A National Evaluation of Treatment Outcomes for Cocaine Dependence (original) (raw)
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Measuring Outcome in the Treatment of Cocaine Dependence
Little is known about the extent to which outcome measures used in studies of the treatment of cocaine dependence are associated with longer-term use and with broader measures of clinical improvement. The current study examined reductions in use, and abstinence-oriented measures, in relation to functioning and longerterm clinical benefits in the treatment of cocaine dependence.
Drug and Alcohol Dependence, 2002
The quest for predictive utility of baseline demographic and drug use characteristics has been difficult. The present article draws data from two studies of cocaine-dependent individuals (N 0/297) in treatment at clinics in Los Angeles, and examines the utility of socio-demographic characteristics of patients and in-treatment performance variables as predictors of success at treatment end, 6 and 12 month follow-up assessments. Socio-demographic variables examined are age, gender, ethnicity, and educational attainment; drug use variables include years of cocaine use, self-reported days of cocaine use, the Addiction Severity Index drug composite score, and two composite measures cited in the literature. The in-treatment variables examined include cocaine urine toxicology results, number of weeks retained, and measures of compliance. The self-reported number of days of cocaine use in the past 30 days provides the most predictive utility of all baseline variables evaluated, and is the most parsimonious of the significant variables associated with substance use at all subsequent timepoints. Matching cocaine-dependent patients with treatment types or intensities based on the self-reported number of cocaine use days at intake may increase patient success rates. #
Inpatient and outpatient cocaine abusers: Clinical comparisons at intake and one-year follow-up
Journal of Substance Abuse Treatment, 1992
Given controversy about the comparative utility of inpatient and outpatient treatment for substance abusers, we compared samples of cocaine-abusing inpatients (n = 149) and outpatients (n = 149) regarding a range of clinical characteristics both at entrance into treatment and one year following this initial assessment. We wished to assess (a) whether inpatient treatment appearedjustified on the basis of more severe clinical problems in this group of patients and (b) the comparative one-year outcome of patients treated in the two conditions. Regarding the presenting clinical picture, inpatients had more severe ratings in numerous areas, with heavier drug use, social impairment, and psychopathology. At one-year follow-up, the direction of clinical ratings had reversed in the two groups, with inpatientsshowing lower problem severity in several areas, particularly cocaine use andpsychopathology. Thus, results of this nonrandomized study of inpatient and outpatient treatment suggest that decisions to hospitalize were made on a rational basis and that inpatient treatment had better long-term efficacy.
Predicting posttreatment cocaine abstinence for first-time admissions and treatment repeaters
American Journal of Public Health, 1999
Identifying and developing effective treatment strategies for cocaine use disorder are a national priority.' Cocaine abuse is widespread throughout the United States, affecting many segments of society, but data on treatment outcomes for cocaine abuse remain sparse.23Notably, several data systems that monitor drug treatment use consistently show that most admissions nationally are for cocaine use and that between 40% and 50% of these clients repeatedly return for treat-ment4'5 (also M. L. Dennis et al., unpublished
Treatment outcome of cocaine-alcohol dependent patients
Drug and Alcohol Dependence, 1997
Cocaine dependent patients (n=27) with and without concurrent alcohol dependence disorder were compared on measures of substance use, addiction severity (ASI), coping, and psychopathology taken before, during, and after outpatient relapse prevention treatment for cocaine dependence. At pre-treatment, the cocaine-alcohol (CA) group reported more frequent alcohol use, and more severe alcohol and family/social problems compared to the cocaine-only (CO) group. By the end of treatment, both groups reported significantly fewer days of alcohol and cocaine use, with sustained reductions observed at 24 weeks following treatment. On most of the addiction severity and psychiatric symptomatology scales, results indicated overall improvement as a function of time, however scores remained relatively 'worse' in the CA group. Implications of these findings and the need for specific programming in the treatment of dual drug use are explored.
Cocaine abuse treatment: A review of current strategies
Journal of Substance Abuse, 1991
The treatment of cocaine abusers is a newly emerging drsciplme, Many of the strategies that are bemg del eloped for this purpose hale been adapted from thc drug and alcoholism treatment S}sterns. These Include use of established programs that are only minimally modified for cocaine abusers, such as the 28-day mpauent hospital, therapeutic community, and 12-step programs Other approaches hale created specific techniques to meet particular clirucal needs of cocaine abusers, such as behavioral, pharmacologic, and nontraditional mtcrventions FInally, several attempts have been made to create Integrated outpatient approaches that address the multiple needs of the cocaine abusers. Man} of the clinical researchers conducting research on these modalities feel opnrmstic about the value of treatmcnt for cocaine abusers Many of the methods appear to have considerable promise However, only recently have well-controlled research efforts begun to provide the Information necessar} for empirically based decision-makmg. Dunng the next several years, outcome studies should provide an excellent set of data to guide treatment efforts. TIllS papcr reviews the treatment efforts that have been conducted, overviews the research data available, and describes some of the outcome research In progress.