AN EXAMINATION OF THE COCAINE RELAPSE PROCESS

Although empirical studies of the relapse process have been done with alcoholics, smokers, and opiate addicts, comparatively little informat ion is available on the relapse process in cocaine abusers. This paper presents data from the Cocaine Relapse Interview (CRI), a structured interview that assesses factors associated with the onset, course, and termination of cocaine relapse episodes. In a sample of 95 cocaine de pendent patients, the experiences that occurred with the greatest freq uency immediately prior to relapse were wanting drugs, being alone, ha ving money, and feeling extremely bored and lonely. Following the onse t of the relapse, the most frequent experience was unpleasant affect, although positive reactions were also relatively common. The factors p erceived as most important in terminating relapse were painful interna l states, help-seeking behaviors, and other coping responses. Three ty pes of relapse experiences, or pathways, were identified: (a) unpleasa nt affect - painful internal states prior to and throughout the relaps e; (b) positive affect - positive affect and pleasant social experienc es prior to relapse coupled with a relatively unproblematic course; an d (c) sensation seeking - sensation seeking and interpersonal problems prior to relapse coupled with mixed emotional reactions and antisocia l behavior during the relapse, and interpersonal problems at relapse t ermination.