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National Institute on Drug Abuse Collaborative Cocaine Treatment Study

Paul Crits-Christoph, PhD; Lynne Siqueland, PhD; Jack Blaine, MD; Arlene Frank, PhD; Lester Luborsky, PhD; Lisa S. Onken, PhD; Larry R. Muenz, PhD; Michael E. Thase, MD; Roger D. Weiss, MD; David R. Gastfriend, MD; George E. Woody, MD; Jacques P. Barber, PhD; Stephen F. Butler, PhD; Dennis Daley, MSW; Ihsan Salloum, MD; Sarah Bishop, MA; Lisa M. Najavits, PhD; Judy Lis, MSN; Delinda Mercer, PhD; Margaret L. Griffin, PhD; Karla Moras, PhD; Aaron T. Beck, MD

Arch Gen Psychiatry. 1999;56:493-502.

Background  This was a multicenter investigation examining the efficacy of 4 psychosocial treatments for cocaine-dependent patients.

Methods  Four hundred eighty-seven patients were randomly assigned to 1 of 4 manual-guided treatments: individual drug counseling plus group drug counseling (GDC), cognitive therapy plus GDC, supportive-expressive therapy plus GDC, or GDC alone. Treatment was intensive, including 36 possible individual sessions and 24 group sessions for 6 months. Patients were assessed monthly during active treatment and at 9 and 12 months after baseline. Primary outcome measures were the Addiction Severity Index–Drug Use Composite score and the number of days of cocaine use in the past month.

Results  Compared with the 2 psychotherapies and with GDC alone, individual drug counseling plus GDC showed the greatest improvement on the Addiction Severity Index–Drug Use Composite score. Individual group counseling plus GDC was also superior to the 2 psychotherapies on the number of days of cocaine use in the past month. Hypotheses regarding the superiority of psychotherapy to GDC for patients with greater psychiatric severity and the superiority of cognitive therapy plus GDC compared with supportive-expressive therapy plus GDC for patients with antisocial personality traits or external coping style were not confirmed.

Conclusion  Compared with professional psychotherapy, a manual-guided combination of intensive individual drug counseling and GDC has promise for the treatment of cocaine dependence.

A complete list of the members of the National Institute on Drug Abuse Collaborative Cocaine Treatment Study and the affiliations of the authors appears below.

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