CONTINUITY OF CARE AND DESIPRAMINE IN PRIMARY COCAINE ABUSERS

The objective of this research was to determine the efficacy of enhanc ed continuity of care and desipramine in increasing treatment attendan ce and abstinence from cocaine in primary cocaine abusers. Study desig n was a random assignment, placebo-controlled factorial with assessmen ts at baseline and at 3 (first week of outpatient treatment), 8, and 1 2 weeks after start of study. Desipramine blood levels were taken at w eeks 2 (inpatient), 3, and 8. Subjects (N = 94 men) were recruited on an inpatient ward and assigned to increased continuity of care or to s tandard treatment, and to active or placebo drug. Main outcome variabl es were toxicology-verified reports of cocaine use, and attendance at counseling sessions. Enhanced continuity of care increased abstinence from cocaine at week 3 and increased attendance at individual counseli ng sessions throughout the 12 weeks of the study. There were no main e ffects for desipramine. Blood levels above 123 ng/ml at week 2 predict ed longer stays in outpatient. We conclude that enhanced continuity of care is a low cost intervention that improves early treatment outcome and attendance; desipramine effects do not warrant its therapeutic us e.