Treating cocaine-using methadone patients: predictors of outcomes in a psychosocial clinical trial.
Cocaine-using methadone patients in two clinics were assigned to 8 months of enhanced methadone treatment-primarily cognitive-behavioral therapy (CBT) for cocaine use-while similar patients in two "sibling" clinics were assigned to standard methadone treatment during 1995-1998. Cocaine use declined significantly from baseline to 4- and 12-month follow-ups. Patients receiving CBT rated the quality of their counseling relationship higher and obtained more supportive services than those receiving standard treatment. However, study treatment condition itself was not associated with outcome. Baseline measures associated with poorer outcomes across both treatment conditions were: currently enrolled in methadone treatment (in contrast to being newly enrolled), higher cocaine use frequency, greater cocaine use associated problem recognition, and an ambivalent attitude toward methadone. The results are consistent with some previous clinical trials showing that psychosocial treatments of different intensities result in similar declines in cocaine use. The findings indicate that methadone maintenance treatment can help dually-addicted patients reduce their cocaine use.
Magura
Stephen
S
Institute for Treatment and Services Research at National Development and Research Institutes, Inc., 71 West 23rd St., 8th Floor, New York, NY 10010, USA.
Rosenblum
Andrew
A
Fong
Chunki
C
Villano
Cherie
C
Richman
Beverly
B
D000328:Adult; D019970:Cocaine-Related Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009518:New York; D010349:Patient Compliance; D011615:Psychotherapy, Group; D013223:Statistics as Topic; D016320:Substance Abuse Treatment Centers; D013997:Time Factors; D016896:Treatment Outcome
D008691:Methadone