Association of cocaine withdrawal symptoms with more severe dependence and enhanced subjective response to cocaine

Mehmet Sofuoglu, Susan Dudish-Poulsen, Scott B. Brown, Dorothy K. Hatsukami

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


The purpose of this two part study was to better characterize cocaine users based on self-reported cocaine withdrawal symptoms by examining screening data and response to smoked cocaine in the human laboratory. The first study sample included male and female non-treatment seeking cocaine users who were screened as potential subjects for inpatient studies. Of the 555 subjects, 462 (82%) endorsed symptoms consistent with DSM-IV criteria for cocaine withdrawal. Cocaine users who met criteria for cocaine withdrawal, compared with those who did not, reported a significantly higher amount of cocaine use and a history of medical and psychosocial problems. Cocaine users meeting DSM-IV withdrawal criteria, which included endorsement of depression, were also more likely to have a history of depression, to have seriously considered suicide, and to have had chemical dependency treatment even when amount spent on cocaine was covaried. The second study sample, which was a subset of Study I, included those who participated in human cocaine studies following the phone screening. Cocaine users who met criteria for cocaine withdrawal (n=34), compared with those who did not (n=10), had enhanced subjective ratings of 'high' and 'feel the effect of last dose' in response to a single delivery of 0.4 mg/kg of smoked cocaine. These results suggest that history of cocaine withdrawal symptoms may be associated with enhanced cocaine responses and greater severity of cocaine dependence.

Original languageEnglish (US)
Pages (from-to)273-282
Number of pages10
JournalDrug and alcohol dependence
Issue number3
StatePublished - Apr 1 2003

Bibliographical note

Funding Information:
This research was supported by grants from National Institute on Drug Abuse (P-50 DA09259 and T32-DA07097) and from the National Center for Research Resources (MO1-RR00400). We would like to thank the General Clinical Research Center nursing staff for technical assistance.


  • Cocaine dependence
  • Dependence
  • Depression
  • Subjective effects


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