Effect of drug user treatment on psychosocial change: a comparison of in-treatment and out-of-treatment cocaine users.

A panel study of 189 in-treatment and 297 out-of-treatment "heavy" drug users was used to evaluate the hypothesis that drug users who participated in drug user treatment would have a greater degree of psychosocial improvement than those who did not participate in treatment. Although time in treatment was significantly associated with improvements in all three domains, a simple path model suggested that changes in cognitive functioning may have mediated changes in self-esteem and emotional functioning. These results indicate that treatment does produce psychological change, and they hint that the cognitive domain may drive most of this change.