DEPRESSION AMONG COCAINE ABUSERS IN TREATMENT - RELATION TO COCAINE AND ALCOHOL-USE AND TREATMENT OUTCOME

Objective: The authors investigated the theoretical and clinical role of depression among cocaine abusers in treatment. Method: Eighty-nine cocaine-abusing patients underwent 2 weeks of substance abuse treatmen t. Posttreatment major depressive disorder, depressive symptoms before and after substance abuse treatment, and alcohol diagnoses were asses sed and their relation to pretreatment substance use, cravings in high -risk situations, and 3-month follow-tip status was examined. Results: High rates of major depressive disorder were found hut were unrelated to pretreatment substance use. The decrease in depressive symptoms du ring treatment was independent of major depressive disorder or alcohol diagnoses and predicted treatment attrition. Higher levels of depress ive symptoms during treatment were associated ith greater urge to use cocaine, alcohol, and other drugs in high-risk situations. Concurrent major depressive disorder and depressive symptoms did not predict coca ine use at follow-up. However, patients who had an alcohol relapse epi sode experienced more depressive symptoms during treatment than did th ose who abstained. Conclusions: The results highlight the relationship of depression to alcohol use among cocaine abusers and suggest a need for further studies of the association between depression and substan ce use disorders.