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Am J Psychiatry 1993; 150:763-769
Copyright © 1993 by American Psychiatric Association
Achieving cocaine abstinence with a behavioral approach
ST Higgins, AJ Budney, WK Bickel, JR Hughes, F Foerg and G Badger
Department of Psychiatry, University of Vermont, Burlington 05401.
OBJECTIVE: The authors compared the efficacy of a multicomponent behavioral
treatment and drug abuse counseling for cocaine-dependent individuals.
METHOD: The 38 patients were enrolled in outpatient treatment and were
randomly assigned to the two treatments. Counseling in the behavioral
treatment was based on the community reinforcement approach, while the drug
abuse counseling was based on the disease model of dependence and recovery.
Patients in the behavioral, but not the drug counseling, treatment also
received incentives contingent on submitting cocaine-free urine specimens.
RESULTS: Of the 19 patients who received behavioral treatment, 58%
completed 24 weeks of treatment, versus 11% of the patients who received
counseling. In the behavioral treatment group 68% and 42% of the patients
achieved at least 8 and 16 weeks of documented continuous cocaine
abstinence, respectively, versus 11% and 5% in the drug abuse counseling
group. CONCLUSIONS: This multicomponent behavioral treatment appears to be
an effective intervention for retaining outpatients in treatment and
establishing cocaine abstinence.
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