A behavioral approach to achieving initial cocaine abstinence

Am J Psychiatry. 1991 Sep;148(9):1218-24. doi: 10.1176/ajp.148.9.1218.


Objective: The aim of this study was to assess the efficacy of a behavioral treatment program for achieving initial cocaine abstinence in individuals enrolled in outpatient treatment for cocaine dependence.

Method: Thirteen consecutively admitted outpatients were offered behavioral treatment consisting of contingency management procedures and the community reinforcement approach. Fifteen consecutively admitted outpatients were offered treatment with 12-step counseling. All 13 of the patients who were offered the behavioral treatment accepted it; 12 of the patients offered 12-step counseling accepted it.

Results: Eleven of the 13 patients in the behavioral treatment were retained for 12 weeks of treatment, compared with five of the 12 patients given 12-step counseling. Ten of the patients given behavioral therapy achieved 4 weeks of continuous cocaine abstinence, compared with only three of those given 12-step counseling. Six of the patients in the behavioral treatment group achieved 8 weeks, and three achieved 12 weeks; none of the patients in the 12-step counseling program achieved 8 weeks.

Conclusions: The behavioral treatment described in this paper offers promise as an effective intervention for achieving initial cocaine abstinence. A randomized trial is underway to assess the generality of these findings.

Publication types

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

MeSH terms

  • Adult
  • Ambulatory Care
  • Attitude to Health
  • Behavior Therapy / methods*
  • Cocaine*
  • Counseling
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Male
  • Patient Dropouts
  • Pilot Projects
  • Reinforcement, Psychology
  • Reinforcement, Social
  • Substance-Related Disorders / prevention & control
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*
  • Time Factors


  • Cocaine