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.
RCT Entities:
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.
Authors: Rebecca K Papas; John E Sidle; Benson N Gakinya; Joyce B Baliddawa; Steve Martino; Michael M Mwaniki; Rogers Songole; Otieno E Omolo; Allan M Kamanda; David O Ayuku; Claris Ojwang; Willis D Owino-Ong'or; Magdalena Harrington; Kendall J Bryant; Kathleen M Carroll; Amy C Justice; Joseph W Hogan; Stephen A Maisto Journal: Addiction Date: 2011-08-18 Impact factor: 6.526
Authors: Kathleen M Carroll; Charla Nich; Donna M Lapaglia; Erica N Peters; Caroline J Easton; Nancy M Petry Journal: Addiction Date: 2012-05-08 Impact factor: 6.526
Authors: Adam C Brooks; Graham Diguiseppi; Alexandre Laudet; Beth Rosenwasser; Dan Knoblach; Carolyn M Carpenedo; Deni Carise; Kimberly C Kirby Journal: J Subst Abuse Treat Date: 2012-02-01
Authors: Kathleen M Carroll; Brian D Kiluk; Charla Nich; Elise E DeVito; Suzanne Decker; Donna LaPaglia; Dianne Duffey; Theresa A Babuscio; Samuel A Ball Journal: Drug Alcohol Depend Date: 2014-01-31 Impact factor: 4.492