Two psychosocial treatments and three drug treatments for cocaine dependence will be compared in a random assignment study, over a four week treatment period. The psychosocial treatments compared will be a one month 15 hour a week day hospital or a six hours, three times a week outpatient program. The drug conditions will be 300 mg daily of amantadine hydrochloride, 300 mg. daily of placebo, or a nonmedication condition. The drug trial will be conducted double blind. Two hundred and forty (240) cocaine dependent men will be studied, 40 in each of the six treatment conditions. Subjects will be followed over a two year period. One half of the subjects will be followed every two months during the first year and every three months in the second year; while the remaining subjects will be followed every six months for two years. A baseline assessment battery will measure psychopathology, risk for AIDS behavior, cocaine and alcohol use, substance abuse related problems, social support, abstinence commitment, moods, and self efficacy. Some of these measures will also be re-evaluated during some of the followup evaluations. Costs during the two year study period will also be ascertained. In study years 3, 4, and 5 promising drugs will be studied in double blind, placebo controlled fashion. This study will provide critical information concerning the efficacy and cost effectiveness of two forms of psychosocial treatment for cocaine dependence. It will also yield important information about the effectiveness of amantadine hydrochloride under two levels of psychosocial treatment. Subsequent drug trials will benefit from the study findings by being able to use the minimal psychosocial treatment found to be effective in the initial study. The study will provide important detailed information about the course of response to treatment for cocaine dependence over a two year followup period. Predictors of favorable treatment response will also be ascertained.
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