Depression is common among opiate users and may serve as a trigger for high-risk drug injection practices, continued drug use, and relapse. Research has shown that individuals with co-occurring depression and substance use are less likely to complete treatment and have poorer prognoses after traditional treatment. However, scientists at the Brown University School of Medicine demonstrated that multisession, combination antidepressant therapy successfully reduced depression in active injection drug users.

Dr. Michael Stein and colleagues recruited 109 out-of-treatment injection drug users diagnosed with depression to participate in the study. Fifty-three participants received combined psychotherapy and pharmacotherapy for their depression during a 3-month period. These participants were scheduled to receive eight individual cognitive behavioral therapy (CBT) sessions and three pharmacotherapy visits. Fifty-six participants did not receive treatment. At the end of 3 months, adherence to treatment was assessed, and all study members participated in follow-up interviews designed to assess their heroin use and severity of depression.

Forty-three percent of participants receiving the combined treatment were considered to be fully adherent to their treatment schedules (receiving more than 75 percent of either psychotherapy or pharmacotherapy). At follow-up, significant reductions in depression were observed. Participants receiving the combined treatment were about 2.5 times more likely than those not receiving treatment to be in depression remission. Nearly 40 percent of participants who were fully adherent to treatment were in remission at 3 months, while only about 12 percent of those not receiving treatment were in remission at this time. Among all participants, depression status was associated with frequency of heroin use. Participants in remission at 3 months reported fewer than 8 days of heroin use during that time compared with roughly 13 days of her
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Contact: Blair Gately
bgately@nida.nih.gov
301-443-6245
NIH/National Institute on Drug Abuse
3-May-2004

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