The relationship of alcohol use to cocaine relapse in cocaine dependent patients in an aftercare study

Objective: To examine the relationship between alcohol use and cocaine rela pse. Method: Ninety-eight cocaine-dependent male patients in aftercare were followed for 6 months following completion of an intensive outpatient reha bilitation program (IOP). Past and current alcohol dependence was assessed at entrance into aftercare, and drinking behavior prior to cocaine relapse and "near miss" episodes was assessed at 3- and 6-month follow-ups. Data on cocaine and alcohol use throughout the follow-up were also obtained. Resul ts: Patients who had never met criteria for alcohol dependence and those wi th current alcohol dependence had worse cocaine outcomes (cocaine use on 10 % and 7%; of the days in the follow-up, respectively) than those with past alcohol dependence (cocaine use on 3% of the days in the follow-up), althou gh alcohol dependence status no longer predicted cocaine use outcomes when cocaine use in IOP was controlled. Alcohol use in 4 of the first 5 follow-u p months significantly predicted cocaine relapse status in the next month a fter cocaine use in IOP and alcohol dependence diagnosis at baseline were c ontrolled. Patients who experienced cocaine relapses were much more likely to report drinking before the onset of the episode than those who had "near misses," particularly on the day of the episode (40% vs 6% at 3 months: 62 % vs 0% at 6 months). Alcohol did not appear to be a factor in the relapses of cocaine patients with no history of alcohol dependence. even though the y did report drinking on 5% of the days in the follow-up. Conclusions: Rela pse prevention efforts with cocaine abusers who have histories of alcohol d ependence should include interventions designed to reduce drinking.