Although the studies that have been conducted so far in therapeutic CM (i.e., studies that employ CM in a clinical setting to prevent relapse of drug-use problems) represent a small percentage of published studies, the results are promising and emphasize that additional research is needed. Implications for future directions of CM research are outlined.
These data suggest that a variety of approaches may prove to be effective, including (a) a combination of behavioral, social, and pharmacological interventions; (b) short-term medical detoxification in conjunction with behavioral treatment; and (c) 12-step based (CUD) self-help groups that focus on relapse prevention. Effective recovery methods need to be developed in order to maximize the outcomes for people with CUDs.
About 25,000 Americans experience cocaine use during a year. Cocaine use disorders were more common in blacks than in whites and among people from low socioeconomic backgrounds and adolescents.
Treatment for cocaine-dependent individuals with a short-term inpatient treatment programme is associated with significant positive outcomes at 3 yr follow-up, with no clinically significant treatment effects on major substance use or health-related problems, as defined by a range of objective measures in clinical and experimental studies.
Cocaine UDs are highly prevalent in the United States and Canada, with cocaine use prevalence higher in men than in women and among minorities. The U.S. and Canadian cocaine UDs prevalence rates are higher than national studies in other countries, and higher than cocaine use rates reported at the state and city level.
Drugs that cause physical dependence or sensitization to cocaine or that prevent its detoxication also lead to cocaine addiction. However, this depends on both the drug used as well as its rate of elimination. The same thing applies to the effectiveness of drugs used to prevent cocaine use in the future. It is still unclear why some individuals get physically dependent or why not, but this depends on their hereditary and environmental factors as well as their current drug use.
Cocaine-dependent patients use cocaine more in the presence of interpersonal cues, and the intensity of craving increases with the degree of craving experienced by the subjects. The amount of cocaine use also increases when cocaine use occurs in the presence of interpersonal cues. Cues do not affect the onset or intensity of cocaine use in the absence of interpersonal cues. The presence of interpersonal cues and the level of cocaine use can determine the degree in which a cue will induce relapse.
There is a bimodal prevalence pattern of cocaine dependence in a large sample of adolescents, with an earlier start in the younger (12 or 13 years) and older (15 or 16 years) group. This pattern of cocaine use disorders among adolescence is consistent with the hypothesis that there may be a biologically distinct sub-populations of adolescent cocaine users that experience early onset of use, late onset of use, or do not show any progression to dependence during adolescence.
Both self-monitoring and behavioral goals improve abstinence for the entire 12-week sample. All patients who received contingency management therapy, regardless of type of goal, did significantly better than those who received only care planning and counseling.
Serious complications may occur from cocaine use disorders. A high frequency of comorbidity, socioeconomic status, and medical management all affect outcome of cocaine use disorders.
Using a small amount of money for every dose of medication delivered to the body is an effective and efficient means for drug addicts to maintain drug abstinence. A recent, short-term, randomized, placebo-controlled study investigated the effectiveness of contingency management for cocaine addicts. The study design consisted of two 12-week assessments of abstinence outcomes, with follow up examinations occurring at week 48. Participants who participated in the contingency management treatment (CMT) group were encouraged to enter a 1-hour counseling session every 3 weeks in which they received their money. CMT participants also received a 1-hour, motivational, counseling session 3 times a week for 2 weeks before the beginning of the experiment.
Recent findings found a relationship between CM and improved QOL in those with cocaine use disorders and provides support for the use of CM with those who use cocaine to help improve their mental health.