Cognitive-behavioral therapy plus contingency management for cocaine use: findings during treatment and across 12-month follow-up.
Contingency management (CM) rapidly reduces cocaine use, but its effects subside after treatment. Cognitive-behavioral therapy (CBT) produces reductions months after treatment. Combined, the 2 might be complementary. One hundred ninety-three cocaine-using methadone-maintained outpatients were randomly assigned to 12 weeks of group therapy (CBT or a control condition) and voucher availability (CM contingent on cocaine-negative urine or noncontingent). Follow-ups occurred 3, 6, and 12 months posttreatment. Primary outcome was cocaine-negative urine (urinalysis 3 times/week during treatment and once at each follow-up). During treatment, initial effects of CM were dampened by CBT. Posttreatment, there were signs of additive benefits, significant in 3- versus 12-month contrasts. Former CBT participants were also more likely to acknowledge cocaine use and its effects and to report employment.
Epstein
David H
DH
Clinical Pharmacology and Therapeutics Branch, National Institute on Drug Abuse, Intramural Research Program Treatment Section, Baltimore, Maryland 21224, USA. depstein@intra.nida.nih.gov
Hawkins
Wesley E
WE
Covi
Lino
L
Umbricht
Annie
A
Preston
Kenzie L
KL
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000704:Analysis of Variance; D015142:Baltimore; D001521:Behavior Therapy / Q000379:methods*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy; D011615:Psychotherapy, Group / Q000379:methods; D012044:Regression Analysis; D014040:Token Economy
D000701:Analgesics, Opioid; D008691:Methadone