Treatment Retention of Crack and Cocaine Users in a National Sample of Long Term Residential Clients

Abstract

Clients entering treatment with cocaine problems are difficult to engage and retain in treatment. Crack users, a subset of cocaine users, are especially difficult to treat. This study investigated whether type of cocaine used (crack or non-crack) was related to retention in treatment. The sample consisted of 900 clients in 13 long-term residential (LTR) programs participating in the national Drug Abuse Treatment Outcome Studies (DATOS). Clients met the DSM-HI-R criteria for cocaine dependence and were at least weekly users of cocaine (including crack). Hierarchical logistic model regression analysis was used to test the relationship between type of cocaine preference and retention. Crack users had lower retention rates than non-crack cocaine users, even after adjusting for covariates. Higher retention was also related to being older, a high school graduate, unmarried, not depressed, alcohol dependent, more motivated for treatment, and having fewer arrests. New strategies to improve retention for crack users through increased client motivation are discussed.

Key Words:

• crack
• cocaine
• Datos
• treatment retention