Psychosocial Predictors of Relapse in Cocaine-Dependent Patients in Treatment

  1. Sánchez Hervás, Emilio 2
  2. Santonja Gómez, Francisco José 3
  3. Secades Villa, Roberto 1
  4. García Fernández, Gloria 1
  5. García Rodríguez, Olaya 1
  6. Zacarés Romaguera, Francisco 1
  1. 1 Universidad de Oviedo
    info

    Universidad de Oviedo

    Oviedo, España

    ROR https://ror.org/006gksa02

  2. 2 Agencia Valenciana de Salud
  3. 3 Universitat de València
    info

    Universitat de València

    Valencia, España

    ROR https://ror.org/043nxc105

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Journal:
The Spanish Journal of Psychology

ISSN: 1138-7416

Year of publication: 2012

Volume: 15

Issue: 2

Pages: 748-755

Type: Article

DOI: 10.5209/REV_SJOP.2012.V15.N2.38886 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: The Spanish Journal of Psychology

Abstract

Relapses in cocaine abusers in treatment are an important problem. The majority of patients are incapable of sustaining abstinence over any length of time. To identify the factors associated to relapses risk in the cocaine use can be an optimal choice to improve the treatment strategies. The aim of this study was to analyze relapse-risk factors in cocaine-dependent patients on treatment. Participants were 102 patients who had begun outpatient treatment at a public health center in Spain. Some functional areas and cocaine use are evaluated for a period of six months. A structural equations model was used to identify possible predictive variables. The results show that social-family environment and economic-employment situation were associated with greater risk of relapse. Likewise, the social-family environment was related to severity of addiction. It is concluded that the incorporation of family intervention strategies and vocational/employment counseling may help to reduce relapse rates in cocaine addicts receiving treatment.

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Funding information

This project was funded by the Spanish Delegación de Gobierno para el Plan Nacional sobre Drogas (Ref.MSC-06-01) run by the Spanish Ministerio de Salud.

