Substance use diagnosis within a community sample of adults: Distinction, comorbidity, and progression over time.

Practicing psychologists conceptualize, assess, and treat clients who use substances in different ways. Using longitudinal data from a multiethnic community sample of 470 adults, the authors examine patterns of abuse and dependence on alcohol, marijuana, and cocaine. Men were significantly more abusive, dependent, and polysubstance dependent on all drugs than women. A large percentage of drug abusers, and over 1/3 with drug dependence, remitted without formal treatment. However, early severe problems with cocaine increased later alcohol problems. Traditional disease progression and drug use acquisition models are not supported. Psychologists should incorporate the natural course of substance use into treatment and prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)