Carolyn E Sartor1, Henry R Kranzler2, Joel Gelernter3. 1. Departments of Genetics and Neurobiology, Yale University School of Medicine, New Haven, Connecticut. 2. Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, Veterans Integrated Service Network 4, Mental Illness Research, Education, and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania. 3. Departments of Genetics and Neurobiology, Yale University School of Medicine, New Haven, Connecticut, Departments of Genetics and Neurobiology, Yale University School of Medicine, New Haven, Connecticut.
Abstract
OBJECTIVE: Cocaine users typically try alcohol or marijuana before cocaine, but this ordering of substance use initiation is not universal. Characterizing cocaine-dependent users who deviate from the typical sequence may be informative for understanding the multiple pathways to cocaine dependence. METHOD: Data were drawn from cocaine-dependent participants (N = 6,333; 41% female) in a multisite study of the genetics of substance dependence who completed in-person structured psychiatric interviews. Participants were categorized with respect to alcohol or marijuana use as (a) never used, (b) used cocaine first, or (c) first used at the same age as or after first cocaine use. The association of a range of demographic, psychiatric, and childhood risk factors with sequences of initiation and the association of those sequences with indicators of dependence course (e.g., severity) were investigated in a series of regression analyses. RESULTS: Women and non-European Americans were overrepresented in the atypical sequence groups. The atypical sequence groups also differed from the typical sequence groups with respect to rates of other substance use disorders. Sequences of substance use initiation were largely unrelated to other psychiatric disorders or childhood risk factors. Individuals who never used marijuana had a lower severity of dependence. CONCLUSIONS: Although only a minority of dependent cocaine users deviate from the typical sequence of substance use initiation, several characteristics distinguish them from those who follow the typical sequence. Findings underscore the diversity in pathways to cocaine dependence.
OBJECTIVE:Cocaine users typically try alcohol or marijuana before cocaine, but this ordering of substance use initiation is not universal. Characterizing cocaine-dependent users who deviate from the typical sequence may be informative for understanding the multiple pathways to cocaine dependence. METHOD: Data were drawn from cocaine-dependent participants (N = 6,333; 41% female) in a multisite study of the genetics of substance dependence who completed in-person structured psychiatric interviews. Participants were categorized with respect to alcohol or marijuana use as (a) never used, (b) used cocaine first, or (c) first used at the same age as or after first cocaine use. The association of a range of demographic, psychiatric, and childhood risk factors with sequences of initiation and the association of those sequences with indicators of dependence course (e.g., severity) were investigated in a series of regression analyses. RESULTS:Women and non-European Americans were overrepresented in the atypical sequence groups. The atypical sequence groups also differed from the typical sequence groups with respect to rates of other substance use disorders. Sequences of substance use initiation were largely unrelated to other psychiatric disorders or childhood risk factors. Individuals who never used marijuana had a lower severity of dependence. CONCLUSIONS: Although only a minority of dependent cocaine users deviate from the typical sequence of substance use initiation, several characteristics distinguish them from those who follow the typical sequence. Findings underscore the diversity in pathways to cocaine dependence.
Authors: C E Sartor; A Agrawal; M T Lynskey; A E Duncan; J D Grant; E C Nelson; P A F Madden; A C Heath; K K Bucholz Journal: Psychol Med Date: 2012-07-18 Impact factor: 7.723
Authors: Arpana Agrawal; Jeffrey F Scherrer; Michael T Lynskey; Carolyn E Sartor; Julia D Grant; Jon Randolph Haber; Pamela A F Madden; Theodore Jacob; Kathleen K Bucholz; Hong Xian Journal: Addict Behav Date: 2011-07-23 Impact factor: 3.913
Authors: Louisa Degenhardt; Lisa Dierker; Wai Tat Chiu; Maria Elena Medina-Mora; Yehuda Neumark; Nancy Sampson; Jordi Alonso; Matthias Angermeyer; James C Anthony; Ronny Bruffaerts; Giovanni de Girolamo; Ron de Graaf; Oye Gureje; Aimee N Karam; Stanislav Kostyuchenko; Sing Lee; Jean-Pierre Lépine; Daphna Levinson; Yosikazu Nakamura; Jose Posada-Villa; Dan Stein; J Elisabeth Wells; Ronald C Kessler Journal: Drug Alcohol Depend Date: 2010-01-08 Impact factor: 4.492
Authors: Julian D Ford; Joel Gelernter; Judith S DeVoe; Wanli Zhang; Roger D Weiss; Kathleen Brady; Lindsay Farrer; Henry R Kranzler Journal: Drug Alcohol Depend Date: 2008-09-04 Impact factor: 4.492