Patterns of drug-related disorders in a prospective study of men chosen for their family history of alcoholism.
OBJECTIVE
Alcohol use disorders (AUDs) and abuse or dependence on illicit substances often co-exist. Most studies evaluating these phenomena have focused on less well-educated individuals, using cross-sectional designs. This study controls for several factors that might contribute to a propensity toward both alcohol and substance-related conditions in a prospective follow-up of middle-class men.


METHODS
The subjects (N = 249) were white sons of alcoholics and controls, followed for 20 years using structured interviews. They were evaluated at baseline and again 10, 15 and 20 years later.


RESULTS
One in five subjects developed an illicit substance-related disorder by the 20-year follow-up, most commonly abuse or dependence on cannabinoids and/or stimulants. The men with these diagnoses were more likely to be recent smokers, to also fulfill criteria for alcoholism and to have a family history of a stimulant use disorder. They were not more likely to have family histories of alcoholism, did not have a lower response to alcohol at age 20 and had no enhanced risk for independent psychiatric disorders, although they did have relatives with manic depressive disease.


CONCLUSIONS
Disorders related to illicit substances were common in this well-educated, highly functional population. Substance-related comorbidity with alcoholism did not seem to reflect several factors known to predict AUDs (e.g., family history of alcoholism and a low response to alcohol). The diagnostic overlap between AUDs and illicit substance-related disorders might reflect concomitant family histories of alcoholism and substance-related conditions and, perhaps, family histories of manic depressive disease.
Schuckit
Marc A
MA
Department of Psychiatry (116A), University of California, San Diego, USA. mschuckit@ucsd.edu
Danko
George P
GP
Smith
Tom L
TL
D000328:Adult; D020751:Alcohol-Induced Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology* / Q000235:genetics* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology