Behavioral Interventions

Many behavioral treatments have been found to be effective for cocaine addiction, including both residential and outpatient approaches. Indeed, behavioral therapies are often the only available, effective treatment approaches to many drug problems, including cocaine addiction, for which there is, as yet, no viable medication. However, integration of both types of treatments is ultimately the most effective approach for treating addiction. It is important to match the best treatment regimen to the needs of the patient. This may include adding to or removing from an individual's treatment regimen a number of different components or elements. For example, if an individual is prone to relapses, a relapse component should be added to the program. A behavioral therapy component that is showing positive results in many cocaine-addicted populations, is contingency management. Contingency management uses a voucher-based system to give positive rewards for staying in treatment and remaining cocaine free. Based on drug-free urine tests, the patients earn points, which can be exchanged for items that encourage healthy living, such as joining a gym, or going to a movie and dinner. Cognitive-behavioral therapy is another approach. Cognitive-behavioral coping skills treatment, for example, is a short-term, focused approach to helping cocaine-addicted individuals become abstinent from cocaine and other substances. The underlying assumption is that learning processes play an important role in the development and continuation of cocaine abuse and dependence. The same learning processes can be employed to help individuals reduce drug use. This approach attempts to help patients to recognize, avoid, and cope; i.e., recognize the situations in which they are most likely to use cocaine, avoid these situations when appropriate, and cope more effectively with a range of problems and problematic behaviors associated with drug abuse. This therapy is also noteworthy because of its compatibility with a range of other treatments patients may receive, such as pharmacotherapy.
Therapeutic communities, or residential programs with planned lengths of stay of 6 to 12 months, offer another alternative to those in need of treatment for cocaine addiction. Therapeutic communities are often comprehensive, in that they focus on the resocialization of the individual to society, and can include on-site vocational rehabilitation and other supportive services. Therapeutic communities typically are used to treat patients with more severe problems, such as co-occurring mental health problems and criminal involvement.

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