SITUATIONS OCCASIONING COCAINE USE AND COCAINE ABSTINENCE STRATEGIES

We interviewed 265 cocaine-experienced methadone patients about situat ions that occasioned their cocaine use and strategies they wed to avoi d cocaine use. Subjects identified an average of IS situations that oc casioned cocaine use. The three most frequently identified were having the drug present (86% of subjects), being offered the drug (85%) and having money available (83%). Subjects reporting fewer situations also reported longer periods of lifetime abstinence (p < 0.01). A principa l components analysis extracted 10 groups of situations that were most frequently identified in combination. Subjects identified a median of seven strategies for avoiding cocaine use; however, there was large i nter-subject variability. This variance was not accounted for by demog raphic variables, employment status or treatment experience. The three strategies identified most frequently were avoiding people and places (81%), thinking about what they could lose (76%) and leaving the situ ation (66%). The total number and type (reactive vs. proactive) of str ategies identified by subjects had no relationship to cocaine abstinen ce, although four specific strategies (thinking about what could be lo st, leaving the situation, moving to a new area and using a different drug) were positively correlated with cocaine abstinence. We discuss i mplications of these results for clinical practice.