TREATMENT OUTCOME OF ALCOHOLICS WITH AND WITHOUT COCAINE DISORDERS

The treatment outcome literature suggests that alcoholics with coexist ing drug dependence have worse prognoses. We compared three groups of inpatients treated on the same hospital unit for disorders of alcohol only (n = 51), cocaine only (n = 27), or both disorders (dual group, n = 27). At follow-up, we contacted 105 (81%) of 129 patients at a mean of 13.4+/-4.1 months after discharge. The three groups significantly and equivalently decreased their consumption of substances at follow u p, and they also had equivalent improvements in employment and in medi cal and psychiatric wellbeing. A nonsignificant trend existed for grea ter abstinence in the alcohol group (53%) than in the dual group (35%) , and with regression analysis diagnostic group and stable residence p redicted abstinence in the past 30 days. Elapsed time before using alc ohol was equivalent for the two alcohol groups, and relapse to alcohol preceded relapse to cocaine by 1 month on average. In sum, outcomes w ere more similar than different for the three groups. Although specifi c treatments to enhance abstinence for cocaine users are indicated, cl inicians should approach cocaine-using alcoholics with equal optimism for improvement as with other alcoholics.