Although primary treatment is generally effective in initially suppressing cocaine use, most cocaine dependent patients begin to abuse cocaine again relatively quickly after treatment has ended. The relapse process has been extensively studied in alcohol abusers and smokers, but comparatively little is known about the factors that lead to cocaine relapse. This proposal is composed of four studies that systematically investigate the process of cocaine relapse. Study 1 involves the development of a structured interview to assess factors involved in the onset, course, and termination of cocaine relapse episodes. A preliminary version of the interview that has already been developed will be refined through further interviews with cocaine dependent patients who have recently relapsed and the test-retest reliability of the completed interview will be evaluated. In Study 2, the completed Cocaine Relapse Interview will be administered to patients who relapse during a 5 month aftercare treatment program to investigate the factors underlying cocaine relapse during aftercare treatment. The concurrent and predictive validity of the interview will also be evaluated in this study. In Study 3, the interview will be administered to cocaine dependent patients in two samples who relapse during the course of the follow-ups to describe factors involved in relapses that have occurred in the period prior to each follow-up point (6, 12, 18, and 24 months post intake) and to determine whether there are any patterns in relapse factors over time. Further psychometric evaluation of the interview will also be undertaken during this study (i.e., factor analysis to aid in the construction of subscales). Study 4 will determine whether the specific factors implicated in cocaine relapse episodes can be predicted by within-subject variables and environmental stressors encountered by subjects prior to their relapse episodes, such as depression, anxiety, low self-efficacy, interpersonal difficulties, lack of social support, and so forth. In Studies 2-4, additional analyses will also be undertaken to identify factors that differentiate cocaine """"""""relapse"""""""" from """"""""lapse"""""""" episodes. The subjects in Study 1 will be recruited from individuals requesting treatment for cocaine dependence at the Treatment Research Unit. The subjects in Studies 2-4 will be patients who are already participating in two studies that are part of a NIDA Center Grant.
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