Abstract
The article which follows this introduction was originally published as a Special (Cover) Article in the American Journal of Psychiatry in the November, 1985 issue, the same month in which the First International Drug Symposium, sponsored by The Bahamas Ministry of Health and The Embassy of the United States of America, was convened to discuss the rock-cocaine epidemic in the Bahamas and other Caribbean Islands. Based on my article, I was invited to participate in the Symposium and to speak about some of my views on the psychological predispositions for drug dependence in general, and in particular, on the psychological predisposition for cocaine dependence. At first, I did not grasp the seriousness and scope of the cocaine problem, but I accepted the invitation, believing I might make a contribution to the Symposium. I was not long in attendance at the Symposium before I realized that the Bahamian citizens, professionals, and health care leaders were facing a major crisis as a consequence of the cocaine epidemic.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
E.J.Khantzian, Opiate addiction: a critique of theory and some implications for treatment, Am. J. Psychother., 28:59–70, (1974).
E.J.Khantzian, C. Treece, Psychodynamics of drug dependence: an overview, in: “Psychodynamics of Drug Dependence: NIDA Research Monograph 12,,” J.D. Blaine, D.A. Julius, eds., National Institute on Drug Abuse, Rockville, Md.,(1977).
I. Chein, D.L.Gerard, R.S.Lee, et al.,“The Road to H: Narcotics, Delinquency, and Social Policy,,” Basic Books, New York, (1964).
D.L.Gerard, C. Kornetsky, Adolescent opiate addiction: a case study, Psychiatr. Q., 28:367–380, (1954).
D.L.Gerard, C. Kornetsky, Adolescent opiate addiction: a study of control and addict subjects, Psychiatr.Q., 29:457–486, (1955).
H. Wieder, E.H. Kaplan, Drug use in adolescents: psychodynamic meaning and phamacogenic effect, Pschoanal. Study Child, 24:399–431, (1969).
H. Milkman, W.A. Frosch, On the preferential abuse of heroin and amphetamine, J. Nerv. Ment. Dis., 156:242–248, (1973).
L. Wurmser, Methadone and the craving for narcotics: observations of patients on methadone maintenance in psychotherapy, in “Proceedings of the Fourth National Methadone Conference, San Francisco, 1972,,” National Association for the Prevention of Addiction to Narcotics, New York, (1972).
L. Wurmser, Psychoanalytic considerations of the etiology of compulsive drug use, J. Am. Psychoanal. Assoc., 22:820–843, (1974).
E. J. Khantzian, A preliminary dynamic formulation of the psychopharma-cologic action of methadone, in “Proceedings of the Fourth National Methadone Conference, San Francisco, 1972, National Association for the Prevention of Addiction to Narcotics,,” (1972).
E.J. Khantzian, An ego-self theory of substance dependence: a contemporary psychoanalytic perspective, in “Theories on Drug Abuse: NIDA Research Monograph 30,,” D.J. Lettieri, M. Sayers, H.W. Pearson, eds. National Institute on Drug Abuse, Rockville,Md., (1980).
E. J. Khantzian, Psychological (structural) vulnerabilities and the specific appeal of narcotics, Ann. N.Y. Acad. Sci., 398:24–32 (1982).
P. Radford, S. Wiseberg, C. Yorke, A study of “main line” heroin addiction, Psychoanal. Study. Child., 27:156–180 (1972).
H. Krystal, H. A. Raskin, “Drug Dependence: Aspects of Ego Functions,,” Wayne State University Press, Detroit (1970).
G. E. Woody, C. P. O’Brien, K. Rickels, Depression and anxiety in heroin addicts: a placebo-controlled study of doxepin in combination with methadone, Am. J. Psychiatry, 132:447–450 (1975).
A. T. McLellan, G. E. Woody, C. P. O’Brien, Development of psychiatric illness in drug abusers, N. Engl. J. Med., 201:1310–1314 (1979).
W. Dorus, E. C. Senay, Depression, demographic dimension, and drug abuse, Am. J. Psychiatry, 137:699–704 (1980).
M. M. Weissman, F. Slobetz, B. Prusoff, et al., Clinical depression among narcotic addicts maintained on methadone in the community, Am. J. Psychiatry, 133:1434–1438 (1976).
