The effectiveness of telephone-based continuing care for alcohol and cocaine dependence: 24-Month outcomes

Abstract

Context: Telephone-based disease management protocols have shown promise in improving outcomes in a number of medical and psychiatric disorders, but this approach to continuing care has received little study in alcohol- and drug-dependent individuals. Objective: To compare telephone-based continuing care with 2 more intensive face-to-face continuing care interventions. Design: A randomized 3-group clinical trial with a 2-year follow-up. Setting: Two outpatient substance abuse treatment programs, one community-based and the other at a Veterans Affairs medical center facility. Patients: Alcohol- and/or cocaine-dependent patients (N = 359) who had completed 4-week intensive outpatient programs. Interventions: Three 12-week continuing care treatments: weekly telephone-based monitoring and brief counseling contacts combined with weekly supportive group sessions in the first 4 weeks (TEL), twice-weekly cognitive-behavioral relapse prevention (RP), and twice-weekly standard group counseling (STND). Main Outcome Measures: Percentage of days abstinent from alcohol and cocaine, total abstinence from alcohol and cocaine, negative consequences of substance use, cocaine urine toxicological results, and γ-glutamyltransferase. Results: Participants in TEL had higher rates of total abstinence over the follow-up than those in STND (P