Heterogeneity of stimulant dependence: a national drug abuse treatment clinical trials network study.
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.
Type
Journal articleSubject
HumansAmphetamine-Related Disorders
Cocaine-Related Disorders
Substance Withdrawal Syndrome
Severity of Illness Index
Age Factors
Comorbidity
Sex Distribution
Drug Tolerance
Models, Psychological
Diagnostic and Statistical Manual of Mental Disorders
Adult
Female
Male
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https://hdl.handle.net/10161/20009Published Version (Please cite this version)
10.1080/10550490902787031Publication Info
Wu, Li-Tzy; Blazer, Dan G; Patkar, Ashwin A; Stitzer, Maxine L; Wakim, Paul G; & Brooner,
Robert K (2009). Heterogeneity of stimulant dependence: a national drug abuse treatment clinical trials
network study. The American journal on addictions, 18(3). pp. 206-218. 10.1080/10550490902787031. Retrieved from https://hdl.handle.net/10161/20009.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Daniel German Blazer
J. P. Gibbons Distinguished Professor Emeritus of Psychiatry
I am currently semi-retired. Most of my recent work has been focused on roles with
the National Academy of Medicine (former Institute of Medicine). I have chaired three
committees during the past four years, one on the mental health and substance use workforce,
one on cognitive aging, and one on hearing loss in adults. I currently also chair
the Board on the Health of Select Populations for the National Academies. In the past
I have been PI on a number of research
Ashwin Anand Patkar
Professor of Psychiatry and Behavioral Sciences
Li-Tzy Wu
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research,
psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns
Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute
on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based
Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse,
Opioid overdose, Opioid use disorder
Alphabetical list of authors with Scholars@Duke profiles.

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