Many believe that cocaine addiction is harder to overcome than other drugs, but this is not necessarily true. Treatment for stimulant use disorders (which includes cocaine use) is an under-researched area. There are no approved medications to treat cocaine addiction but there are behavioral therapies and self-help groups that can be effective. Unfortunately, not enough resources have been devoted to developing specialized approaches or evaluating their efficacy.
Outpatient Treatment Setting
This form of treatment is most commonly recommended for individuals with cocaine use disorders and allows them to live at home or in a community residence while traveling to a treatment facility for psychosocial treatment, including individual and group therapy.
Outpatient treatments can vary in intensity so that individuals may come for treatment for just one or two hours a week, all the way up to six hours a day a few times a week. Outpatient treatment may last for a number of months and treatment intensity may be phased down after achieving progress. The intensity of the treatment required is determined on an individual basis.
Residential Treatment Setting
These programs can last as long as 6 months. They are not hospital-based but in environments where psychosocial support, medication-assisted treatment, vocational support and other opportunities are available.
This treatment option is not often recommended for individuals with cocaine use disorders unless they have multiple substance use disorders, in addition to having mental health disorders or any other health problems. These types of longer-term programs can help individuals gain stability and support before they return to their communities.
Established Treatment or Therapy Approaches
Cognitive-Behavioral Therapy
This is an individual or group therapy approach used at many outpatient and residential treatment programs where individuals learn to identify triggering thoughts and feelings which may have led them to use drugs problematically in the past and to develop new strategies for coping. It may involve learning new constructive ways to deal with cravings, high-risk situations and negative thoughts, which would otherwise lead them back to drug use.
Contingency Management
This is another therapy approach which may be used in different types of treatment settings. In this approach, individuals get rewards for not using drugs. This is done to help them develop the skills they need and be able to deal with what triggers their drug use, especially in the early days of their recovery. Studies show that this is a feasible and promising treatment option.
Harm reduction psychotherapy combines traditional psychotherapy with interventions that aim to reduce cocaine use and/or the problematic effects of cocaine dependence, which may include reduced use, moderation, reduced risky practices or abstinence.
Matrix Model
This is an abstinence-based therapy option which includes aspects of several different treatment approaches, including cognitive behavioral therapy, contingency management and 12-step programs, among others. It involves support, family education and individual counseling. It has been getting a lot of attention in the treatment community, primarily because it is seen as an evidence-based treatment.
Treatment Approaches Requiring More Research
Medication assisted treatment (MAT)
This involves the use of prescription medications as a way to help individuals to reduce or stop their drug use. While MAT for opioid dependence has been studied extensively, trials for MAT for cocaine use disorders have not all been consistently successful and have not been extensively studied. If effective medications are developed, MAT could be an especially important treatment option.