Who benefits from extended continuing care for cocaine dependence?
Open accessAbstract
The goal of this study was to determine which cocaine dependent patients engaged in an intensive outpatient program (IOP) were most likely to benefit from extended continuing care (24 months). Participants (N=321) were randomized to: IOP treatment as usual (TAU), TAU plus Telephone Monitoring and Counseling (TMC), or TAU plus TMC plus incentives for session attendance (TMC+). Potential moderators examined were gender, stay in a controlled environment prior to IOP, number of prior drug treatments, and seven measures of progress toward IOP goals. Outcomes were: (1) abstinence from all drugs and heavy alcohol use, and (2) cocaine urine toxicology. Follow-ups were conducted at 3, 6, 9, 12, 18, and 24 months post-baseline. Results indicated that there were significant effects favoring TMC+ over TAU on the cocaine urine toxicology outcome for participants in a controlled environment prior to IOP and for those with no days of depression early in IOP. Trends were obtained favoring TMC over TAU for those in a controlled environment (cocaine urine toxicology outcome) or with high family/social problem severity (abstinence composite outcome), and TMC+ over TAU for those with high family/social problem severity or high self-efficacy (cocaine urine toxicology outcome). None of the other potential moderator effects examined reached the level of a trend. These results generally do not suggest that patients with greater problem severity or poorer performance early in treatment on the measures considered in this report will benefit to a greater degree from extended continuing care.
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- Authors
- McKay, J. R., Van Horn, D. H. A., Lynch, K. G., Ivey, M., Cary, M. S., Drapkin, M., & Coviello, D.
- Affiliations
- Philadelphia VA Medical Center (US)
- University of Pennsylvania (US)
- Corresponding author
- McKay, James R.
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 39
- Issue
- 3
- Pages
- 660-668
- ISSN
- 0306-4603 (ISSN-L)
- PMC
- PMC3925615
- OpenAlex
- W2007120629
- Cited by
- 26
- References
- 27
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K24DA029062, R01DA020623, K02DA000361)
- National Institute of Allergy and Infectious Diseases (P30AI045008)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cocaine dependence, intensive outpatient treatment, abstinence, alcohol consumption, treatment moderators, self-efficacy, depression
- MeSH terms
- Adult, Ambulatory Care, Cocaine, Counseling, Female, Humans, Long-Term Care, Male, Middle Aged, Motivation, Patient Compliance, Psychotherapy, Group, Recurrence, Telephone, Substance Abuse Detection, Treatment Outcome, Cocaine-Related Disorders
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