Among drug treatment patients, 64% had alcohol dependence, 44% had antisocial personality disorder, and 24% had major depression, with Caucasians and males showing higher rates of cannabis dependence while women had higher rates of depression and anxiety.
Read this if you want to understand how cannabis dependence relates to other psychiatric conditions and how demographics affect treatment patterns.
64% of drug-dependent treatment patients also had alcohol dependence
What the researchers found
Researchers interviewed drug-dependent individuals in treatment using a structured diagnostic tool. The rates of co-occurring psychiatric disorders were striking.
Lifetime prevalence rates included: alcohol dependence (64%), antisocial personality disorder (44%), phobic disorders (39%), major depression (24%), dysthymia (12%), and generalized anxiety disorder (10%). These rates far exceeded general population prevalences.
Race and gender differences were significant. Caucasians had higher rates of cannabis, alcohol, hallucinogen, opiate, and sedative dependence, plus higher rates of depression, dysthymia, and anxiety compared to African-Americans. Men had higher cannabis dependence rates than women, while women had higher rates of depression, dysthymia, panic, and OCD.
The racial differences in treatment populations contrasted with community surveys, suggesting differential treatment-seeking patterns rather than true prevalence differences.
Why it matters
This study documented the extensive psychiatric comorbidity among cannabis and other drug-dependent individuals, showing that substance use disorders rarely exist in isolation. The racial differences in treatment populations versus community surveys highlighted important disparities in access to or willingness to seek treatment.
The numbers in context
Alcohol dependence: 64%. ASPD: 44%. Phobic disorders: 39%. Major depression: 24%. Dysthymia: 12%. GAD: 10%. Caucasians and males had higher cannabis dependence rates.
How the study worked
Cross-sectional diagnostic study using the NIMH Diagnostic Interview Schedule to assess DSM-III-R disorders in drug treatment patients. Stratified by race and gender.
What this study cannot tell us
Treatment-seeking populations may not represent all drug-dependent individuals. Race was used as a category, which may oversimplify complex social and cultural factors. DSM-III-R criteria are now outdated. The cross-sectional design cannot determine which conditions preceded which.
How to read the evidence
A well-structured diagnostic study using standardized instruments. Good methodology but limited to treatment-seeking populations, which may not represent all affected individuals.
When this study was published
Published in 2000 using DSM-III-R criteria. Diagnostic criteria have been updated to DSM-5, which may produce different prevalence estimates.
The bigger picture
The high rates of co-occurring disorders established that effective treatment for cannabis and other drug dependencies must address psychiatric comorbidities simultaneously. The racial disparities in treatment populations versus community samples remain an important health equity issue.
Questions still open
- Why do Caucasians and African-Americans show different treatment-seeking patterns? Would treating the underlying psychiatric disorders improve substance use outcomes? How do current DSM-5 criteria change these prevalence estimates?
Common questions
Do people with cannabis problems usually have other disorders?
Were there gender differences?
Read the original research
Substance dependence and other psychiatric disorders among drug dependent subjects: race and gender correlates.
The American journal on addictions, 9(2), 113-25
Citation
Compton, W M; Cottler, L B; Ben Abdallah, A; Phelps, D L; Spitznagel, E L; Horton, J C. (2000). Substance dependence and other psychiatric disorders among drug dependent subjects: race and gender correlates.. The American journal on addictions, 9(2), 113-25.
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