Predicting posttreatment cocaine abstinence for first-time admissions and treatment repeaters.
OBJECTIVE
This study examined client and program characteristics that predict posttreatment cocaine abstinence among cocaine abusers with different treatment histories.


METHODS
Cocaine abusers (n = 507) treated in 18 residential programs were interviewed at intake and 1-year follow-up as part of the nationwide Drug Abuse Treatment Outcome Study (DATOS). Program directors provided the program-level data in a mail survey. We applied the hierarchical linear modeling approach for the analysis.


RESULTS
No prior treatment and longer retention in DATOS programs were positive predictors of posttreatment abstinence. The interactive effect of these 2 variables was also significantly positive. Program that offered legal services and included recovering staff increased their clients' likelihood of cocaine abstinence. Crack use at both the client and program level predicted negative impact. None of the program variables assessed differentially affected the outcomes of first-timers and repeaters.


CONCLUSIONS
Although treatment repeaters were relatively difficult to treat, their likelihood of achieving abstinence was similar to that of first-timers if they were retained in treatment for a sufficient time. First-timers and repeaters responded similarly to the treatment program characteristics examined. The treatment and policy implications of these findings are discussed.
Hser
Y I
YI
Neuropsychiatric Institute, University of California, Los Angeles, USA. yhser@ucla.edu
Joshi
V
V
Anglin
M D
MD
Fletcher
B
B
D000328:Adult; D019970:Cocaine-Related Disorders / Q000523:psychology* / Q000628:therapy*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D015397:Program Evaluation; D012008:Recurrence; D012114:Residential Treatment; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome