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Longer Treatment Helps Severe Cocaine Addiction

Reuters Health
Jun 15

The severity of an individual's cocaine addiction and their other life problems should be assessed when decisions are being made about treatment for their addiction, a National Institute on Drug Abuse-sponsored report suggests.

The findings indicate that for patients with moderate to severe problems, a minimum of 3 months of treatment is needed to achieve long-term positive benefits.

In a study of over 1,600 cocaine addicts treated in community-based treatment programs between 1991 and 1993, researchers found that those who underwent a short-term inpatient program were more likely to be using cocaine a year later compared with those who underwent long-term residential treatment.

Dr. D. Dwayne Simpson of Texas Christian University in Fort Worth, and colleagues then looked at a "problem severity index," which took into account other factors, such as multidrug use, alcohol-dependence, criminal activity, unemployment, lack of support from family and friends, and symptoms of depression or anxiety.

They found that 20% of patients with low scores on the problem severity index reported continued cocaine use after treatment, compared with 32% of those with medium or high problem severity.

Further analysis showed that 15% of those with severe problems prior to treatment relapsed to weekly cocaine use after long-term residential treatment (longer than 90 days). Patients with severe problems placed in shorter or nonresidential treatment programs had relapse rates of 38% and 29%, respectively, according to the report.

"The treatment of cocaine dependence... appears to be increasingly effective when delivered in a graduated response to problem severity," the authors conclude.

"Clearly, these findings argue against the efforts that have been made recently to cut back on the length of drug abuse treatment in order to save money," said Dr. Alan I. Leshner, director of the National Institute on Drug Abuse, in a statement.

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