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Bibliographic References

  • Alterman, A. I., McKay, J. R., Mulvaney, F. D., Cnaan, A., Cacciola, J. S., Tourian, K. A.,Merikle, E. P. (2000). Baseline prediction of 7-month cocaine abstinence for cocaine dependence patients. Drug and Alcohol Dependence, 59, 215-221. http://dx.doi.org/10.1016/S0376-8716(99)00124-6
  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders text revised, DSM-IV-TR (4th Ed.). Washington, DC: Author.
  • Anderson, K. G., Ramo, D. E., Schulte, M. T., Cummings, K., & Brown, S. A. (2008). Impact of relapse predictors on psychosocial functioning of SUD youth one year after treatment. Substance Abuse, 29, 97-106. http://dx.doi.org/10.1080/08897070802093411
  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571. http://dx.doi.org/10.1001/archpsyc.1961.01710120031004
  • Bentler, P. (2005). EQS 6 Structural equations program manual. Encino, CA: Multivariate Software Inc.
  • Bohnert, A., German, D., Knowlton, A., & Latkin, C. (2010). Friendship networks of inner-city adults: A latent class analysis and multi-level regression of supporter types and the association of supporter latent class membership with supporter and recipient drug use. Drug and Alcohol Dependence, 107,134-140. http://dx.doi.org/10.1016/j.drugalcdep.2009.09.012
  • Buchanan, A., & Latkin, C. (2008). Drug use in the social network of heroin and cocaine Users before and after drug cessation. Drug Alcohol Depend, 96, 286-289. http://dx.doi.org/10.1016/j.drugalcdep.2008.03.008
  • Byrne, B. M. (2006). Structural Equations modeling with EQS. Mahwah, New Jersey, NJ: Lawrence Erlbaum Associates.
  • Derogatis, L. R., Lipman, R. S., & Covi, L. (1973). SCL-90: An outpatient psychiatric rating scale-preliminary report. Psychopharmacological Bulletin, 9, 13-28.
  • Dobkin, P., De Civita, M., Paraherakis, A., & Gill, K. (2002). The role of social support in treatment retention and outcomes among outpatient adult substance abusers. Addiction, 97, 347-356. http://dx.doi.org/10.1046/j.1360-0443.2002.00083.x
  • Dolan, S., Martin, R., & Rohsenow, D. (2008). Self-efficacy for cocaine abstinence: Pretreatment correlates and relationship to outcomes. Addictive Behaviors, 33, 675-688. http://dx.doi.org/10.1016/j.addbeh.2007.12.001
  • Dutra, L., Stathopoulou, G., Basden, S. L., Leyro, T. M., Powers, M. B., & Otto, M. W. (2008). A meta-analytic review of psychosocial interventions for substance use disorders. American Journal of Psychiatry, 165, 179-187. http://dx.doi.org/10.1176/appi.ajp.2007.06111851
  • Fernández-Montalvo, J., & López-Goñi, J. (2010). Comparison of completers and dropouts in psychological treatment for cocaine addiction. Addiction Research & Theory, 18, 433-441. http://dx.doi.org/10.3109/16066350903324826
  • Grella, C., Hser, Y. I., & Hsieh, S. (2003). Predictors of drug treatment re-entry following relapse to cocaine use in DATOS. Journal of Substance Abuse Treatment, 25, 145-154. http://dx.doi.org/10.1016/S0740-5472(03)00128-4
  • Hair, J. E., Tatham, R. L., Anderson, R. E., & Black, W. C (2001). Multivariate data analysis. New York, NY: Prentice Hall.
  • Hawks, R., & Chiang, C. (1986). Urine testing for drugs of abuse. Research Monograph, no 73. Maryland, MD: National Institute for Drug Abuse (NIDA).
  • Heinz, A. J., Wu, J., Witkiewitz, K., Epstein, D. D., & Preston, K. L. (2009). Marriage and relationship closeness as predictors of cocaine and heroin use. Addictive Behaviors, 34, 258-263. http://dx.doi.org/10.1016/j.addbeh.2008.10.020
  • Hser, Y. I., Evans, E., Huang, D., & Anglin, M. D. (2004). Relationship between drug treatments services, retention, and outcomes. Psychiatric Services, 55, 767-774. http://dx.doi.org/10.1176/appi.ps.55.7.767
  • Hser, Y. I., Joshi, V., Anglin, M. D., & Fletcher, B. (1999). Predicting post-treatment cocaine abstinence for first-time admissions and treatment repeaters. American Journal of Public Health, 89, 661-671. http://dx.doi.org/10.2105/AJPH.89.5.666
  • Hser, Y. I., Stark, M. E., Paredes, A., Huang D., Anglin, D., & Rawson, R. (2006). A 12-year follow-up of a treated cocainedependent sample. Journal of Substance Abuse Treatment, 30, 219-226. http://dx.doi.org/10.1016/j.jsat.2005.12.007
  • Kokkevi, A., & Hartgers, C. (1995). European adaptation of a multidimensional assessment instrument for drug and alcohol dependence. European Addiction Research, 1, 208-210. http://dx.doi.org/10.1159/000259089
  • López, A., Becoña, E., Casete, L., Lage, T., García-Janeiro, J., Senra, A., Cancelo, J. (2009). Variables significativas para explicar el consumo de cocaína a los dos años de demanda de tratamiento [Significant variables to explain cocaine use two years after treatment demand]. Behavioural Psychology/Psicología Conductual, 17, 203-216.
  • Marlatt, A. (1996). Models of relapse and relapse prevention: A commentary. Experimental and Clinical Psychopharmacology, 4, 55-60. http://dx.doi.org/10.1037//1064-1297.4.1.55
  • Marlatt, A., & Gordon, R. (1985). Relapse Prevention: Maintenance strategies in the treatment of addictive behaviors. New York, NY: Guilford Press.
  • Marlatt, G. A., Parks, G. A., & Witkiewitz, K. (2002). Clinical guidelines for implementing Relapse Prevention Therapy: A guideline developed for the Behavioral Health Recovery Management Project. Seattle, WA: University of Washington, Addictive Behaviors Research Center.
  • McCamant, L., Zani, B., McFarland, B., & Gabriel, R. (2007). Prospective validation of substance abuse severity measures from administrative data. Drug and Alcohol Dependence, 86, 37-45. http://dx.doi.org/10.1016/j.drugalcdep.2006.04.016
