Changes concurrent with initiation of abstinence from cocaine abuse

In an exploration of changes that occur with initiation of cocaine abstinence, this study examined treatment outcomes in four domains--behavior (cocaine use), affect (depression), cognition (schematic self-representations), and psychophysiology (reactivity to drug cues). Nineteen patients initially entered this 8-week outpatient psychopharmacotherapy trial for the treatment of cocaine dependence. Thirteen completed treatment, and eleven maintained abstinence during the last four weeks of the study. In addition to a demonstrated change in their cocaine-using behavior, these "abstainers" reported reduced depression, increased congruency with "ideal" self-schemas, increased discrepancy with "addict" self-schemas, and generally more positive self-representations. In addition, "abstainers" reported reduced posttreatment craving in the presence of cocaine cues, but evidenced no change in physiological reactivity. Implications of these findings for research and treatment are discussed.