Factors accounting for cocaine use two years following initiation of continuing care

Autor:	Frank D. Mulvaney, Elizabeth Merikle, Janelle M. Koppenhaver, James R. McKay, Richard V. Weiss
Rok vydání:	2001
Předmět:	Adult Counseling Employment Male medicine.medical_specialty media_common.quotation_subject Psychological intervention Medicine (miscellaneous) Relapse prevention law.invention Cocaine-Related Disorders Social support Randomized controlled trial Recurrence law medicine Humans Psychiatry Veterans media_common Motivation Addiction Attendance Social Support Abstinence Prognosis Self Efficacy United States Psychiatry and Mental health Mood Multivariate Analysis Substance Abuse Treatment Centers Psychology Follow-Up Studies
Zdroj:	Addiction. 96:213-225
ISSN:	0965-2140
DOI:	10.1046/j.1360-0443.2001.9622134.x
Popis:	Aims To examine the relationship between various interpersonal, intrapersonal and situational factors assessed at 6, 12 and 18 months after entrance to continuing care, and cocaine use in subsequent periods. Design A randomized clinical trial with a 2-year follow-up. Setting An outpatient US Veterans Administration substance abuse treatment program. Participants Cocaine-dependent male veterans (N = 132) entering continuing care. Interventions 12-Step focused group treatment vs. individualized relapse prevention continuing care. Measurements Motivation, coping and mood, social support, co-morbid problem severity, treatment attendance, self-help participation and cocaine use variables were assessed at each follow-up. Findings During the 2-year follow-up, patients used cocaine on fewer than 8% of the days in each of the four 6-month periods, which represented a highly significant decrease in relation to cocaine use prior to treatment. In univariate analyses, abstinence commitment, self-efficacy, positive mood, support from family, employment, attendance in continuing care and self-help participation at two or more of the follow-ups predicted less cocaine use in subsequent 6-months periods. Readiness to change and medical, psychiatric, legal and family/social problem severities either did not predict, or were inconsistently related to, subsequent cocaine use. In multivariate analyses, degree of self-help participation emerged as the strongest and most consistent predictor of cocaine use. However, when current cocaine use at each follow-up was controlled, none of the predictors was significant at more than one follow-up point. There was little evidence of interactions between treatment condition and the predictor variables. Conclusions Continued self-help participation and the early achievement of cocaine abstinence appear to be important factors in the maintenance of good cocaine use outcomes over extended periods. The results also highlight the importance of controlling for various post-treatment factors when evaluating the relationship between any one factor and subsequent outcome, as many of the factors that were significant predictors in the univariate analyses were no longer significant when other factors were controlled.
Databáze:	OpenAIRE
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