Assessment and Treatment Overview - Cocaine Use Disorders

Assessment and Treatment Overview

The two primary goals of cocaine treatment are: 1) the initiation of abstinence through disruption of binge cycles and 2) the prevention of relapse. Treatment planning to achieve these goals must be considered in the context of the individual clinical presentation of the patient. Initial assessment to determine immediate needs is necessary to determine the most appropriate level of care (inpatient or outpatient treatment) as well as other psychiatric and medical considerations important to the development of the treatment plan.

The majority of those with cocaine use disorders are most appropriately treated in an outpatient setting. Outpatient treat-ment may vary by provider but generally includes multiple weekly contacts for the initial months of treatment because less frequent contact is not effective in the initiation or maintenance of absti-nence these sessions consist of some combination of individual drug counseling, peer support groups, family or couples therapy, urine toxicology monitoring, education sessions, psychotherapy and psychiatric treatment that may include pharmacotherapy for cocaine addiction or comorbid psychiatric disorders. Inpatient treatment is reserved for those who have been refractory to out-patient treatment, whose compulsive use of cocaine represents an imminent danger (e.g., suicidality associated with cocaine toxic-ity or acute abstinence), who have other comorbid psychiatric or medical disorders, or who are dependent on more than one sub-stance and require monitored detoxification.