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

Thiago Wendt Viola; Saulo Gantes Tractenberg; Luis Eduardo Wearick-Silva; Caroline Silva de Oliveira Rosa; Júlio Carlos Pezzi; Rodrigo Grassi-Oliveira

doi:10.1016/j.drugalcdep.2014.09.003

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.

Authors

Thiago Wendt Viola¹, Saulo Gantes Tractenberg¹, Luis Eduardo Wearick-Silva¹, Caroline Silva de Oliveira Rosa¹, Júlio Carlos Pezzi², Rodrigo Grassi-Oliveira³

Affiliations

¹ Centre of Studies and Research in Traumatic Stress, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681, prédio 11, sala 928, 90619-900 Porto Alegre, RS, Brazil.
² Health Science Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
³ Centre of Studies and Research in Traumatic Stress, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681, prédio 11, sala 928, 90619-900 Porto Alegre, RS, Brazil. Electronic address: rodrigo.grassi@pucrs.br.

PMID: 25262527
DOI: 10.1016/j.drugalcdep.2014.09.003

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