Differences at treatment entry between opioid-dependent and cocaine-dependent males and females

Objectives: This study compared the psychosocial characteristics and psychiatric diagnoses of opioid-dependent and cocaine-dependent men and women. Methods: Opioid-dependent patients fulfilled a current opioid but not current cocaine dependence diagnosis (n = 115); cocaine-dependent patients fulfilled a current cocaine but not current opioid dependence diagnosis (n = 144). All enrolled in a treatment research clinic. Participants completed a demographic questionnaire, the Addiction Severity Index, and the Structured Clinical Interview for the DSM-IV, Axes I and II. Analyses included comparisons between males (n = 153) and females (n = 106) to examine possible interactive effects of sex with primary drug of abuse. Results: Greater number and problem severity for cocaine versus opioid dependent patients was found across multiple domains, and was especially notable for alcohol problems, family/social difficulties, and psychiatric comorbidity. Women differed from men by having more medical and employment problems, higher rates of lifetime Major Depression, and lower rates of personality disorders. Discussion: There are substantial differences between cocaine and opioid dependent patients, and between females and males within dependence types. Assessment and treatment planning for patients and resource allocation by substance abuse treatment programs should recognize these differences. Efforts to match substance-abusing patients to treatments can benefit from recognition of differences between cocaine and opioid dependent females and males.