Abstract
The authors report a longitudinal study describing the progression and circumstances of cocaine dependence within a large group of men with different usage histories, from initiation of use to entrance into a treatment program at a Veterans Affairs medical center several years later. Data illustrating the course of the disorder were retrospectively collected, using a “natural history” methodology successfully used in prior research. Four patterns of escalation of cocaine use are described. Generally, as the cocaine career progressed, there was a decrease in the consumption of alcohol and other drugs.