Psychosocial functioning and cocaine use during treatment: strength of relationship depends on type of urine-testing method.

Abstract	Although improvement in psychosocial functioning is a common goal in substance-abuse treatment, the primary outcome measure in most cocaine trials is urinalysis-verified cocaine use. However, the relationship between cocaine use and psychosocial outcomes is not well documented. To investigate this relationship and identify the optimal urine-screen method, we retrospectively analyzed data from two 25-week randomized controlled trials of abstinence reinforcement (AR) in 368 cocaine/heroin users maintained on methadone. Cocaine use was measured thrice weekly by qualitative urinalysis, benzoylecgonine concentration (BE), and an estimate of New Uses of cocaine by application of an algorithm to BE. Social adjustment (SAS-SR), current diagnosis of cocaine dependence (DSM-IV criteria), and depression symptoms (Beck Depression Inventory) were determined at study exit. Cocaine use was significantly lower in AR groups than in controls. Across groups, in-treatment cocaine use was significantly associated with worse social adjustment, current cocaine dependence, and depression at exit. Significant differences were detected more frequently with New Uses than qualitative urinalysis or BE. Nevertheless, the amount of variance accounted for by the urine screens was typically <15%. Cocaine use during treatment, especially when measured with New Uses criteria, can predict psychosocial functioning, but cannot substitute for direct measures of psychosocial functioning.
Authors	Udi E Ghitza, David H Epstein, Kenzie L Preston
Journal	Drug and alcohol dependence (Drug Alcohol Depend) Vol. 91 Issue 2-3 Pg. 169-77 (Dec 01 2007) ISSN: 0376-8716 [Print] Ireland
PMID	17624688 (Publication Type: Journal Article, Research Support, N.I.H., Intramural)
Chemical References	Cocaine
Topics	Adult Cocaine (urine) Cocaine-Related Disorders (prevention & control, psychology, urine) Depression (epidemiology) Heroin Dependence (epidemiology) Humans Monitoring, Physiologic (methods) Patient Dropouts Reinforcement, Psychology Social Adjustment Social Support

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.

Realize the full power of the drug-disease research graph!