A general hospital day program combining peer-led and professional treatment of cocaine abusers.
OBJECTIVE
Cocaine abuse, particularly in crack form, is highly prevalent among patients with severe socioeconomic disadvantages who are treated in municipal general hospitals. The authors describe and evaluate a day treatment program for 30 such patients that combines peer-led self-help and professional care provided by a general hospital psychiatric service.


METHODS
Treatment outcomes at one year for 92 patients referred to the day program from the hospital's psychiatric services and 58 perinatal patients referred from the obstetric services were examined using chi square and regression analyses to determine whether certain variables, especially referral source, were related to outcome. An acceptable treatment outcome was defined as three successive negative urinalyses before termination or at the end of one year of treatment.


RESULTS
Almost all the patients were unemployed members of ethnic minorities, and most abused at least one substance in addition to cocaine. The 150 patients attended the program an average of 44 times during the year, and 39 percent had an acceptable treatment outcome. Patients referred from psychiatric services had a better outcome than perinatal patients.


CONCLUSIONS
Peer-led milieu treatment and professional services can be combined in the general hospital to provide intensive ambulatory care for socioeconomically disadvantaged substance abusers. Techniques and services for engaging perinatal patients in treatment should be developed.
Galanter
M
M
Division of Alcoholism and Drug Abuse, New York University School of Medicine, New York 10016.
Egelko
S
S
De Leon
G
G
Rohrs
C
C
D000328:Adult; D003042:Cocaine; D003631:Day Care, Medical / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006746:Hospital Bed Capacity, 500 and over; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009519:New York City; D010348:Patient Care Team / Q000458:organization & administration*; D010349:Patient Compliance; D010379:Peer Group; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012657:Self-Help Groups; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
D003042:Cocaine