Treatment dropout in cocaine addicts

Authors

  • Emilio Sánchez-Hervás UCA Catarroja. Consellería de Sanitat. Valencia. Enviar correspondencia a: Emilio Sánchez Hervás Unidad de Conductas Adictivas-Centro de Salud. Avd. Rambleta, 63. 46470 Catarroja. Valencia.
  • Roberto Secades-Villa Universidad de Oviedo.
  • Francisco José Santonja Gómez Centro Estema. Universidad Miguel Hernández. Alicante.
  • Francisco Zacarés Romaguera Universidad de Oviedo.
  • Olaya García-Rodríguez Universidad de Barcelona.
  • Elena Martin Yanez UCA Campanar. Consellería de Sanitat. Valencia.
  • María Calatayud Francés UCA Alzira. Hospital la Ribera. Consellería de Sanitat. Valencia.
  • Gloria García Fernández Universidad de Oviedo.

DOI:

https://doi.org/10.20882/adicciones.215

Keywords:

cocaine, treatment dropout, addiction severity

Abstract

The high rate of dropout from treatment programs is one of the most serious problems in the field of drug dependence. Early identification of predictors of dropout risk can provide useful information on the specific treatment needs of these types of patient. The aim of this study was to identify predictors of premature cessation of an outpatient treatment program for cocaine addicts. The study was carried out at public healthcare units in a Spanish city. Participants were 91 cocaine addicts admitted for treatment for their addiction, assessed by means of interview and various self-report measures. For identifying predictive variables the researchers used a factor analysis, a cluster analysis and a CHAID analysis. The variables that obtained predictive capacity were the MAST scores and the combined alcohol and drugs scores on the EuropASI. These three variables were grouped in a single factor which was called addictive severity. The predictive analysis showed that this factor had some degree of capacity for the prediction of dropout, but that it was not completely determinant. The results suggest the advantageousness of detecting at the admission stage those patients who might require more attention to their motivational aspects, greater treatment control and intensity, or the provision of complementary interventions.

Author Biography

Emilio Sánchez-Hervás, UCA Catarroja. Consellería de Sanitat. Valencia. Enviar correspondencia a: Emilio Sánchez Hervás Unidad de Conductas Adictivas-Centro de Salud. Avd. Rambleta, 63. 46470 Catarroja. Valencia.

References

Dutra L, Stathopoulou G, Basden S, Leyro T, Powers M, Otto M. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry 2008; 165: 179-187.

Veach L, Remley T, Kippers S, Sorg J. Retention predictors related to intensive outpatient programs for substance use disorders. Am J Drug Alcohol Abuse 2000; 26: 417-428.

Simpson D, Joe,G, Fletcher B, Hubbard R, Anglin D. A national evaluation of treatment outcomes for cocaine dependence. Arch Gen Psychiatry 1999; 56: 507-514.

Simpson D, Joe G, Broone K. A national 5-year follow-up of treatment outcomes for cocaine dependence. Arch Gen Psychiatry. 2002; 59: 538-544.

Hubbard R. Overview of 5-year follow-up outcomes in the drug abuse treatment outcome studies (DATOS). Journal of Substance Abuse Treatment 2003; 25: 125 – 134.

National Treatment Agency for Substance Misuse (NHS). National Evaluation of crack cocaine treatment and outcome study (NECTOS): A multicentre evaluation of dedicated crack treatment services. National Treatment Agency for Substance Misuse. UK. 2007.

Rowan-Szal G, Joe G, Simpson D. Treatment retention of crack cocaine users in a national sample of long term residential clients. Add Res & Theory 2000; 8: 51-64.

Grella C, Hser Y, Hsieh S. Predictors of drug treatment re-entry following relapse to cocaine use in DATOS. J Subs Abuse Treat 2003; 25: 145–154.

Hser Y, Evans E, Huang D, Anglin D. Relationship between drug treatment services, retention, and outcomes. Psych Services 2004; 55: 767-774.

Ray G, Weisner C, Mertens J. Relationship between use of psychiatric services and five-year alcohol and drug treatment outcomes. Psych Services 2005; 56: 164-171.

Grella C, Stein J. Impact of program services on treatment outcomes of patients with co-morbid mental and substance use disorders, Psych Services 2006; 57: 1007–1015.

Meiers P, Best D. Programme factors that influence completion of residential treatment. Drug Alc Review 2006; 25: 349-355.

McMahon R. Substance abuse problems, psychiatric symptoms, and post-treatment status in MCMI psychopathology subgroups of cocaine dependent. Am J Drug Alc Abuse 2008; 34: 195-202.

