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.
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