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Relationship between intravenous use and achieving initial cocaine abstinence
A J Budney1, S T Higgins, W Bickel
1Department of Psychiatry, University of Vermont, Burlington 05401.
Drug and Alcohol Dependence
|April 1, 1993
Summary
Route of cocaine administration did not significantly impact abstinence duration in outpatient treatment. Both intravenous and intranasal users achieved comparable cocaine abstinence, suggesting outpatient settings can be effective for initial recovery.
Area of Science:
- Addiction research
- Clinical psychology
- Public health
Background:
- Cocaine use disorder is a significant public health issue.
- Understanding factors influencing treatment outcomes is crucial for effective interventions.
- The route of cocaine administration (intravenous vs. intranasal) may impact treatment response.
Purpose of the Study:
- To determine if the route of cocaine administration influences cocaine abstinence during the initial 6 weeks of outpatient treatment.
- To compare abstinence durations between intravenous and intranasal cocaine users in different treatment modalities.
Main Methods:
- A study involving 59 individuals receiving either behavioral treatment or standard drug counseling in an outpatient setting.
- Assessment of demographic and substance use characteristics at intake, differentiating between intravenous and intranasal users.
- Measurement of continuous cocaine abstinence duration over a 6-week treatment period.
Main Results:
- Intravenous users, at intake, reported lower education, less skilled jobs, lower marriage rates, more negative consequences, higher per-occasion use, and greater weekly spending compared to intranasal users.
- No significant difference was found in the average duration of cocaine abstinence between intravenous (2.6 weeks) and intranasal (3.3 weeks) users over 6 weeks.
- In behavioral treatment, abstinence durations were similar (4.2 weeks for both groups). In standard treatment, intravenous users had shorter abstinence (0.9 weeks) than intranasal users (2.4 weeks), though not statistically significant.
- Hepatitis and employment instability were linked to shorter abstinence in intravenous users; employment instability, lower job skill, drug use severity, and memory loss were linked to shorter abstinence in intranasal users.
Conclusions:
- Intravenous cocaine users can achieve initial abstinence in outpatient settings comparable to inpatient treatment durations.
- Outpatient treatment can be effective for initial cocaine abstinence regardless of administration route.
- Specialized outpatient treatment approaches may be necessary to optimize outcomes for intravenous cocaine users.