Identification of patients with coexisting alcohol and cocaine disorders at a community mental health center.

To measure the prevalence of cocaine abuse at a community mental health center's inpatient alcohol unit, a 20 item document was used to obtain information from the medical records of 162 patients admitted from January 1988 through July 1988. The data collected were analyzed to evaluate the assessment, diagnosis, treatment and referral of patients with coexisting alcohol and cocaine disorders. Of the 162 patients in the sample, 154 (95%) had a diagnosis of alcohol abuse/withdrawal and five (3%) had a diagnosis of cocaine abuse. Fifty-five patients had used cocaine for at least one year and 39 (24%) of the patients had a positive laboratory test for the drug upon admission. Eighty-six patients, over 53 percent of the sample, met the DSM III-R criteria for cocaine abuse, but only five (3%) of the patients were referred to substance abuse clinics or support groups upon discharge. These findings highlight the inadequate diagnosis, treatment and follow-up of patients with coexisting alcohol and cocaine disorders.