SPECIFICITY OF SUBSTANCE USE IN ANXIETY-DISORDERED SUBJECTS

The current research (1) examines empirical evidence to substantiate t he relationship between substance choice and chronology of onset of an xiety and substance use disorders, and (2) provides information on the specificity of substance choice among anxiety disorders. A study grou p of 181 subjects in the Harvard Anxiety Research Project (HARP) who h ad a history of substance use disorder were the focus of this examinat ion. Subjects whose anxiety disorder had an onset before their substan ce use disorder (primary anxiety) were compared with those whose subst ance use preceded onset of an anxiety disorder (secondary anxiety) for differences in distribution of subjects among categories of substance of abuse. Primary and secondary anxiety groups do not have different ages of onset for substance use disorder, nor was there greater likeli hood for choosing alcohol for any of the anxiety disorders. However, t here is a decreased risk of alcohol use in the small group of generali zed anxiety subjects and an increased risk of opioid use in the small group of posttraumatic stress disorder subjects. There was no indirect support for the self-medication hypothesis. Neither age of onset data , specific substance association, nor proximal diagnosis association s upport a simple interaction. The strongest finding supported an ''avoi dance'' of CNS stimulants. (C) 1995 by W.B. Saunders Company