The relationship of alcohol use to cocaine relapse in cocaine dependent patients in an aftercare study
The relationship of alcohol use to cocaine relapse in cocaine dependent patients in an aftercare study
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DOI：
10.15288/jsa.1999.60.176
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发表时间：
1999-03-01
期刊：
影响因子：
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通讯作者：
McLellan, AT
中科院分区：
文献类型：
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作者：
McKay, JR;Alterman, AI;McLellan, AT
目的：探讨饮酒与可卡因复吸的关系。方法：对98例男性可卡因依赖者在完成强化门诊康复计划(IOP)后进行6个月的随访。在进入后续护理时评估过去和现在的酒精依赖，并在3个月和6个月的随访中评估可卡因复发和“险些错过”事件之前的饮酒行为。还获得了整个随访期间可卡因和酒精使用的数据。结果：从未达到酒精依赖标准的患者和目前有酒精依赖的患者的可卡因结果(可卡因使用率分别为10%和7%；在随访中的天数分别为10%和7%)比过去有酒精依赖的患者(在随访中的可卡因使用率为3%)更差，尽管当眼压中可卡因的使用得到控制后，酒精依赖状态不再预测可卡因的使用结果。在前5个月的随访中，有4个月的饮酒显著预测了眼压中的可卡因使用和基线的酒精依赖诊断得到控制后的下个月的可卡因复发状态。有过可卡因复发经历的患者在发病前报告饮酒的可能性比那些有“险些发生”的患者要高得多，特别是在发病当天(3个月时40%对6%：6个月时62%对0%)。酒精似乎不是没有酒精依赖史的可卡因患者复发的一个因素。尽管他们在后续调查中确实报告有5%的时间饮酒。结论：对于有酒精依赖史的可卡因滥用者，预防复发的努力应该包括旨在减少饮酒的干预措施。
Objective: To examine the relationship between alcohol use and cocaine relapse. Method: Ninety-eight cocaine-dependent male patients in aftercare were followed for 6 months following completion of an intensive outpatient rehabilitation program (IOP). Past and current alcohol dependence was assessed at entrance into aftercare, and drinking behavior prior to cocaine relapse and "near miss" episodes was assessed at 3- and 6-month follow-ups. Data on cocaine and alcohol use throughout the follow-up were also obtained. Results: Patients who had never met criteria for alcohol dependence and those with current alcohol dependence had worse cocaine outcomes (cocaine use on 10% and 7%; of the days in the follow-up, respectively) than those with past alcohol dependence (cocaine use on 3% of the days in the follow-up), although alcohol dependence status no longer predicted cocaine use outcomes when cocaine use in IOP was controlled. Alcohol use in 4 of the first 5 follow-up months significantly predicted cocaine relapse status in the next month after cocaine use in IOP and alcohol dependence diagnosis at baseline were controlled. Patients who experienced cocaine relapses were much more likely to report drinking before the onset of the episode than those who had "near misses," particularly on the day of the episode (40% vs 6% at 3 months: 62% vs 0% at 6 months). Alcohol did not appear to be a factor in the relapses of cocaine patients with no history of alcohol dependence. even though they did report drinking on 5% of the days in the follow-up. Conclusions: Relapse prevention efforts with cocaine abusers who have histories of alcohol dependence should include interventions designed to reduce drinking.