B. J. Rounsaville, M. M. Weissman, H. Kleber, et al., Heterogeneity of psychiatric diagnosis in treated opiate addicts, Arch. Gen. Psychiatry, 39:161–166 (1982).
B. J. Rounsaville, M. M. Weissman, K. Crits-Cristoph, et al., Diagnosis and symptoms of depression in opiate addicts: course and relationship to treatment outcome, Arch. Gen. Psychiatry, 39:151–156 (1982).
K. Vereby, ed., Opiods in Mental Illness: Theories, Clinical Observations, and Treatment Possibilities, Ann. N. Y. Acad. Sci., 398:1–512 (1982).
C. Treece, B. Nicholson, DSM-III personality type and dose levels in methadone maintenance patients, J. Nerv. Ment. Pis., 168:621–628 (1980).
B. Nicholson, C. Treece, Object relations and differential treatment response to methadone maintenance, J. Nerv. Ment. Dis., 169:424–429 (1981).
E. J. Khantzian, C. Treece, PSM-III psychiatric diagnosis of narcotic addicts: recent findings, Arch. Gen. Psychiatry (in press).
S. J. Blatt, W. Berman, S. Bloom-Feshback, et al., Psychological assessment of psychopathology in opiate addicts, J. Nerv. Ment. Dis., 156–165 (1984).
B. J. Rounsaville, W. Glazer, C. H. Wilber, et al., Short-term interpersonal psychotherapy in methadone-maintained opiate addicts, Arch. Gen. Psychiatry, 40:629–636 (1983).
G. E. Woody, L. Luborsky, A. T. McLellan, et al, Psychotherapy for opiate addicts, Arch. Gen. Psychiatry, 40:639–645 (1983).
A. T. Butterworth, Pepression associated with alcohol withdrawal: imipramine therapy compared with placebo, Q. J. Stud. Alcohol., 32:343–348 (1971).
J. E. Overall, P. Brown, J. P. Williams, et al., Prug treatment of anxiety and depression in detoxified alcoholic patients, Arch. Gen. Psychiatry, 29:218–221 (1973).
F. M. Quitkin, A. Rifkin, J. Kaplan, et al., Phobic anxiety syndrome complicated by drug dependence and addiction, Arch. Gen. Psychiatry, 27:159–162 (1972).
F. H. Gawin, H. P. Kleber, Cocaine abuse treatment, Arch. Gen. Psychiatry, 41:903–908 (1984).
E. J. Khantzian, Self-selection and progression in drug dependence, Psychiatry Digest, 10:19–22 (1975).
E. J. Khantzian, J. E. Mack, A. F. Schatzberg, Heroin use as an attempt to cope: clinical observations, Am. J. Psychiatry, 131:160–164 (1974).
E. J. Khantzian, Impulse problems in addiction: cause and effect relationships, in “Working With the Impulsive Person,,” H. Wishnie, ed., Plenum, New York (1979).
J. V. Spotts, F. C. Shontz, “The Life Styles of Nine American Cocaine Users,,” National Institute on Prug Abuse, Washington, P.C. (1977).
E. J. Khantzian, F. Gawin, H. P. Kleber, et al., Methylphenidate treatment of cocaine dependence-a preliminary report, J. Substance Abuse Treatment, 1:107–112 (1984).
E. J. Khantzian, N. J. Khantzian, Cocaine addiction: is there a psychological predisposition?, Psychiatric Annals, 14(10):753–759 (1984).
E. J. Khantzian, An extreme case of cocaine dependence and marked improvement with methylphenidate treatment, Am. J. Psychiatry, 140: 784–785 (1983).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1987 Plenum Press, New York
About this paper
Cite this paper
Khantzian, E.J. (1987). The Self-Medication Hypothesis of Addictive Disorders: Focus on Heroin and Cocaine Dependence. In: Allen, D.F. (eds) The Cocaine Crisis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1837-8_7
Download citation
DOI: https://doi.org/10.1007/978-1-4613-1837-8_7
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9026-1
Online ISBN: 978-1-4613-1837-8
eBook Packages: Springer Book Archive