Service utilization patterns in cocaine use disorder: A data-driven study

Over the past decade, cocaine use disorders (CoUD) have become increasingly prevalent in Europe's outpatient addiction care settings. This study examines clinically meaningful subgroups among individuals seeking outpatient care for CoUD in Berlin, a metropolitan area with particularly high prevalence rates to inform treatment strategies.

Using 2024 person-level routine data of the Berlin Addiction Care Statistical Service, latent class analyses (LCA) were conducted to identify subgroups among clients entering outpatient care with primary CoUD (n = 1223) based on patterns of substance use disorder (SUD) comorbidity and cocaine use prior to admission. Identified classes were subsequently compared with respect to sociodemographic characteristics and treatment-related variables applying Holm-Bonferroni adjusted group comparisons.

A three-class solution best fitted the data: (1) CoUD-only (low comorbidity), (2) CoUD+Alcohol Use Disorders (AUD), and (3) CoUD+Multiple SUDs. The CoUD+AUD class was more likely to be employed and tertiary educated. The CoUD-only class showed more first-time treatment entries, shorter treatment duration, and lower rates of scheduled completion and symptom improvement. The CoUD+Multiple SUDs class showed comparable treatment outcomes to the CoUD-only class.

These findings underscore the importance of recognizing heterogeneity in care needs among individuals with CoUD. Tailored treatment approaches, including early-stage interventions for less complex cases and integrated strategies for those with comorbid SUDs, may enhance treatment effectiveness and optimize resource allocation.