Journal de recherche et de thérapie en toxicomanie

Abstrait

Role of Two Clusters of Cocaine-Dependent Outpatients in Treatment Retention

Flavia Ismael and Danilo Antonio Baltieri

Background: Cocaine dependents are a highly heterogeneous population. An appropriate system of classification should represent a broad understanding of underlying psychosocial aspects of cocaine dependence, as well as being related to a therapeutic proposal, a possible prognosis, and different forms of approach. Our aim was to identify types of cocaine dependents and evaluate if these types show different retention rates in a cognitive behavioral treatment.
Methods: The sample comprised 100 cocaine-dependent outpatients who were enrolled in an individual and manualized cognitive-behavioral treatment. Classes of participants sharing common psychosocial features, cocaine use-related aspects, and impulsiveness were identified with latent class analysis. The association of sociodemographic, clinical, and psychological variables with treatment retention was also investigated.
Results: Two clusters were delineated. Participants belonging to cluster 1 (n=60) were characterized by higher impulsiveness level, more years of cocaine use, higher educational level, more previous treatment episodes for cocaine addiction, and more frequent family history of cocaine use problems than Cluster 2 (n=40). Cluster 1 persons adhered longer to the treatment. As to the independent variables, only the highest educational level and the route of administration (crack cocaine) were associated with higher treatment retention.
Conclusions: Information about patients’ characteristics linked to noncompliance or dropout should be used to make treatment programs more responsive and attractive, combining more intensive and diversified psychosocial interventions.