Original articleNaltrexone and relapse prevention treatment for cocaine-dependent patients
Section snippets
Participants
Eighty-five men and women between the ages of 18 and 50 years who met current DSM-IV criteria (American Psychiatric Association, 1994) for dependence on cocaine were enrolled in this treatment study after completing an intake evaluation and detoxification program. Potential patients were excluded if they met DSM-IV criteria for current dependence on alcohol or any other psychoactive substance (except nicotine or cannabis), or for past opioid abuse or dependence. Also excluded were patients with
Sociodemographics
Table 1 shows that the four treatment groups did not differ sociodemographically. Overall, the sample was primarily male (72.9%), Black (58.8%), and employed (50.6%). The mean age (±SD) was 34.2 ± 7.1 with 12.8 ± 1.9 years of education. Lifetime (years) and current (last 30 days) cocaine use reported at intake was 8.6 ± 4.8 and 12.4 ± 9.4, respectively. The groups reported similar levels of problem severity as assessed by the ASI subscales.
Retention
Of the 85 randomized participants (intent-to-treat
Discussion
In cocaine-dependent patients, naltrexone appears to interact with the type of therapy received. Participants receiving the combination of naltrexone 50 mg and relapse prevention therapy evidenced significantly fewer cocaine-positive urines than participants receiving other treatment combinations. Predicted differences on secondary outcomes, including retention, quantitative cocaine use, and craving, were not found. Treatment integrity measures suggest that the independent variables of
Acknowledgements
Support for this research was provided by Grant DA-09262-04 from the National Institute on Drug Abuse, and from the Department of Psychiatry and Behavioral Sciences, University of Texas—Houston. Portions of this work were presented at the 62nd Annual Scientific Meeting of the College on Problems of Drug Dependence, Acapulco, Mexico, 1999. The authors would like to acknowledge the dedicated efforts of the staff at the Treatment Research Clinic of the Substance Abuse Medications Development
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