Heil S H, Badger G J, Higgins S T
Department of Psychiatry, University of Vermont, Burlington 05401-1419, USA.
J Stud Alcohol. 2001 Jan;62(1):14-22. doi: 10.15288/jsa.2001.62.14.
Concurrent dependence on alcohol is common among those seeking treatment for cocaine dependence. More information is needed about differences between those with and without concurrent alcohol dependence, including possible special treatment needs or outcome differences.
Data were obtained from 302 adults (70% men) enrolled in outpatient treatment for cocaine dependence. Individuals who did and those who did not meet criteria for alcohol dependence were compared on demographics, drug use, treatment outcome and other variables.
With regard to cocaine use, alcoholics were more likely than nonalcoholics to report an intranasal route of administration, use of cocaine in social settings, more simultaneous use of cocaine and alcohol, and more adverse consequences of their cocaine use. With regard to alcohol use, alcoholics reported consuming alcohol more frequently and in larger amounts, had longer drinking histories and were more likely than nonalcoholics to report increases in alcohol consumption when using cocaine. Alcoholics were heavier cigarette smokers than nonalcoholics and reported more severe employment, legal, family and psychiatric problems. There were overall improvements in both groups from intake through 12 months after treatment. With regard to treatment retention and cocaine abstinence, alcoholics had better outcomes than nonalcoholics when treated with intensive behavioral counseling plus incentives, but the reverse was true when treated with control treatments.
Compared with nonalcoholic cocaine-dependent subjects, codependent patients exhibit a wider array of problems, many of which merit professional attention. Both alcoholics and nonalcoholics exhibit substantial improvements during treatment, with alcoholics perhaps requiring extra treatment efforts for successful outcomes.
在寻求可卡因依赖治疗的人群中，同时存在酒精依赖的情况很常见。需要更多关于有和没有同时存在酒精依赖者之间差异的信息，包括可能的特殊治疗需求或结果差异。
数据来自302名参加可卡因依赖门诊治疗的成年人（70%为男性）。比较了符合和不符合酒精依赖标准的个体在人口统计学、药物使用、治疗结果及其他变量方面的情况。
在可卡因使用方面，酗酒者比不酗酒者更有可能报告采用鼻内给药途径、在社交场合使用可卡因、更多地同时使用可卡因和酒精，以及其可卡因使用带来更多不良后果。在酒精使用方面，酗酒者报告饮酒更频繁、量更大，饮酒史更长，并且比不酗酒者更有可能报告在使用可卡因时饮酒量增加。酗酒者比不酗酒者吸烟更多，并且报告有更严重的就业、法律、家庭和精神问题。两组从治疗开始到治疗后12个月总体上都有改善。在治疗保留率和可卡因戒断方面，当采用强化行为咨询加激励措施治疗时，酗酒者比不酗酒者有更好的结果，但采用对照治疗时情况则相反。
与不酗酒的可卡因依赖者相比，共病患者表现出更广泛的问题，其中许多问题值得专业关注。酗酒者和不酗酒者在治疗期间都有显著改善，酗酒者可能需要额外的治疗努力才能取得成功的结果。
