Factors associated with the transition from abuse to dependence among substance abusers: Implications for a measure of addictive liability

Abstract

This study was conducted to test the validity of a measure that has potential to bridge research on the addictive liability of drugs and on individuals' liability to addiction, which to date have evolved in largely parallel arenas. The length of time between onset of abuse and dependence (LOTAD) has evolved from recent findings on transitions through levels of addiction; it was hypothesized that shorter LOTAD is indicative of greater addictive liability. Hypotheses were based on animal studies and human studies. Retrospective data from the DSM-IV Substance Use Disorders Work Group were reanalyzed using configural frequency analysis, survival curves, bivariate Kendall's tau associations, and linear regression. The sample consisted of participants recruited from community and clinical settings. The measure was the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). The shortest LOTADs were observed for disorders related to use of cocaine and opiates, followed by cannabis and then alcohol regardless of the subsample that was analyzed. As hypothesized, females and early initiators of drug use had shorter LOTADs compared to men and other initiators of drug use; no consistent differences in LOTAD were observed between AfricanAmericans and Caucasians. None of the LOTAD variance associated with differences between drugs could be accounted for by gender, early use of the drug, or ethnicity. Specific areas of research where LOTAD might be useful as well as how LOTAD might be improved are discussed.

Different lengths of times for progressions in adolescent substance involvement

“…In theory, substances with greater addictive liabilities will generate faster progressions from initiation to greater involvement (e.g., regular use). Differences in the average times of progressions in users of different substances (e.g., alcoholics vs. cocaine addicts) appear to parallel animal findings on addictive liability (Ridenour et al,2003(Ridenour et al, ,2005. Faster progressions have been observed for women compared to men (consistent with animal studies on addictive liability) and early initiators compared to later initiators of substance use (consistent with human studies on addictive liability) (Ridenour et al, 2005).…”

“…One phenotype with potential utility for genetic, clinical, addictive liability (risk for addiction), and translational addiction research is the speed at which substance users progress from mild to more severe involvement (Chen & Anthony, 2004;Ridenour et al,2003Ridenour et al, ,2005Wagner & Anthony, 2002). In theory, substances with greater addictive liabilities will generate faster progressions from initiation to greater involvement (e.g., regular use).…”

“…If a phenotype in people is found to parallel addictive liability studies in animals, it could accelerate the transfer of knowledge from animals to people (e.g., used in genetic association studies). Moreover, a phenotype that gauges drug-related constructs' contributions to addiction liability could be used to integrate drug-specific liability with the common addiction liability model as well as parse the contributions to overall addiction liability of drugrelated constructs, intrapersonal characteristics, and environmental variables (Ridenour et al, 2005).…”

“…These realms of addiction research include genetic research, clinical diagnostic nomenclature (Hasin & Grant, 2004;Langenbucher et al, 2004;Ridenour, Cottler, Compton, Spitznagel, & Cunningham-Williams, 2003), abuse/addictive liability drug research Balster & Bigelow, 2003;Fischman & Foltin, 1991;Griffiths, Bigelow, & Ator, 2003;Ridenour, Maldonado-Molina, Compton, Spitznagel, & Cottler, 2005), and efforts to provide translational interpretations of animal research to people (Ahmed & Koob, 1998;Deroche-Gamonet, Belin, & Piazza, 2004;Vanderschuren & Everitt, 2004). The quality and type of research that can be conducted are limited by measures available.…”

Drug use and dependence in cocaine dependent subjects, community-based individuals, and their siblings

“…In the NCS sample described above, it appears that cocaine is more addictive than marijuana because proportionately more users progressed to dependence. Other studies also suggest that cocaine may be the most addictive substance among the common drugs (i.e., alcohol, marijuana, opiates) (Ridenour et al, 2003;Ridenour et al, 2005). Thus, an increase of cocaine use in the population will lead to a greater change in drug dependent individuals than will an increase in marijuana use, and may be a more severe public health problem.…”