Pathological Gambling Among Cocaine-Dependent Outpatients

• Published in: The American journal of psychiatry 2000-07, Vol.157 (7), p.1127-1133
• Main Authors: Hall, Gladys W., Carriero, Nicholas J., Takushi, Ruby Y., Montoya, Ivan D., Preston, Kenzie L., Gorelick, David A.
• Format: Article
• Language: English
• Subjects: Addictions; Addictive behaviors; Addicts; Adolescent; Adult; Adult and adolescent clinical studies; Age of Onset; Ambulatory Care; Biological and medical sciences; Bromocriptine - therapeutic use; Bupropion - therapeutic use; Carbamazepine - therapeutic use; Cocaine; Cocaine-Related Disorders - diagnosis; Cocaine-Related Disorders - drug therapy; Cocaine-Related Disorders - epidemiology; Comorbidity; Disruptive, Impulse Control, and Conduct Disorders - diagnosis; Disruptive, Impulse Control, and Conduct Disorders - epidemiology; Disruptive, Impulse Control, and Conduct Disorders - therapy; Drug addiction; Female; Gambling; Gambling - psychology; Humans; Length of Stay; Male; Medical sciences; Middle Aged; Miscellaneous; Outpatient care facilities; Outpatient treatment; Pathological gambling; Prevalence; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Substance Abuse Detection; Substance abuse treatment; Substance Abuse Treatment Centers; Treatment Outcome
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.157.7.1127

OBJECTIVE: The authors investigated the occurrence of pathological gambling among cocaine-dependent outpatients, its influence on short-term outcome of treatment, and comparative characteristics of patients with and without pathological gambling.METHOD: The subjects were 313 cocaine-dependent (200 also opiate-dependent) outpatients in clinical trials of medication for cocaine dependence. Pathological gambling (DSM-III-R criteria) was assessed with the Diagnostic Interview Schedule, and sociodemographic and socioeconomic characteristics were determined with the Addiction Severity Index. Outcome was defined as time in treatment (proportion of maximum scheduled time) and proportion of cocaine-positive urine samples during treatment.RESULTS: Pathological gambling had a lifetime occurrence rate of 8.0% and a current (past month) occurrence of 3.8%. Onset preceded the onset of cocaine dependence in 72.0% of the patients (and preceded onset of opiate dependence in 44.4%). Patients with pathological gambling (lifetime or current) did not differ significantly from other patients in length of treatment or proportion of cocaine-positive urine samples. Those with lifetime pathological gambling were significantly more likely to have tobacco dependence (84.0% versus 61.1%) and antisocial personality disorder (56.0% versus 19.8%), to be unemployed (84.0% versus 49.3%), to have recently engaged in illegal activity for profit (64.0% versus 38.5%), and to have been incarcerated (62.5% versus 33.9%).CONCLUSIONS: Pathological gambling is substantially more prevalent among cocaine-dependent outpatients than in the general population. Patients with pathological gambling differ from other cocaine-dependent outpatients in some sociodemographic characteristics but not in short-term outcome of treatment for cocaine dependence.