Treating cocaine dependence: new challenges for the therapeutic community

The basic treatment principles for addiction are consistent, regardless of whether the drug of choice is alcohol, heroin or cocaine. However, attention to the distinctive characteristics of both a particular class of drugs, such as stimulants, and the populations that use them, gives counselors and programs a distinct advantage in treatment. This advantage is particularly powerful in the early stages of treatment, in which simply increasing the time of retention improves the possibility of a positive outcome. Programs that wish to address the needs of the newer cocaine-abusing population seeking treatment need to focus more on the outpatient phase of treatment. In this model, the residential stage is seen as the launching platform for the recovery process, rather than the time period when the major transformations will occur. The task is to find ways to build structure in the outpatient treatment that is adequate to the changing needs of recovering clients. By so doing, programs will enrich their offerings to their existing components and most likely improve the potential of a long-term successful outcome for everyone.