One-year follow-up of disulfiram and psychotherapy for cocaine-alcohol users: sustained effects of treatment.
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.
Carroll
K M
KM
Department of Psychiatry, Yale University School of Medicine, USA. kathleen.carroll@yale.edu
Nich
C
C
Ball
S A
SA
McCance
E
E
Frankforter
T L
TL
Rounsaville
B J
BJ
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
D000427:Alcohol Deterrents; D004221:Disulfiram