Cocaine dependence treatment on an inpatient detoxification unit

A psychoanalytic-developmental treatment model includes individual and group psychotherapy which enables compulsive freebase cocaine smokers to articulate explanations for their drug dependence. Relapse prevention education includes recommendations for aftercare treatment. Psychosocial history and DSM-III diagnostic data (N = 31) reveals histories of dysfunctional family dynamics, high rates of depressive disorders, and personality disorders. A case history illustrates application of our treatment model and problems in currently available post-detox treatment. Residential therapeutic communities (TCs) need to offer variable program lengths and specialized crack residences in therapeutic milieus with trained clinical staff. TC programs should offer inpatient psychotherapy, family therapy, and provide direct entrance into program affiliated outpatient services. Recommendations for outpatient services include adjuncts to established anonymous self-help group networks in order to reduce changes of relapse.