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Psychosocial Treatments for Cocaine Dependence
Rethinking Lessons Learned
Arch Gen Psychiatry. 1999;56:503-504.
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THIS ISSUE of the ARCHIVES reports results from a multisite study testing the relative efficacy of different forms of nonpharmacologic treatments for cocaine dependence.1 This is a great study—it naturally builds on results from similar studies with opioid-dependent patients, hypotheses are clearly defined, important control groups are included, the sample size is large, training of therapists was careful and thorough, and analyses are state of the art. There are no fatal flaws in the work, and one would expect results similar to those found in earlier studies of opioid-dependent patients. They are not—and therein lies the opportunity to rethink lessons learned.
First, it is useful to place the current study in context. An investigation on the efficacy of psychotherapy in methadone-maintained patients conducted in the early 1980s randomly assigned patients to receive supportive-expressive psychotherapy, cognitive-behavioral psychotherapy, or routine drug counseling.2 Patients in psychotherapy groups had better outcomes than patients who . . . [Full Text of this Article]
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