Use of Cocaine by Heavy Drinkers Increases Vulnerability to Developing Alcohol Dependence: A 4-Year Follow-Up Study
J Clin Psychiatry 2008;69(4):563-570
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: The development of alcohol dependence is associated
with specific individual personality traits and previous consumption of other
drugs of abuse. However, there is little information on these risk factors in
heavy drinkers before and after they meet the criteria for alcohol dependence.
This study examined the influence of cocaine use and the role of impulsivity in
the development of DSM-IV alcohol dependence in nondependent drinkers in a
4-year follow-up study.
Method: A prospective cohort study was conducted to establish
the risk factors associated with DSM-IV alcohol dependence. Four hundred
seventy-one (nondependent) heavy drinkers were enrolled in a prospective study.
At baseline, 280 were classified as heavy drinkers (HD) and 191 as heavy
drinkers who also used cocaine (HD + Co). Clinical variables related to alcohol
and cocaine use were assessed at 2 years and at the end of the 4-year follow-up
period. The study was conducted from September 2001 until September 2006 in
Results: At the 4-year follow-up assessment, 67.9% of the HD +
Co group met DSM-IV criteria for alcohol dependence compared to 13.6% of the HD
group. Odds ratios for alcohol dependence were 12.3 and 7.0 for male and female
cocaine users, respectively. Clinical and psychological variables related to
impulsivity were associated with the development of alcohol dependence. The
amount of cocaine used during follow-up was associated with a more rapid
progression to alcohol dependence.
Conclusions: This study revealed that cocaine use or an
impulsive personality in heavy drinkers increased the risk of developing DSM-IV
alcohol dependence by 3.8 and 12.6 times, respectively. These results may be
useful in designing new strategies for preventing the development of alcohol