Does Concurrent Cocaine Use Compromise 1-Year Treatment Outcomes for Opiate Users?

Abstract

The current study aimed to determine whether cocaine use compromises treatment outcomes for opiate users. Data were collected from 404 opiate users at treatment intake and 1-year follow-up as part of a national treatment outcome study. Because of higher intake measures, cocaine users improved in more outcomes than nonusers, but comparisons between groups found that cocaine users had more coexisting problems. Regression analysis revealed that those who used cocaine at intake were more likely to use cocaine at 1-year follow-up, to commit crime, and to be homeless. It is concluded that treatment for opiate use “works” even in the presence of concurrent cocaine use.

RÉSUMÉ

Est-Ce Que La Prise Simultanee De CocaÏNe Compromet L'Issue D'Une Annee De Traitement Pour Les Usagers D'Opiaces

Les travaux ont pour but de déterminer si l'usage de cocaïne compromet les résultats du traitement pour les usagers d'opiacés. Des données ont été rassemblées auprès de 404 usagers d'opiacés à la prise du traitement, puis 1 an plus tard, dans le cadre d'une étude nationale des résultats du traitement. En raison de mesures d'usage plus importantes, les usagers de cocaïne ont augmenté leurs résultats par rapport aux non-usagers, mais des comparaisons entre les groupes ont trouvé que les usagers de cocaïne avaient davantage de problèmes concurrents. L'analyse de régression a révélé que ceux qui prenaient de la cocaïne à la prise du traitement étaient plus susceptibles de prendre de la cocaïne un an plus tard, de commettre des délits et d’être sans domicile. Il est conclus que le traitement pour l'usage d'opiacés «marche» même en présence d'usage simultané de cocaïne.

Mots clés: résultats de traitement contre les drogues, The Research Outcome Study in Ireland (ROSIE) ou La Recherche pour l'Etude des Résultats en Irlande, usage des opiacés, usage de cocaïne, régression.

RESUMEN

¿El Uso Concurrente De La Cocaína Pone En Peligro Los Resultados Del Tratamiento De Consumidores De Opiáceos?

Este estudio se plantea determinar si el consumo de la cocaína pone en peligro los resultados de los adictos a los opiáceos. Los resultados del estudio se recopilaron entre 404 adictos a los opiáceos bajo tratamiento de ingestión y con un seguimiento de un año, resultados estos que pertenecen a un estudio nacional de tratamiento. Debido al incremento de la suma de la ingestión, los resultados de los adictos a la cocaína son mejores que los de los que no consumen cocaína, pero la comparación entre los grupos revela que los adictos a la cocaína padecieron más problemas coexistentes. Los análisis de la regresión revelaron que aquéllos que tomaron cocaína durante la ingesta era más probable que volvieran a consumir cocaína dentro de un año, así como que volvieran a cometer algún delito o a seguir en la indigencia. Se concluye que el tratamiento para el opiáceo ‘funciona’ incluso en la presencia de la ingesta concurrente de cocaína. (Palabras 100)

Palabras clave: resultados de tratamiento de drogas, estudio ROSIE, consumo de opiáceos, consumo de cocaína, regresión.

Keywords:

• drug user treatment outcomes
• ROSIE Project
• opiate use
• cocaine use
• regression

THE AUTHORS

Dr. Gemma M. Cox was Research Officer in the National Advisory Committee on Drugs in Ireland and recently took up a position as Evaluation Manager at Young Ballymun. She has extensive experience in undertaking research on problem drug use and related areas both in the voluntary sector and within academia. Her main research interests are service provision, harm reduction, hepatitis C virus infection, and other drug-related harms.

Dr. Catherine M. Comiskey holds a B.A. (Mod.) degree in mathematics and philosophy from Trinity College Dublin and M.Sc. and Ph.D. degrees in mathematical and statistical modeling in epidemiology from Dublin City University. She was Senior Lecturer at the Mathematics Department of National University of Ireland but recently moved to Trinity College Dublin, where she is now Associate Professor of health care statistics. Her interests cover all areas of health care research with a particular emphasis on modeling the incidence, prevalence, and spread of drug use. Her research output is aimed at assisting and informing health care and health treatment policy.

Notes

1 Treatment can be briefly and usefully defined as a planned, goal-directed, temporal-based, change process, which is bounded (by culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help-based (such as Alcoholics Anonymous and Narcotics Anonymous), and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users—of whatever types—that are not also used with substance nonusers. In the West, with the relatively new treatment ideologies of “harm reduction” and “quality-of-life,” there are now new sets of goals in addition to those derived from/associated with the older tradition of abstinence-driven models. Editor's note.