Cocaine addiction is a global problem, and some European countries have higher rates of cocaine use than the United States. “Cocaine accounted for 46.9% of all treatment admissions for drug dependence in Spain, and 62.5% of the total if we consider only those cases treated for the first time in the person’s life,” said researchers from Spain. In an attempt to determine how the Community Reinforcement Approach (CRA) to treatment worked compared to the CRA plus a voucher system, the researchers conducted a study on 64 individuals who met the criteria for cocaine addiction. The team enrolled half of the participants into a standard care treatment program, in which they received group therapy twice a week for six months, and then once a week for the next six months. The therapy focused on addiction awareness, strategies for managing emotions and the development of coping skills. The participants were taught problem solving techniques and were educated on addiction prevention and given skills to resolve interpersonal problems. The second group of participants was enrolled in a similar program, but they also received vouchers based on positive drug tests. The vouchers could be redeemed throughout the year for products and services that supported a drug free lifestyle.
Based on specimens gathered from both groups throughout the study, the researchers found that the participants, who were offered incentive via the vouchers, achieved much higher rates of abstinence. “Among patients assigned to the CRA plus vouchers condition, 65.5% completed 12 months of treatment versus 28.6% of those assigned to the standard care condition,” said the team. “At the 12-month assessment, 58.6% of patients assigned to the CRA plus vouchers condition were abstinent, compared with 25.7% in the standard care condition; furthermore, 34.5% of patients assigned to the CRA plus vouchers condition achieved twelve months of continuous cocaine abstinence, versus 17.1% in the standard care condition. Those treated in the CRA plus vouchers condition also achieved greater improvements in psychosocial functioning than those treated in the standard care condition.”
Secades-Villa, Roberto, Olaya García-Rodríguez, Gloria García-Rodríguez, Emilio Sánchez-Hervás, Jose R. Fernandez-Hermida, and Stephen T. Higgins. “Community Reinforcement Approach plus Vouchers among Cocaine-dependent Outpatients: Twelve-month Outcomes.” Psychology of Addictive Behaviors 25.1 (2011): 174-79. Print.
© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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