Treatment of cocaine and alcohol dependence with psychotherapy and disulfiram

Autor:	Kathleen M. Carroll, Elinore McCance, Samuel A. Ball, Charla Nich, Bruce J. Rounsavile
Rok vydání:	1998
Předmět:	Adult Male medicine.medical_specialty business.product_category Psychotherapist Substance-Related Disorders media_common.quotation_subject Medicine (miscellaneous) Alcohol abuse Cocaine dependence law.invention Randomized controlled trial Cocaine law Disulfiram medicine Humans Psychiatry media_common Breathalyzer Cognitive Behavioral Therapy Alcohol dependence Abstinence medicine.disease Combined Modality Therapy Psychiatry and Mental health Alcoholism Supportive psychotherapy Female business Psychology medicine.drug Alcohol Deterrents
Zdroj:	Addiction (Abingdon, England). 93(5)
ISSN:	0965-2140
Popis:	Aims. To evaluate disulfiram and three forms of manual guided psychotherapy for individuals with cocaine dependence and concurrent alcohol abuse or dependence. Design. Randomized controlled trial. Setting. Urban substance abuse treatment center. Participants. One hundred and twenty-two cocaine/alcohol abusers (27% female; 61% African-American or Hispanic). Interventions. One of five treatments delivered over 12 weeks: cognitive behavioral treatment (CBT) plus disulfiram; Twelve Step facilitation (TSF) plus disulfiram; clinical management (CM) plus disulfiram; CBT plus no medication; TSF plus no medication. Measurements. Duration of continuous abstinence from cocaine or alcohol; frequency and quantity of cocaine and alcohol use by week, verified by urine toxicology and breathalyzer screens. Findings. Disulfiram treatment was associated with significantly better retention in treatment, as well as longer duration of abstinence from alcohol and cocaine use. The two active psychotherapies (CBT and TSF) were associated with reduced cocaine use over time compared with supportive psychotherapy (CM). Cocaine and alcohol use were strongly related throughout treatment, particularly for subjects treated with disulfiram. Conclusions. For the large proportion of cocaine-dependent individuals who also abuse alcohol, disulfiram combined with outpatient psychotherapy may be a promising treatment strategy. This study underlines (a) the significance of alcohol use among treatment-seeking cocaine abusers, (b) the promise of the strategy of treating co-morbid disorders among drug-dependent individuals, and (c) the importance of combining psychotherapy and pharmacotherapy in the treatment of drug use disorders.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2e48ca249617650e051b2ac7851e2abc https://pubmed.ncbi.nlm.nih.gov/9692270 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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