The effect of individual cocaine withdrawal symptoms on outcomes in cocaine users

Preclinical and clinical studies suggest that individual drug withdrawal symptoms may have differential effects on addictive behaviors. The goals of this study were (1) to explore the dimensions of DSM-IV cocaine withdrawal symptoms and (2) to examine the association of these dimension and individual withdrawal symptoms with problems related to drug dependence in male and female cocaine users. The results of the principal components analyses of withdrawal symptoms supported a two factor model. The first one is labeled the depressive symptoms factor and included symptoms of depressed mood, psychomotor agitation, psychomotor retardation, craving for cocaine, insomnia, and vivid, unpleasant dreams. The second factor labeled the somatic symptoms factor included symptoms of increased appetite, hypersomnia, and fatigue. The depressive symptoms factor, in comparison to the somatic symptoms factor, was associated with more frequent reporting of having chemical dependency treatment, having depressed mood for longer than 2 weeks, and trading cocaine for sex. When the individual withdrawal symptoms were examined, depressed mood, psychomotor agitation, vivid, unpleasant dreams, and fatigue were associated with more frequent reporting of some of these outcomes. Our findings support two dimensions in cocaine withdrawal symptoms with differential effects on cocaine dependence outcomes.