  • McKay, J., Merikle, E., Mulvaney, F., Weiss, R., & Koppenhaver, J. (2001). Factors accounting for cocaine use two years following initiation of continuing care. Addiction, 96, 213-225. http://dx.doi.org/10.1046/j.1360-0443.2001.9622134.x
  • McLellan, T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grison, G., Argelou, M. (1992). The 5th Edition of the addiction severity index. Journal of Substance Abuse Treatment, 9, 199-213.
  • McMahon, R. (2001). Personality, stress, and social support in cocaine relapse prediction. Journal of Substance Abuse Treatment, 21, 77-87. http://dx.doi.org/10.1016/S0740-5472(01)00187-8
  • McMahon, R. (2008). Substance abuse problems, psychiatric symptoms, and post-treatment status in MCMI psychopathology subgroups of cocaine dependent. American Journal of Drug and Alcohol Abuse, 34, 195-202. http://dx.doi.org/10.1080/00952990701877094
  • Messina, N., Farabee, D., & Rawson, R. (2003). Treatment responsivity of cocaine-dependent patients with antisocial personality disorder to cognitive-behavioral and contingency management interventions. Journal of Consulting and Clinical Psychology, 71, 320-329. http://dx.doi.org/10.1037/0022-006X.71.2.320
  • Miller, P., & Tonigan, J. (1996). Assessing drinkers' motivation for change. The Stages of Change Readiness Treatment Eagerness Scale (SOCRATES). Psychology of Addictive Behaviors, 10, 81-89. http://dx.doi.org/10.1037//0893-164X.10.2.81
  • Poling, J., Kosten, T., & Sofuoglu, M. (2007). Treatment outcomes predictors for cocaine dependence. American Journal Drug Alcohol Abuse, 33, 191-206. http://dx.doi.org/10.1080/00952990701199416
  • Polivy, J., & Herman, C. P. (2002). If at first you don't succeed: False hopes of self change. American Psychologist, 57, 677-689. http://dx.doi.org/10.1037//0003-066X.57.9.677
  • Project MATCH Research Group. (1997). Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58, 7-29.
  • Ray, G. T., Weisner, C. M., & Mertens, J. R. (2005). Relationship between use of psychiatric services and five-year alcohol and drug treatment outcomes. Psychiatric Services, 56, 164-171. http://dx.doi.org/10.1176/appi.ps.56.2.164
  • Rodríguez, J., Fernandez, A., Valdés, M., Hernandez, E., Ramirez, S., & Roman, A. (2008). A comparison of the peers method and tradicional methodologies and risk behaviors in studies of the prevalence of drug comsumption in a population of female, chilean students. The Spanish Journal of Psychology, 11, 564-572.
  • Sánchez Hervás, E., Secades, R., Santonja, F., Zacares, F., & Garcia, O. (2009). Addictive severity in cocaine addicts measured with the EuropASI: Differences between composite scores and severity ratings. The American Journal on Addictions, 18, 375-378. http://dx.doi.org/10.1080/10550490903077952
  • Santonja, F., Sánchez-Hervás, E., Secades, R., Zacares, F., García-Rodríguez, O., & García-Rodriguez, G. (2010). Pretreatment characteristics as predictors of retention in cocaine-dependent outpatients. Addictive Disorder and Their Treatment, 9, 93-98. http://dx.doi.org/10.1097/ADT.0b013e3181bff7ec
  • Seltzer, M. L. (1971). The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. The American Journal of Psychiatry, 127, 1653-1658.
  • Simpson, D., Joe, G., & Broone, K. (2002). A national 5-year follow-up of treatment outcomes for cocaine dependence. Archives of General Psychiatry, 59, 538-544. http://dx.doi.org/10.1001/archpsyc.59.6.538
  • Siqueland, L., Crits-Christoph, P., Frank, A., Daley, D., Weiss, R., Chittams, J.,Luborsky, L. (1998). Predictors of dropout from psychosocial treatment of cocaine dependence. Drug and Alcohol Dependence, 52, 1-13. http://dx.doi.org/10.1016/S0376-8716(98)00039-8
  • Sun, A. (2007). Relapse among substance-abusing women: Components and processes. Substance Use & Misuse, 42, 1-21. http://dx.doi.org/10.1080/10826080601094082
  • Tate, S. R., Wu, J., McQuaid, J. R., Cummins, K., Shriver, C., Krenek, M., & Brown, S. A. (2008). Comorbidity of substance dependence and depression: role of life stress and self efficacy in sustaining abstinence. Psychology of Addictive Behaviors, 22, 47-57. http://dx.doi.org/10.1037/0893-164X.22.1.47
  • Tate, S., Brown, S., Unrod, M., & Ramo, D. (2004). Context of relapse for substance-dependent adults with and without comorbid psychiatric disorders. Addictive Behaviors, 29, 1707-1724. http://dx.doi.org/10.1016/j.addbeh.2004.03.037
  • Terra, M. B., Barros, H. M., Stein, A. T., Figueira, I., Athayde, L. D., Ott, D. R., da Silveira, D. X. (2008). Predictors of relapse in 300 Brazilian alcoholic patients: A 6-month followup study. Substance Use & Misuse, 43, 403-411. http://dx.doi.org/10.1080/10826080701202999
  • Waldrop, A., Back, S., Verduin, M., & Brady, K. (2007). Triggers for cocaine and alcohol use in the presence and absence of posttraumatic disorder. Addictive Behaviors, 32, 634-639. http://dx.doi.org/10.1016/j.addbeh.2006.06.001
  • Weiss, R. D., Griffin, M. L., Mazurick, C., Berkman, B., Gastfriend, D. R., Frank, A., Moras, K. (2003). The relationship between cocaine craving, psychosocial treatment, and subsequent use. American Journal of Psychiatry, 160, 1320-1325. http://dx.doi.org/10.1176/appi.ajp.160.7.1320
  • Witkiewitz, K., & Marlatt, G. A. (2004). Relapse prevention for alcohol and drug problems: That was Zen, this is Tao. American Psychologist, 59, 224-235. http://dx.doi.org/10.1037/0003-066X.59.4.224
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