Community reinforcement approach for combined opioid and cocaine dependence - Patterns of engagement in alternate activities

We compared outcomes for agonist-maintained patients with combined opioid a nd cocaine dependence who were treated in an earlier clinical trial with gr oup drug counseling (DC; n = 57) or in a current trial with the Community R einforcement Approach (CRA; n = 60). The association between engagement in nondrug-related activities and abstinence was also evaluated. There were no significant differences between the treatments in retention or drug use. T he total number of hours and average hours per week engaged in nondrug-rela ted activities was significantly higher for CRA-treated patients who achiev ed abstinence from opioids, cocaine, or both combined than for those who ne ver achieved abstinence. Although CRA was not more effective overall than D C, the finding that engagement in reinforcing community activities unrelate d to drug use (e.g., planned pleasurable events or parenting activities) wa s associated with abstinence suggests that the planning and reinforcement o f specific nondrug-related social, vocational, and recreational activities is a crucial component of CRA. (C) 2000 Elsevier Science Inc. All rights re served.