title: Factors in sustained recovery from cocaine dependence.
abstract: The goal was to identify factors that predicted sustained cocaine abstinence and transitions from cocaine use to abstinence over 24 months. Data from baseline assessments and multiple follow-ups were obtained from three studies of continuing care for patients in intensive outpatient programs (IOPs). In the combined sample, remaining cocaine abstinent and transitioning into abstinence at the next follow-up were predicted by older age, less education, and less cocaine and alcohol use at baseline, and by higher self-efficacy, commitment to abstinence, better social support, lower depression, and lower scores on other problem severity measures assessed during the follow-up. In addition, higher self-help participation, self-help beliefs, readiness to change, and coping assessed during the follow-up predicted transitions from cocaine use to abstinence. These results were stable over 24 months. Commitment to abstinence, self-help behaviors and beliefs, and self-efficacy contributed independently to the prediction of cocaine use transitions. Implications for treatment are discussed.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA. jimrache@mail.med.upenn.edu
authors.forename: James R
authors.initials: JR
authors.lastname: McKay
authors.forename: Deborah
authors.initials: D
authors.lastname: Van Horn
authors.forename: Lior
authors.initials: L
authors.lastname: Rennert
authors.forename: Michelle
authors.initials: M
authors.lastname: Drapkin
authors.forename: Megan
authors.initials: M
authors.lastname: Ivey
authors.forename: Janelle
authors.initials: J
authors.lastname: Koppenhaver
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology; D000553:Ambulatory Care / Q000379:methods*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D020377:Self Efficacy; D012657:Self-Help Groups / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
references.citation: Am J Public Health. 1999 May;89(5):666-71
references.pmid: 10224976
references.citation: Addict Behav. 2008 Dec;33(12):1581-9
references.pmid: 18790574
references.citation: Arch Gen Psychiatry. 1994 Mar;51(3):177-87
references.pmid: 8122955
references.citation: J Addict Dis. 2009 Jul;28(3):250-7
references.pmid: 20155594
references.citation: Drug Alcohol Depend. 2011 Apr 1;114(2-3):225-8
references.pmid: 21041041
references.citation: Drug Alcohol Depend. 2011 Mar 1;114(1):41-8
references.pmid: 20970927
references.citation: J Consult Clin Psychol. 1991 Aug;59(4):526-32
references.pmid: 1918556
references.citation: J Subst Abuse Treat. 2005;28 Suppl 1:S63-72
references.pmid: 15797640
references.citation: J Stud Alcohol. 1997 Jan;58(1):7-29
references.pmid: 8979210
references.citation: Am J Community Psychol. 1983 Feb;11(1):1-24
references.pmid: 6837532
references.citation: Am J Drug Alcohol Abuse. 2007;33(2):191-206
references.pmid: 17497542
references.citation: Addiction. 1996 Dec;91 Suppl:S155-72
references.pmid: 8997790
references.citation: J Consult Clin Psychol. 2013 Dec;81(6):1063-73
references.pmid: 24041231
references.citation: J Stud Alcohol. 2003 Nov;64(6):862-73
references.pmid: 14743951
references.citation: J Consult Clin Psychol. 1979 Feb;47(1):106-12
references.pmid: 429642
references.citation: J Consult Clin Psychol. 2004 Dec;72(6):967-79
references.pmid: 15612844
references.citation: J Subst Abuse Treat. 2005;28 Suppl 1:S51-62
references.pmid: 15797639
references.citation: J Nerv Ment Dis. 1980 Jan;168(1):26-33
references.pmid: 7351540
references.citation: Addict Behav. 2002 Mar-Apr;27(2):251-60
references.pmid: 11817766
references.citation: Alcohol Clin Exp Res. 1993 Oct;17(5):1078-83
references.pmid: 8279669
references.citation: Br J Addict. 1988 Apr;83(4):393-402
references.pmid: 3395719
references.citation: Alcohol Res Health. 2006;29(1):55-62
references.pmid: 16767855
