One-year follow-up of disulfiram and psychotherapy for cocaine-alcohol users: sustained effects of treatment

Aim. To evaluate outcomes 1 year after cessation of treatment for cocaine‐ and alcohol‐dependent individuals. Design. Randomized controlled trial. Setting. Urban substance abuse treatment center. Participants. Ninety‐six of 122 subjects randomized to treatment. Interventions. One of five treatments...

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Bibliographic Details
Published in:Addiction (Abingdon, England) England), 2000-09, Vol.95 (9), p.1335-1349
Main Authors: Carroll, Kathleen M., Nich, Charla, Ball, Samuel A., McCance, Elinore, Frankforter, Tami L., Rounsaville, Bruce J.
Format: Article
Language:English
Subjects:
Addiction
Adult
Alcohol
Alcohol dependence
Alcohol Deterrents - therapeutic use
Alcoholism
Alcoholism - complications
Alcoholism - therapy
Biological and medical sciences
Cocaine
Cocaine-Related Disorders - complications
Cocaine-Related Disorders - therapy
Cognitive Therapy
Combined Modality Therapy
Dependency rehabilitation
Disulfiram
Disulfiram - therapeutic use
Drug abuse
Drug abusers
Drug addiction
Drug addictions
Female
Follow-Up Studies
Followup studies
Humans
Male
Medical sciences
Medical treatment
Psychology
Psychotherapy
Psychotherapy - methods
Substance abuse treatment
Temperance
Toxicology
Treatment
Treatment Outcome
U.S.A
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Summary:Aim. To evaluate outcomes 1 year after cessation of treatment for cocaine‐ and alcohol‐dependent individuals. Design. Randomized controlled trial. Setting. Urban substance abuse treatment center. Participants. Ninety‐six of 122 subjects randomized to treatment. Interventions. One of five treatments delivered over 12 weeks. Cognitive‐behavioral treatment (CBT) plus disulfiram; Twelve‐Step facilitation (TSF) plus disulfiram; clinical management (CM) plus disulfiram; CBT without disulfiram; TSF without disulfiram. Measurements. Percentage of days of cocaine and alcohol use during follow‐up, verified by urine toxicology screens and breathalyzer tests. Results. First, as a group, participants reported significant decreases in frequency of cocaine, but not alcohol, use after the end of treatment. Secondly, the main effects of disulfiram on cocaine and alcohol use were sustained during follow‐up. Finally, initiation of abstinence for even brief periods of time within treatment was associated with significantly better outcome during follow‐up. Conclusions. These findings support the efficacy of disulfiram with this challenging population and suggest that comparatively brief treatments that facilitate the initiation of abstinence may have long‐term benefits.
ISSN:0965-2140
1360-0443
DOI:10.1046/j.1360-0443.2000.95913355.x