiatry. 2007 Jul;64(7):830-42
pubmed: 17606817
Cardiovasc Toxicol. 2020 Feb;20(1):20-27
pubmed: 31273689
J Urban Health. 2019 Feb;96(1):49-54
pubmed: 30635841
J Clin Psychiatry. 2017 Jan;78(1):e64-e70
pubmed: 28129499
Lancet Psychiatry. 2017 Jun;4(6):469-476
pubmed: 28456501
Alcohol Clin Exp Res. 2019 May;43(5):979-987
pubmed: 30951210
Am J Public Health. 2017 Mar;107(3):430-432
pubmed: 28177817
Drug Alcohol Depend. 2003 Jul 20;71(1):7-16
pubmed: 12821201
Drug Alcohol Depend. 1995 Jul;39(1):37-44
pubmed: 7587973
Drug Alcohol Depend. 2019 Aug 1;201:16-22
pubmed: 31174140
Arch Gen Psychiatry. 2007 May;64(5):566-76
pubmed: 17485608
MMWR Morb Mortal Wkly Rep. 2019 May 03;68(17):388-395
pubmed: 31048676
Suicide Life Threat Behav. 2020 Aug;50(4):867-883
pubmed: 32030810
Adicciones. 2016 Mar 02;28(1):6-18
pubmed: 26990385
Mol Psychiatry. 2009 Nov;14(11):1051-66
pubmed: 18427559
J Subst Abuse Treat. 2017 Dec;83:15-26
pubmed: 29129192
J Clin Psychiatry. 2006 Feb;67(2):247-57
pubmed: 16566620
Drug Alcohol Depend. 2011 Jan 15;113(2-3):88-95
pubmed: 20828942
Addict Behav. 2002 May-Jun;27(3):437-49
pubmed: 12118630
Alcohol Clin Exp Res. 2017 May;41(5):1054-1062
pubmed: 28295414
J Am Coll Cardiol. 2017 Jul 4;70(1):101-113
pubmed: 28662796
AIDS Behav. 2016 Feb;20(2):345-52
pubmed: 26370100
J Psychopharmacol. 2013 Nov;27(11):987-97
pubmed: 23824247
Alcohol Clin Exp Res. 2018 Dec;42(12):2453-2465
pubmed: 30395350
Drug Alcohol Depend. 2019 Apr 1;197:228-235
pubmed: 30852375
Addiction. 2020 Sep;115(9):1668-1680
pubmed: 32056311
Drug Alcohol Depend. 1997 Sep 25;47(3):171-85
pubmed: 9306043
Alcohol Clin Exp Res. 2018 Nov;42(11):2256-2265
pubmed: 30204248
Drug Alcohol Depend. 2008 Nov 1;98(1-2):123-8
pubmed: 18579319
Drug Alcohol Depend. 2011 May 1;115(1-2):120-30
pubmed: 21145178
Eur Addict Res. 2020;26(1):10-19
pubmed: 31618748
Drug Alcohol Depend. 2020 Mar 1;208:107857
pubmed: 31968301
Drug Alcohol Depend. 2005 Oct 1;80(1):105-16
pubmed: 16157233
Drug Alcohol Depend. 2014 Apr 1;137:3-19
pubmed: 24556275
Sci Transl Med. 2018 Mar 28;10(434):
pubmed: 29593105
Alcohol Clin Exp Res. 2020 Aug;44(8):1625-1635
pubmed: 32619058
Drug Alcohol Depend. 2019 Dec 1;205:107648
pubmed: 31677490
J Stud Alcohol Drugs. 2019 Jul;80(4):431-440
pubmed: 31495380
Arch Gen Psychiatry. 2004 Apr;61(4):361-8
pubmed: 15066894
Drug Alcohol Depend. 1997 Sep 25;47(3):207-16
pubmed: 9306046
Addiction. 2014 Dec;109(12):2071-8
pubmed: 25041688
Drug Alcohol Depend. 2016 Jan 1;158:1-7
pubmed: 26652899
JAMA Psychiatry. 2019 Apr 1;76(4):374-381
pubmed: 30865232
Soc Psychiatry Psychiatr Epidemiol. 2015 Nov;50(11):1609-40
pubmed: 26210739
Addiction. 2020 May;115(5):946-958
pubmed: 31912625
Drug Alcohol Depend. 2017 Dec 1;181:219-222
pubmed: 29102827
J Subst Abuse Treat. 2018 Sep;92:46-50
pubmed: 30032944
Drug Alcohol Depend. 1997 Mar 14;44(2-3):133-41
pubmed: 9088785