COCAINE ABUSE AMONG METHADONE-MAINTENANCE PATIENTS - ARE THERE EFFECTIVE TREATMENT STRATEGIES

Cocaine abuse among patients in methadone maintenance treatment has su bstantially increased in the past decade. No standard treatment approa ches exist to address this problem. Empirical evidence has been collec ted on the effectiveness of several categories of techniques for treat ing this problem, including pharmacotherapies, behavioral methods (con tingency management and relapse prevention), and methadone dose adjust ment. Data on the effectiveness of these techniques is summarized. In addition, other treatment interventions that may be efficacious for th is population, including day treatment and sober-living facilities, ar e described. Finally, methadone clinic management procedures that may aid in the reduction of cocaine abuse by methadone patients are discus sed. Although many of these efforts are in early stages of evaluation, there are some reasons for optimism in the development of treatment f or these patients.