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Heterogeneity of stimulant dependence: a national drug abuse treatment clinical trials network study.

We investigated the presence of DSM-IV subtyping for dependence on cocaine and amphetamines (with versus without physical dependence) among outpatient stimulant users enrolled in a multisite study of the Clinical Trials Network (CTN). Three mutually exclusive groups were identified: primary cocaine users (n = 287), primary amphetamine users (n = 99), and dual users (cocaine and amphetamines; n = 29). Distinct subtypes were examined with latent class and logistic regression procedures. Cocaine users were distinct from amphetamine users in age and race/ethnicity. There were four distinct classes of primary cocaine users: non-dependence (15%), compulsive use (14%), tolerance and compulsive use (15%), and physiological dependence (tolerance, withdrawal, and compulsive use; 56%). Three distinct classes of primary amphetamine users were identified: non-dependence (11%), intermediate physiological dependence (31%), and physiological dependence (58%). Regardless of stimulants used, most female users were in the most severe or the physiological dependence group. These results lend support for subtyping dependence in the emerging DSM-V.

Pubmed ID: 19340639


  • Wu LT
  • Blazer DG
  • Patkar AA
  • Stitzer ML
  • Wakim PG
  • Brooner RK


The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions

Publication Data

April 2, 2009

Associated Grants

  • Agency: PHS HHS, Id: HHSN271200522071C

Mesh Terms

  • Adult
  • Age Factors
  • Amphetamine-Related Disorders
  • Cocaine-Related Disorders
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Tolerance
  • Female
  • Humans
  • Male
  • Models, Psychological
  • Severity of Illness Index
  • Sex Distribution
  • Substance Withdrawal Syndrome