Article |

Cocaine Withdrawal-Reply

Herbert G. Kleber, MD; Frank H. Gawin, MD
Arch Gen Psychiatry. 1987;44(3):298. doi:10.1001/archpsyc.1987.01800150122017.
Text Size: A A A
Published online

Brower and Paredes suggest that our three-phase conceptualization of cocaine abstinence phenomena may require revision because (1) naturalistic methods limit the reliability and validity of our findings, (2) physical signs and symptoms are not described, and (3) we disregard previous convention regarding the term withdrawal, since we apply it to protracted psychologic abstinence phenomenon (phase 2: withdrawal), such as anhedonia, rather than to immediate postbinge symptoms (phase 1: crash) that are accompanied by physical distress. They suggest that our reconceptualization should be merged with the existing conceptualization and that both phase 1 and phase 2 should be termed withdrawal. They bring up three disparate issues.

First, naturalistic methods do limit the reliability, validity, and generalizability of our findings. The second paragraph of our "Comment" section already states this. Once naturalistic observation defines a framework, highly structured investigations can proceed. If our report has value, it is in its contribution


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.