But these treatments have not been as successful for cocaine users, who have demonstrated high relapse and dropout rates. Three Cognitive/Behavioral Treatments Appear Effective in Outpatient Settings

Early research indicates relapse prevention, community reinforcement/contingency management, and neurobehavioral therapy are potentially promising cocaine-addiction treatment approaches for promoting extended periods of client abstinence and treatment retention in outpatient treatment settings. Neurobehavioral retention rates also proved favorable. But recent animal research has demonstrated the positive effects of a new immunization procedure in protecting rats against the stimulant effects of cocaine. To date, however, few well-designed evaluation studies have assessed the utility of acupuncture treatment. But the limited research findings are somewhat favorable. However, according to cocaine treatment experts, additional research is needed before standard, generalizable cocaine treatment strategies can be formulated for cocaine addicts of varying demographic and clinical groups. Methodology

To determine the extent to which cocaine therapies have proven successful, we identified studies with current reportable data on two outcome variables: drug abstinence and treatment retention. Cocaine Outcomes by Treatment Setting

In addition to the study of particular treatment approaches (such as relapse prevention, community reinforcement/contingency management, and neurobehavioral therapy), researchers are also beginning to examine the results of cocaine treatment in different types of settings (that is, outpatient, inpatient, day-hospital, and therapeutic communities). Methadone Maintenance: Some Treatment Programs Are Not Effective; Greater Federal Oversight Needed. 2, No. 1-4.
Why GAO Did This Study

Pursuant to a congressional request, GAO reviewed the extent to which federally funded cocaine treatment therapies have proven successful and additional research initiatives that are needed to increase knowledge of cocaine treatment effectiveness.

What GAO Found

GAO found that: (1) cocaine treatment research is still in its early stages; (2) preliminary study results have shown that relapse prevention, community reinforcement and contingency management, and neurobehavioral therapy may produce prolonged periods of abstinence among cocaine users; (3) relapse prevention programs have the highest abstinence rates, followed by community reinforcement and neurobehavioral programs; (4) community reinforcement programs have the highest retention rates, followed by relapse prevention and neurobehavioral programs; (5) pharmacological agents have not proven to be consistently effective in preventing cocaine use, and none have been submitted for Food and Drug Administration approval; (6) animal researchers have demonstrated the positive effects of a new immunization procedure in blocking the stimulant effects of cocaine; (7) few researchers have assessed the effectiveness of acupuncture treatment, but some research findings are favorable; and (8) experts believe that more rigorous treatment evaluation studies that focus on important treatment components, appropriate treatment intensities and durations, and clients' readiness and motivation for treatment are needed before standard cocaine treatment protocols can be formulated.