A COCAINE-POSITIVE BASE-LINE URINE PREDICTS OUTPATIENT TREATMENT ATTRITION AND FAILURE TO ATTAIN INITIAL ABSTINENCE

The primary study objective was to ascertain whether a prior finding t hat the baseline cocaine urine toxicology predicted treatment dropout for cocaine dependent outpatients could be extended to three additiona l cocaine dependent outpatient treatment samples and whether the urine toxicology also predicted attainment of initial abstinence for the fo ur samples. A secondary objective was to ascertain the extent to which other baseline variables accounted for additional outcome variance ov er and above that afforded by urine toxicology. To evaluate the first objective, the relationships between the baseline cocaine urine and ea ch of two measures of within treatment response - the completion of tr eatment or the attainment of initial abstinence - were determined for each of the treatment samples. The second objective was evaluated by a stepwise, hierarchical logistic regression analysis, with the urine t oxicology entered in the first step, baseline Addiction Severity Index (ASI) variables in the second step, and achievement of initial abstin ence as the outcome. In all four samples, patients with a urine indica tive of recent cocaine use were less than half as likely to complete t reatment or achieve initial abstinence. Individual ASI baseline Variab les did not contribute statistically significant variance over and abo ve that predicted by the cocaine urine toxicology. The findings confir m the utility of the initial cocaine urine as a predictor of unfavorab le outpatient treatment response. (C) 1997 Elsevier Science Ireland Lt d.