title: One-year follow-up of disulfiram and psychotherapy for cocaine-alcohol users: sustained effects of treatment.
abstract: OBJECTIVE
  To evaluate outcomes 1 year after cessation of treatment for cocaine- and alcohol-dependent individuals.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Urban substance abuse treatment center.
  
  
  METHODS
  Ninety-six of 122 subjects randomized to treatment.
  
  
  METHODS
  One of five treatments delivered over 12 weeks. Cognitive-behavioral treatment (CBT) plus disulfiram; Twelve-Step facilitation (TSF) plus disulfiram; clinical management (CM) plus disulfiram; CBT without disulfiram; TSF without disulfiram.
  
  
  METHODS
  Percentage of days of cocaine and alcohol use during follow-up, verified by urine toxicology screens and breathalyzer tests.
  
  
  RESULTS
  First, as a group, participants reported significant decreases in frequency of cocaine, but not alcohol, use after the end of treatment. Secondly, the main effects of disulfiram on cocaine and alcohol use were sustained during follow-up. Finally, initiation of abstinence for even brief periods of time within treatment was associated with significantly better outcome during follow-up.
  
  
  CONCLUSIONS
  These findings support the efficacy of disulfiram with this challenging population and suggest that comparatively brief treatments that facilitate the initiation of abstinence may have long-term benefits.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, USA. kathleen.carroll@yale.edu
authors.forename: K M
authors.initials: KM
authors.lastname: Carroll
authors.forename: C
authors.initials: C
authors.lastname: Nich
authors.forename: S A
authors.initials: SA
authors.lastname: Ball
authors.forename: E
authors.initials: E
authors.lastname: McCance
authors.forename: T L
authors.initials: TL
authors.lastname: Frankforter
authors.forename: B J
authors.initials: BJ
authors.lastname: Rounsaville
mesh_terms: D000328:Adult; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D000437:Alcoholism / Q000150:complications / Q000628:therapy*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004221:Disulfiram / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011613:Psychotherapy / Q000379:methods*; D013695:Temperance; D016896:Treatment Outcome
chemical_list: D000427:Alcohol Deterrents; D004221:Disulfiram