Simpson, D. D., Joe, G. W., & Broome, K. M. (2002). A national 5-year follow-up of treatment outcomes for cocaine dependence. Archives of General Psychiatry, 59, 538-544.
Abstract: 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.