The purpose of this application is to serve as a Collaborative Treatment Site for the NIDA Collaborative Study to compare three forms of psychosocial treatment in ambulatory cocaine abusers: 1) Supportive-expressive psychotherapy, 2) Cognitive-behavioral psychotherapy, and 3) Drug counseling. Patients will be randomized to one of these three forms of therapy in addition to receiving standard drug counseling. The interaction between patient characteristics (e.g., sociodemographic characteristics, substance use history, psychiatric status), type of therapy, and treatment outcome will also be addressed. In addition to this major study, a substudy will be performed to characterize more clearly the process of relapse and recovery in cocaine abusers. The substudy will examine three specific dimensions of this process by addressing the following questions. 1. What abstinence symptoms do patients experience after stopping cocaine use? Are abstinence symptoms similar in inpatients and outpatients? 2. Does the degree of motivation for treatment correlate with treatment retention and/or outcome? What is the interaction between motivation, specific forms of therapy, and treatment outcome? 3. What is the nature of self-help group activities in which cocaine abusers participate? Does the frequency of attendance and/or degree of participation correlate with overall treatment outcome? Patients seeking treatment for cocaine use disorders at the outpatient program of the Alcohol and Drug Abuse Treatment Center of McLean Hospital and the Chemical Dependence Unit (West End Group Practice) of the Massachusetts General Hospital will be recruited for this study. Subjects will receive (a) drug counseling, and (b) one of the three aforementioned forms of psychotherapy, to which they will be randomly assigned. Study subjects will periodically be interviewed and complete questionnaires to monitor their progress, cocaine abstinence symptoms, motivation and attitude toward treatment, and participation in self-help activities. Urine toxicological screens and breathalyzer tests will also be performed to monitor drug and alcohol use. This study aims to study the efficacy of these three commonly used forms of therapy in the treatment of patients with cocaine use disorders.
| Najavits, Lisa M; Harned, Melanie S; Gallop, Robert J et al. (2007) Six-month treatment outcomes of cocaine-dependent patients with and without PTSD in a multisite national trial. J Stud Alcohol Drugs 68:353-61 |
| Najavits, Lisa M; Runkel, Ragna; Neuner, Christina et al. (2003) Rates and symptoms of PTSD among cocaine-dependent patients. J Stud Alcohol 64:601-6 |
| Najavits, L M; Crits-Christoph, P; Dierberger, A (2000) Clinicians' impact on the quality of substance use disorder treatment. Subst Use Misuse 35:2161-90 |
