title: Association of cocaine withdrawal symptoms with more severe dependence and enhanced subjective response to cocaine.
abstract: The purpose of this two part study was to better characterize cocaine users based on self-reported cocaine withdrawal symptoms by examining screening data and response to smoked cocaine in the human laboratory. The first study sample included male and female non-treatment seeking cocaine users who were screened as potential subjects for inpatient studies. Of the 555 subjects, 462 (82%) endorsed symptoms consistent with DSM-IV criteria for cocaine withdrawal. Cocaine users who met criteria for cocaine withdrawal, compared with those who did not, reported a significantly higher amount of cocaine use and a history of medical and psychosocial problems. Cocaine users meeting DSM-IV withdrawal criteria, which included endorsement of depression, were also more likely to have a history of depression, to have seriously considered suicide, and to have had chemical dependency treatment even when amount spent on cocaine was covaried. The second study sample, which was a subset of Study I, included those who participated in human cocaine studies following the phone screening. Cocaine users who met criteria for cocaine withdrawal (n=34), compared with those who did not (n=10), had enhanced subjective ratings of 'high' and 'feel the effect of last dose' in response to a single delivery of 0.4 mg/kg of smoked cocaine. These results suggest that history of cocaine withdrawal symptoms may be associated with enhanced cocaine responses and greater severity of cocaine dependence.
authors.affiliation: Department of Psychiatry, VA Connecticut Healthcare System, School of Medicine, Yale University, 950 Campbell Ave, Bldg 36/116A4, West Haven, CT 06516, USA. mehmet.sofuoglu@yale.edu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sofuoglu
authors.forename: Susan
authors.initials: S
authors.lastname: Dudish-Poulsen
authors.forename: Scott B
authors.initials: SB
authors.lastname: Brown
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
mesh_terms: D000328:Adult; D001143:Arousal / Q000187:drug effects; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000534:rehabilitation*; D004357:Drug Synergism; D005059:Euphoria / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis*
chemical_list: D003042:Cocaine