Counseling as an intervention for the cocaine abusing methadone maintenance patient.

摘要

This study is a retrospective analysis of institutional data from Bay Area Addiction Research and Treatment (B.A.A.R.T.), which has owned and operated methadone clinics throughout California for over 20 years. Over 4,000 patients are enrolled in B.A.A.R.T.'s methadone maintenance program statewide. In 1997, California Assembly Bill 2071, which mandated changes in how California Methadone programs provided counseling, was passed. This study achieved its two aims---to further establish the efficacy of the clinical intervention of counseling, sufficiently cost-effective to be implemented in most methadone programs and to assess the impact of Assembly Bill 2071 on cocaine abuse.;Records of 179 patients continuously active in treatment beginning 12 months prior to and two years after AB 2071's implementation were reviewed. These patients were also defined as cocaine abusers. Data were reviewed to assess the impact of additional counseling mandated by AB 2071 on cocaine use among B.A.A.R.T. methadone clinic patients. Cocaine abusers' urinalysis results during a one-year baseline were compared to the time period following 2071's implementation. The independent variable was amount of counseling received; the dependent variable was cocaine use. The prediction was that cocaine abusing methadone maintenance patients would have fewer cocaine positive urines following AB 2071's implementation than in the baseline period preceding AB 2071.;Results supported the main hypothesis: cocaine abusing patients seen in clinics and counties B.A.A.R.T. serves used significantly less cocaine following AB 2071. Additional findings were that actual time in counseling was more impactful than simply conducting a session and that heroin abuse was also reduced. There were no differences found between men and women in response to the counseling treatment. Notably, amount of time in counseling is a significant factor in reducing cocaine use.