Weiss R D, Martínez-Raga J, Hufford C
Alcohol and Drug Abuse Program McLean Hospital Belmont, Massachusetts, USA.
Am J Drug Alcohol Abuse. 1996 May;22(2):173-84. doi: 10.3109/00952999609001652.
This study was undertaken to compare cocaine-dependent patients with and without an opioid use disorder, in an effort to identify important clinical similarities and differences between the two groups. Ninety patients hospitalized for cocaine dependence were divided according to whether or not they had a coexisting opioid use disorder; 32 patients (35.6%) had an opioid diagnosis and 58 (64.4%) did not. The groups were compared on substance use histories, psychopathology, severity of drug-related problems, and 3-months cocaine use outcome. Patients with an opioid diagnosis had more current major depression, antisocial personality disorder, and other substance use disorders. They also had higher medical and drug scores on the Addiction Severity Index, and longer cocaine use histories. Nonetheless, 3-month cocaine use outcome was similar for both groups. Interestingly, patients with an opioid diagnosis engaged in more treatment during the follow-up period. Cocaine-dependent patients with a coexisting opioid use disorder may thus constitute a subgroup with worse prognostic characteristics, for whom differential treatments may improve outcome.
本研究旨在比较有和没有阿片类物质使用障碍的可卡因依赖患者，以确定两组之间重要的临床异同。90名因可卡因依赖住院的患者根据是否并存阿片类物质使用障碍进行分组；32名患者（35.6%）有阿片类物质诊断，58名（64.4%）没有。对两组患者的物质使用史、精神病理学、药物相关问题的严重程度以及3个月的可卡因使用结果进行了比较。有阿片类物质诊断的患者当前患有更多的重度抑郁症、反社会人格障碍和其他物质使用障碍。他们在成瘾严重程度指数上的医疗和药物得分也更高，可卡因使用史更长。尽管如此，两组的3个月可卡因使用结果相似。有趣的是，有阿片类物质诊断的患者在随访期间接受了更多治疗。因此，并存阿片类物质使用障碍的可卡因依赖患者可能构成一个预后特征较差的亚组，针对他们的差异化治疗可能会改善治疗结果。
