The effects of commitment to abstinence and acute stress on return to drug use were examined in a study of treated alcoholics, opiate users, and cigarette smokers (N = 221). Subjects were followed for 12 weeks or until they used their problem drug for 7 consecutive days. Commitment to absolute abstinence at end of treatment was related to a lower risk of returning to use and longer time between the first use and relapse. Withdrawal symptoms and negative and positive moods predicted first drug use, but only when assessed retrospectively. Prospective analyses failed to reveal a link between these variables and return to use. These findings suggest a reevaluation of current models of relapse. Acute stress may be less important in precipitating return to drug use than previously believed.

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In a prospective study of 104 cocaine patients, a baseline assessment was conducted while Ss were in treatment. After treatment completion, Ss were assessed once a week for 12 weeks, then 6 months from study start. A goal of absolute abstinence, greater expected success in quitting, and positive moods predicted a lower risk of a lapse in the first 12 weeks of follow-up. Stress (negative moods, physical symptoms, hassles, and life events) did not predict. Use of more coping strategies predicted abstinence for Caucasian but not for African-American Ss. Baseline measures of expected success and desire to quit predicted continuous abstinence at 6 months but not at statistically significant levels. Results suggest that solidifying abstinence goals and enhancing positive moods may facilitate early abstinence.

In a large sample of urban police officers, 18.1% of males and 15.9% of females reported experiencing adverse consequences from alcohol use and 7.8 % of the sample met criteria for lifetime alcohol abuse or dependence. Female officers had patterns of alcohol use similar to male officers and substantially more than females in the general population. Critical incident exposure and PTSD symptoms were not associated with level of alcohol use. Greater psychiatric symptoms were related to adverse consequences from alcohol use. There was a noteworthy gender by work stress interaction: greater routine work stress related to lower current alcohol use in female officers.

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