Continuing care for cocaine dependence: comprehensive 2-year outcomes.

Area of Science:

• Addiction Medicine
• Psychology
• Public Health

Background:

• Cocaine dependence is a significant public health issue requiring effective long-term treatment strategies.
• Continuing care models are crucial for maintaining treatment gains in addiction recovery.
• Previous research has established the efficacy of standard counseling and relapse prevention in shorter-term studies.

Purpose of the Study:

• To evaluate the 2-year outcomes of outpatient continuing care for cocaine dependence.
• To compare the effectiveness of standard counseling (STND) versus individualized relapse prevention (RP).
• To examine how abstinence goals and co-occurring substance dependence influence treatment outcomes.

Main Methods:

• A randomized controlled trial involving 132 cocaine-dependent patients.
• Assignment to either standard group counseling (STND) or individualized relapse prevention (RP) for continuing care.
• Assessment of cocaine and alcohol use outcomes over a 2-year period.

Main Results:

• A main effect for continuing care condition was observed for only one of eight outcome variables.
• Patients in RP with absolute abstinence goals showed better cocaine outcomes than those in STND.
• Patients with less stringent abstinence goals in STND showed better cocaine outcomes than those in RP.
• RP improved cocaine outcomes (Months 1-6) and alcohol outcomes (Months 13-24) for patients with current cocaine or alcohol dependence.

Conclusions:

• The effectiveness of continuing care models for cocaine dependence is contingent on patient-specific factors, such as abstinence goals.
• Individualized relapse prevention may be more beneficial for cocaine-dependent patients with high motivation for abstinence.
• Patients with co-occurring substance use disorders may benefit from relapse prevention in terms of both cocaine and alcohol use outcomes.