A national 5-year follow-up of treatment outcomes for cocaine dependence

Arch Gen Psychiatry. 2002 Jun;59(6):538-44. doi: 10.1001/archpsyc.59.6.538.


Background: Long-term (5-year) outcomes of community treatment for cocaine dependence were examined in relation to problem severity at treatment entry and treatment exposure throughout the follow-up period.

Methods: Interviews were conducted at 1 and 5 years after treatment for 708 subjects (from 45 programs in 8 cities) who met DSM-III-R criteria for cocaine dependence when admitted to treatment in 1991-1993. Primary outcome measures included cocaine use and arrests. Self-reported cocaine use showed high overall agreement with urine (79% agreement) and hair (80% agreement) toxicology analyses.

Results: Weekly cocaine use was reported by 25% of the sample at 5 years, slightly higher than the 21% at 1 year. Similarly, 26% had cocaine detected in urine specimens at follow-up and 18% reported having been arrested. Poorer long-term outcomes were related to higher problem severity at treatment admission and low treatment exposure.

Conclusions: The large decreases in cocaine use 1 year after treatment discharge were sustained during the 5-year follow-up. Severity of drug and psychosocial problems at intake was predictive of long-term outcomes and outcomes improved in direct relation to level of treatment exposure.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cocaine-Related Disorders / diagnosis
  • Cocaine-Related Disorders / psychology
  • Cocaine-Related Disorders / therapy*
  • Cognitive Behavioral Therapy
  • Crime / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Outcome Assessment, Health Care
  • Psychiatric Status Rating Scales
  • Psychotherapy
  • Residential Treatment
  • Severity of Illness Index
  • Social Control, Formal
  • Substance Abuse Detection
  • Substance Abuse Treatment Centers / statistics & numerical data
  • Therapeutic Community
  • Treatment Outcome
  • United States