Effects of ethnicity on low-dose opiate stabilization.

In a recent randomized clinical trial using buprenorphine (2 and 6 mg) and methadone (35 and 65 mg), we compared low-level opiate withdrawal symptoms among Whites (n = 84), Hispanics (n = 20), and African Americans (n = 21). During the first 2 months of opiate stabilization, persistent low-level opiate withdrawal symptoms were significantly lower in African-Americans and Hispanics than in the white patients. As expected pharmacologically, this relative underreporting of low-level withdrawal by minority patients was greater for the low opiate doses (buprenorphine 2 mg and methadone 35 mg). This underreporting may reflect sociocultural as well as biological differences, because subjective, but not objective, withdrawal symptoms showed this ethnic difference.

Psychiatric comorbidity in white and African-American cocaine addicts seeking substance abuse treatment.

OBJECTIVE: Few diagnostic studies have reported rates of psychiatric comorbidity among cocaine addicts according to race. This study examines psychiatric comorbidity in African-American and white cocaine addicts. METHODS: Rates of psychiatric comorbidity were assessed in 263 cocaine addicts seeking substance abuse treatment. The sample included 163 non-Hispanic whites and 100 African Americans. Diagnoses were based on patient interviews using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L). The SADS-L was supplemented to include DSM-III-R criteria for substance abuse or dependence and other psychiatric diagnoses and DSM-III criteria for attention deficit disorder. RESULTS: Overall, 55.7 percent of the cocaine addicts met Research Diagnostic Criteria for a current psychiatric diagnosis, and 73.5 percent met criteria for a lifetime psychiatric diagnosis. Whites and African Americans did not differ significantly in overall psychiatric comorbidity. However, whites had significantly higher rates of life-time major depression, alcohol dependence, attention deficit disorder, and conduct disorder. African-American addicts, particularly women, were more likely to meet criteria for a current diagnosis of phobia. CONCLUSIONS: Psychiatric comorbidity is common among cocaine addicts, and the rates for specific disorders vary by race. Differences in current and lifetime rates should be noted. Cocaine addicts seeking treatment should be assessed for comorbid alcohol dependence and other psychiatric disorders, including anxiety, affective, and personality disorders.