Outpatient treatment for cocaine abuse: a controlled comparison of relapse prevention and twelve-step approaches

This study sought to assess the efficacy of treatment for cocaine abuse and to compare the relative effectiveness of a cognitive-behavioral relapse prevention treatment with that of a Twelve-Step recovery support group in an outpatient group treatment setting. One hundred ten subjects seeking treatment were alternately assigned to relapse prevention or Twelve-Step treatment. Self-report data were collected at baseline, posttreatment, and 6-month follow-up. There were no differential effects of treatment type on cocaine or marijuana use over time. However, subjects in both treatment conditions reduced cocaine and marijuana use at posttreatment. Subjects in both groups reduced their alcohol use from pretreatment to posttreatment. Subjects receiving Twelve-Step treatment showed greater increases from posttreatment to 6-month follow-up in alcohol use than did relapse prevention participants. Treatment attendance was negatively related to cocaine use at posttreatment and cocaine and marijuana use at 6-month follow-up. Difficulties in conducting cocaine treatment outcome research are discussed as are treatment and research implications of the findings.