Chi F, Weisner C. Nine-year psychiatric trajectories and substance use outcomes: an application of the group-based modeling approach. Eval Review. 2008; 32: 39-58.

Najavist L, Lester K. Gender differences in cocaine dependence. Drug Alc Dependen 2008; 97: 190-194.

Zhang Z, Gerstein D, Friedmann P. Patient satisfaction and sustained outcomes of drug abuse treatment. J Health Psych 2008; 13: 388-400.

Aharonovich E, Nunes E, Hasin D. Cognitive impairment, retention and abstinence among cocaine abusers in cognitivebehavioral treatment Drug Alc Depend 2003; 71: 207-211.

Barber J, Gallop R, Crits-Christoph P, Frank A, Thase M, Weiss R, Gibbons M. The role of therapist adherence, therapist competence, and the alliance in predicting outcome of individual drug counseling: Results from the National Institute of Drug Abuse Collaborative Cocaine Treatment Study. Psych Research 2006; 16: 229-240.

Patkar A, Murray H, Mannelli P, Gottheil, P, Weinstein S, Vergare M. Pre-treatment measures of impulsivity, aggression and sensation seeking are associated with treatment outcome for African-American cocaine-dependent patients. J Add Diseases 2004; 23: 109-122.

Weiss R, Griffin M, Gallop R, Najavits L, Frank A, Crits-Christoph P, Thase M, Blaine J,Gastfriend D, Daley, D. The effect of 12-step self-help group attendance and participation on drug use outcomes among cocaine-dependent patients. Drug Alc Dependen 2005; 77: 177-184.

Carroll K, Nich C, Ball S. Practice makes progress? Homework assignments and outcome in treatment of cocaine dependence. J Cons Cli Psychology 2005; 73: 749-755.

Carroll K, Fenton L, Ball S, Nich C, Frankforter T, Shi J, Rounsaville B. Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients A randomized placebocontrolled trial Arch Gen Psychiatry 2004; 61: 264-272.

García-Rodríguez O, Secades-Villa R, Álvarez H, Río A, Fernández-Hermida J, Carballo J, Errasti J, Al-Halabi S. Efecto de los incentivos sobre la retención en un tratamiento ambulatorio para adictos a la cocaína. Psicothema 2007; 19: 134-139.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, 4th edition. Washington: APA. 2000.

Kokkevi A, Hartgers C. European adaptation of a multidimensional

assessment instrument for drug and alcohol dependence. Europ Add Research 1995; 1: 208-210.

Derogatis L, Lipman R, Covi L. SCL-90: An outpatient psychiatric

rating scale-preliminary report. Psych Bulletin 1973; 9: 13-28.

Beck A, Ward C, Mendelson M, Mock J. Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-571.

Seltzer M. The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. Am J Psychiatry 1971; 127:1653-1658.

Miller P, Tonigan J. Assessing drinkers’ motivation for change. The Stages of Change Readiness Treatment Eagerness Sacale (SOCRATES). Psych Addic Behav 1996; 10: 81-89.

Hair J, Anderson R, Tatham R, Black W. Multivariate analysis. Prentice Hall. 2001.

Lévy-Magin, J. Varela, J. Análisis multivariante para las ciencias sociales. Madrid. Prntice Hall. [Multivariate analysis for the social sciences]. 2003.

Stotts A, Mooney M, Sayre S, Novy M, Schmitz J, Grabowski J. Illusory predictors: Generalizability of findings in cocaine treatment retention research. Addic Behav 2007, 32: 2819–2836.

López A, Becoña E, Moratinos M, Montes A, Fernández I. Martínez J, y col. Evolución del tratamiento y consumo en personas con dependencia de la cocaína, a los doce meses, en función de la psicopatología asociada y el funcionamiento cotidiano. Adicciones 2007, 19: 251-266.

Gainey R, Wells E, Hawkins J, Catalano R. Predicting treatment retention among cocaine users. Subst Use Misuse 1993, 28:487-505.

McCaul M. Predictors of outpatient treatment retention: patient versus substance use characteristics. Drug Alc Depend 2001, 62: 9-17.

Dennis M, Foss M, Scott C. An eight-year perspective on the relationship between the duration of abstinence and other aspects of recovery. Eval Review 2007, 31: 585-612. 2007, 31:585-612.

Secades-Villa R, Magdalena Y. Predictores de la retención en una comunidad terapéutica para drogodependientes. Adicciones 2000, 12: 365-371.

Published

2010-03-01

Issue

Section

Originals