Factors in sustained recovery from cocaine dependence

Abstract

The goal was to identify factors that predicted sustained cocaine abstinence and transitions from cocaine use to abstinence over 24 months. Data from baseline assessments and multiple follow-ups were obtained from three studies of continuing care for patients in intensive outpatient programs (IOPs). In the combined sample, remaining cocaine abstinent and transitioning into abstinence at the next follow-up were predicted by older age, less education, and less cocaine and alcohol use at baseline, and by higher self-efficacy, commitment to abstinence, better social support, lower depression, and lower scores on other problem severity measures assessed during the follow-up. In addition, higher self-help participation, self-help beliefs, readiness to change, and coping assessed during the follow-up predicted transitions from cocaine use to abstinence. These results were stable over 24 months. Commitment to abstinence, self-help behaviors and beliefs, and self-efficacy contributed independently to the prediction of cocaine use transitions. Implications for treatment are discussed.

Published by Elsevier Inc.

Figures

Figure 1

Results of transition analyses with six time-varying predictor variables from Self-Help and Cognitive Behavioral/Motivational domains. Graphs show the probability of transitioning into a cocaine abstinent state at the subsequent follow-up (from 0.00 to 1.00), as a function of scores on the predictor variable and cocaine use state at the prior follow-up (e.g., cocaine abstinent or using cocaine). See text for a description of the scales for each predictor variable.

Figure 2

Results of transition analyses with six time-varying predictor variables from Social Support and Stress domains. Graphs show the probability of transitioning into a cocaine abstinent state at the subsequent follow-up (from 0.00 to 1.00), as a function of scores on the predictor variable and cocaine use state at the prior follow-up (e.g., cocaine abstinent or using cocaine). See text for a description of the scales for each predictor variable. Results for Medical and Employment Problem Severities not shown.