Long-term cannabis abuse and early-onset cannabis use increase the severity of cocaine withdrawal during detoxification and rehospitalization rates due to cocaine dependence

Drug Alcohol Depend. 2014 Nov 1:144:153-9. doi: 10.1016/j.drugalcdep.2014.09.003. Epub 2014 Sep 16.

Abstract

Background: Long-term and early-onset cannabis consumption are implicated in subsequent substance- related problems. The aim of this follow-up study was to investigate whether these patterns of cannabis use could impact cocaine withdrawal severity and cocaine craving intensity during detoxification. In addition, we investigated their impact in the rehospitalization rates due to cocaine dependence 2.5 years after detoxification assessment.

Methods: The sample was composed of 93 female cocaine-dependent inpatients who were enrolled in an inpatient detoxification unit. Cocaine withdrawal symptoms were measured at the 4th, 9th and 14th days of detoxification using the cocaine selective severity assessment (CSSA). Data on the age of first years of drug use - alcohol, cannabis and cocaine - and the years of substance abuse were obtained using the Addiction Severity Index (ASI-6). Other relevant clinical variables were also investigated, including a 2.5 years follow-up assessment of number of rehospitalization due to cocaine dependence.

Results: Early-onset cannabis use and long-term cannabis abuse were associated with an increase instead of a reduction in the severity of cocaine withdrawal symptoms and craving intensity during detoxification. In addition, long-term cannabis abuse predicted higher number of rehospitalization due to cocaine dependence after 2.5 years of the first detoxification assessment.

Conclusions: Early-onset cannabis use and long-term cannabis abuse are associated with a worse detoxification treatment response. Our findings may help to identify patients who will struggle more severely to control cocaine withdrawal syndrome during early drug abstinence, and indicate that cannabis use prior to cocaine withdrawal should be considered an adverse factor.

Keywords: Addictive behavior; Adolescent; Cannabis; Cocaine; Hospitalization; Substance withdrawal syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cocaine / adverse effects*
  • Cocaine-Related Disorders / diagnosis*
  • Cocaine-Related Disorders / epidemiology
  • Cocaine-Related Disorders / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Marijuana Abuse / diagnosis*
  • Marijuana Abuse / epidemiology
  • Marijuana Abuse / therapy
  • Mental Health Services / trends
  • Patient Readmission / trends*
  • Severity of Illness Index*
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / epidemiology
  • Substance Withdrawal Syndrome / therapy
  • Time Factors
  • Young Adult

Substances

  • Cocaine