A National 5-Year Follow-up of Treatment Outcomes for Cocaine Dependence

TLDR

Long‑term outcomes of community treatment for cocaine dependence were examined in relation to problem severity at entry and treatment exposure over five years. The study interviewed 708 participants from 45 programs across eight cities at 1‑ and 5‑year follow‑ups, assessing cocaine use and arrests. At five years, 25 % reported weekly cocaine use, 26 % had urine evidence of use, and 18 % had been arrested; poorer outcomes were linked to higher initial severity and lower treatment exposure, while the reductions in use seen at one year were maintained throughout the follow‑up.

Abstract

<h3>Background</h3> Long-term (5-year) outcomes of community treatment for cocaine dependence were examined in relation to problem severity at treatment entry and treatment exposure throughout the follow-up period. <h3>Methods</h3> Interviews were conducted at 1 and 5 years after treatment for 708 subjects(from 45 programs in 8 cities) who met<i>DSM-III-R</i>criteria for cocaine dependence when admitted to treatment in 1991-1993. Primary outcome measures included cocaine use and arrests. Self-reported cocaine use showed high overall agreement with urine (79% agreement) and hair (80% agreement) toxicology analyses. <h3>Results</h3> Weekly cocaine use was reported by 25% of the sample at 5 years, slightly higher than the 21% at 1 year. Similarly, 26% had cocaine detected in urine specimens at follow-up and 18% reported having been arrested. Poorer long-term outcomes were related to higher problem severity at treatment admission and low treatment exposure. <h3>Conclusions</h3> The large decreases in cocaine use 1 year after treatment discharge were sustained during the 5-year follow-up. Severity of drug and psychosocial problems at intake was predictive of long-term outcomes and outcomes improved in direct relation to level of treatment exposure.