A national 5-year follow-up of treatment outcomes for cocaine dependence.
BACKGROUND
Long-term (5-year) outcomes of community treatment for cocaine dependence were examined in relation to problem severity at treatment entry and treatment exposure throughout the follow-up period.


METHODS
Interviews were conducted at 1 and 5 years after treatment for 708 subjects (from 45 programs in 8 cities) who met DSM-III-R criteria for cocaine dependence when admitted to treatment in 1991-1993. Primary outcome measures included cocaine use and arrests. Self-reported cocaine use showed high overall agreement with urine (79% agreement) and hair (80% agreement) toxicology analyses.


RESULTS
Weekly cocaine use was reported by 25% of the sample at 5 years, slightly higher than the 21% at 1 year. Similarly, 26% had cocaine detected in urine specimens at follow-up and 18% reported having been arrested. Poorer long-term outcomes were related to higher problem severity at treatment admission and low treatment exposure.


CONCLUSIONS
The large decreases in cocaine use 1 year after treatment discharge were sustained during the 5-year follow-up. Severity of drug and psychosocial problems at intake was predictive of long-term outcomes and outcomes improved in direct relation to level of treatment exposure.
Simpson
D Dwayne
DD
Institute of Behavioral Research, Texas Christian University, Box 298740, Fort Worth, TX 76129, USA. ibr@tcu.edu
Joe
George W
GW
Broome
Kirk M
KM
D000328:Adult; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003415:Crime / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012114:Residential Treatment; D012720:Severity of Illness Index; D012926:Social Control, Formal; D015813:Substance Abuse Detection; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D013808:Therapeutic Community; D016896:Treatment Outcome; D014481:United States