Heterogeneity of Stimulant Dependence: A National Drug Abuse Treatment Clinical Trials Network Study |
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| Authors: | Li‐Tzy Wu ScD Dan G Blazer MD PhD Ashwin A Patkar MD Maxine L Stitzer PhD Paul G Wakim PhD Robert K Brooner PhD |
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| Institution: | 1. Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Duke Clinical Research Institute, Durham, North Carolina;2. Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland;3. National Institute on Drug Abuse, Bethesda, Maryland |
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| 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. |
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