Adoption of drug avoidance activities among patients in contingency management and cognitive-behavioral treatments.

This study of 97 cocaine-dependent subjects assessed differences in the effects of cognitive behavioral therapy (CBT) and non-CBT treatments, such as contingency management (CM) and methadone maintenance, on patients' adoption of drug avoidance activities (DAA) after treatment, and whether the adoption of these activities was associated with sustained reductions in cocaine use during the follow-up period. Subjects who had been exposed to CBT reported more frequent engagement in drug-use avoidance activities at treatment end and at the 1-year follow-up than did subjects assigned to either the CM or control conditions. The composite DAA scores were significantly related to cocaine abstinence at both follow-up contacts. This finding suggests the importance of adopting a range of avoidance activities and engaging in them frequently, rather than relying on any single activity. Further, a series of multivariate regression models revealed that a subject's total DAA score accounted for more variance than did treatment group assignment in predicting reduced cocaine use over the 1-year follow-up period.