Heterogeneity of stimulant dependence: a national drug abuse treatment clinical trials network study

Am J Addict. 2009 May-Jun;18(3):206-18. doi: 10.1080/10550490902787031.

Abstract

We investigated the presence of DSM-IV subtyping for dependence on cocaine and amphetamines (with versus without physical dependence) among outpatient stimulant users enrolled in a multisite study of the Clinical Trials Network (CTN). Three mutually exclusive groups were identified: primary cocaine users (n = 287), primary amphetamine users (n = 99), and dual users (cocaine and amphetamines; n = 29). Distinct subtypes were examined with latent class and logistic regression procedures. Cocaine users were distinct from amphetamine users in age and race/ethnicity. There were four distinct classes of primary cocaine users: non-dependence (15%), compulsive use (14%), tolerance and compulsive use (15%), and physiological dependence (tolerance, withdrawal, and compulsive use; 56%). Three distinct classes of primary amphetamine users were identified: non-dependence (11%), intermediate physiological dependence (31%), and physiological dependence (58%). Regardless of stimulants used, most female users were in the most severe or the physiological dependence group. These results lend support for subtyping dependence in the emerging DSM-V.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Amphetamine-Related Disorders / classification
  • Amphetamine-Related Disorders / diagnosis*
  • Amphetamine-Related Disorders / epidemiology
  • Cocaine-Related Disorders / classification*
  • Cocaine-Related Disorders / diagnosis
  • Cocaine-Related Disorders / epidemiology
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Tolerance
  • Female
  • Humans
  • Male
  • Models, Psychological
  • Severity of Illness Index
  • Sex Distribution
  • Substance Withdrawal Syndrome