Cocaine Treatment

Three cognitive/behavioral approaches--relapse prevention, community reinforcement/contingency management, and neurobehavioral therapy--have shown positive results in the treatment of cocaine addiction. Preliminary findings show that clients treated with these therapies remained abstinent and in treatment for long periods. These findings are particularly encouraging because initial treatments used during the early 1980s were not very successful. Although too few studies have been done to draw definite conclusions about the utility of any of these treatments, more research should be completed within the next several years. Research experts agree that continued research and study are needed to enhance and confirm--or deny--these early results.

GAO found that: (1) cocaine treatment research is still in its early stages; (2) preliminary study results have shown that relapse prevention, community reinforcement and contingency management, and neurobehavioral therapy may produce prolonged periods of abstinence among cocaine users; (3) relapse prevention programs have the highest abstinence rates, followed by community reinforcement and neurobehavioral programs; (4) community reinforcement programs have the highest retention rates, followed by relapse prevention and neurobehavioral programs; (5) pharmacological agents have not proven to be consistently effective in preventing cocaine use, and none have been submitted for Food and Drug Administration approval; (6) animal researchers have demonstrated the positive effects of a new immunization procedure in blocking the stimulant effects of cocaine; (7) few researchers have assessed the effectiveness of acupuncture treatment, but some research findings are favorable; and (8) experts believe that more rigorous treatment evaluation studies that focus on important treatment components, appropriate treatment intensities and durations, and clients' readiness and motivation for treatment are needed before standard cocaine treatment protocols can be formulated.