references.citation: J Consult Clin Psychol. 1998 Aug;66(4):691-6
references.pmid: 9735588
references.citation: J Consult Clin Psychol. 2004 Feb;72(1):81-90
references.pmid: 14756617
references.citation: Am Psychol. 2004 May-Jun;59(4):224-35
references.pmid: 15149263
references.citation: Drug Alcohol Depend. 1997 Jun 6;46(1-2):79-85
references.pmid: 9246555
references.citation: J Pers Soc Psychol. 1986 May;50(5):992-1003
references.pmid: 3712234
references.citation: Addiction. 1995 May;90(5):699-710
references.pmid: 7795506
references.citation: Drug Alcohol Depend. 2007 May;88 Suppl 2:S24-30
references.pmid: 17056207
references.citation: Drug Alcohol Depend. 2002 Sep 1;68(1):35-48
references.pmid: 12167551
references.citation: J Stud Alcohol Drugs. 2007 Sep;68(5):641-8
references.pmid: 17690796
references.citation: Am J Addict. 2002 Winter;11(1):24-40
references.pmid: 11876581
references.citation: Exp Clin Psychopharmacol. 2000 Aug;8(3):377-86
references.pmid: 10975629
references.citation: J Subst Abuse Treat. 2005;28 Suppl 1:S73-82
references.pmid: 15797641
references.citation: J Clin Psychol. 1991 Mar;47(2):310-5
references.pmid: 2030139
references.citation: Arch Gen Psychiatry. 1998 Mar;55(3):259-65
references.pmid: 9510220
references.citation: J Nerv Ment Dis. 1993 Feb;181(2):71-9
references.pmid: 8426174
references.citation: Behav Res Ther. 1979;17(2):157-60
references.pmid: 426744
references.citation: Drug Alcohol Depend. 2006 Feb 28;81(3):313-22
references.pmid: 16171953
references.citation: Addict Sci Clin Pract. 2007 Dec;4(1):45-55
references.pmid: 18292710
references.citation: Arch Gen Psychiatry. 1999 Jun;56(6):507-14
references.pmid: 10359464
references.citation: Am J Psychiatry. 2003 Jul;160(7):1320-5
references.pmid: 12832248
references.citation: Am J Psychiatry. 1994 Feb;151(2):254-9
references.pmid: 8296899
references.citation: Eval Rev. 2001 Apr;25(2):113-61
references.pmid: 11317714
references.citation: Addiction. 1996 Dec;91 Suppl:S173-89
references.pmid: 8997791
references.citation: J Stud Alcohol. 1996 Jan;57(1):65-72
references.pmid: 8747503
references.citation: Psychol Addict Behav. 2008 Dec;22(4):557-62
references.pmid: 19071981
references.citation: J Consult Clin Psychol. 1997 Oct;65(5):778-88
references.pmid: 9337497
references.citation: Addict Behav. 2006 Nov;31(11):1974-87
references.pmid: 16503094
references.citation: Addiction. 2001 Feb;96(2):213-25
references.pmid: 11182866
references.citation: J Subst Abuse Treat. 2009 Apr;36(3):321-30
references.pmid: 18835677
references.citation: J Consult Clin Psychol. 1995 Apr;63(2):296-307
references.pmid: 7751491
references.citation: J Subst Abuse Treat. 2006 Apr;30(3):219-26
references.pmid: 16616166
references.citation: J Consult Clin Psychol. 1988 Aug;56(4):520-8
references.pmid: 3198809
references.citation: J Consult Clin Psychol. 1994 Aug;62(4):843-50
references.pmid: 7962889
references.citation: J Consult Clin Psychol. 1999 Jun;67(3):420-7
references.pmid: 10369063
references.citation: J Consult Clin Psychol. 2007 Feb;75(1):95-103
references.pmid: 17295568
references.citation: J Nerv Ment Dis. 1985 Jul;173(7):412-23
references.pmid: 4009158
references.citation: Am J Addict. 2009 Jan-Feb;18(1):81-6
references.pmid: 19219669
references.citation: J Consult Clin Psychol. 2009 Aug;77(4):633-44
references.pmid: 19634957
references.citation: Drug Alcohol Depend. 2007 Jan 5;86(1):1-21
references.pmid: 16759822
references.citation: Psychol Addict Behav. 2011 Sep;25(3):426-38
references.pmid: 21480681
references.citation: J Consult Clin Psychol. 2010 Dec;78(6):912-23
references.pmid: 20873894
references.citation: Arch Gen Psychiatry. 2002 Jun;59(6):538-44
references.pmid: 12044196
references.citation: Arch Gen Psychiatry. 2005 Feb;62(2):199-207
references.pmid: 15699297
references.citation: Psychol Addict Behav. 2008 Jun;22(2):157-67
references.pmid: 18540713