El consumo de cocaína es un problema de tendencia creciente en nuestro país. La ausencia de fármacos eficaces para el tratamiento de la adicción a esta sustancia así como de programas terapéuticos validados empíricamente hace necesario acudir a programas que han demostrado su eficacia en otros países. El objetivo de este estudio es evaluar la eficacia de uno de los programas con mejores resultados en Estados Unidos: La Aproximación de Reforzamiento Comunitario (CRA) más Terapia de Incentivo para la adicción a la cocaína. Se pretenden valorar las tasas de retención y abandono en el tratamiento, y el consumo de cocaína durante los tres primeros meses de intervención. La muestra estuvo compuesta por 37 pacientes adictos a la cocaína que fueron asignados aleatoriamente a dos condiciones: experimental (CRA más Terapia de Incentivo) y control (Tratamiento Están-dar), ambos en un contexto asistencial ambulatorio. Los resultados mostraron que el 85,7% de los pacientes del grupo experimental completó 12 semanas de tratamiento frente al 69,6% del grupo control. En el grupo experimental, el 57,1% de los pacientes se mantuvo abstinente de forma continuada frente al 39,1% del grupo control. Estos resultados coinciden con los encontrados en estudios previos realizados siempre fuera de España. No obstante, se necesitan estudios a más largo plazo y con un mayor número de sujetos para confirmar la eficacia de este programa. ABSTRACTCocaine use is an increasingly serious problem in Spain. The absence of effective drugs for the treatment of cocaine addiction and of empirically validated therapy programmes makes it necessary to resort to programmes that have shown their effectiveness in other countries. The aim of the present study was to explore the effectiveness of one of the programmes that has obtained the best results in the United States: the Community Reinforcement Approach (CRA) Plus Vouchers for the treatment of cocaine addiction. We assessed treatment retention and dropout rates and cocaine use during the first three months of intervention. The sample was made up of 37 patients addicted to cocaine who were assigned at random to one of two conditions: experimental (CRA Plus Vouchers) or control (Standard Treatment), both in the outpatient context. The results showed that 85.7% of the experimental group patients completed 12 weeks of treatment, compared to 69.6% of the control group. In the experimental group, 57.1% of the patients maintained continuous abstinence, compared to 39.1% of the control group. These results coincide with those of previous studies, all from outside Spain. Nevertheless, longer-term studies with larger samples are necessary in order to confirm the effectiveness of this program.
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