Best Approach to Treating Cocaine Addiction
Melacia Cullars, Tommy Foster, Taylor Hagin, Mark Sturgess
Psychology 335
February 16, 2015
Professor Jennifer Slothower

Best Approach to Treating Cocaine Addiction
Currently the research that Rawson et al. (2002) notes that methadone treatment is deemed the best treatment for cocaine addiction. Methadone is a synthetic agent that occupies the receptors that have been occupied by cocaine in the brain to relieve euphoria, intoxication and withdrawal symptoms. The real issues arise from the length of methadone treatment. Even though researches show that, no ill effects arise from continual use. However, the Center for Disease Control (2002) shows that most patients under methadone abandon the treatment before a year is complete; the clinic sometimes encourages the patients to leave or the patients fail to comply with the program. Amore obvious reason is that taking methadone becomes difficult and unpleasant for most patients. In effect, most methadone patients relapse and start using cocaine again. In this light, the question of which treatment approach is best for treating cocaine addicts still remain. Considerably, other drug addiction treatments, such as CBT- cognitive-behavioral therapy and CM –contingency management show promise in helping patient dissuade from taking drug, even after the initial drug treatment is stopped. In this light, hypothesis for creating an effective cocaine treatment is draw from the use of CBT and CM after the initial treatment of methadone.

Research Question
What is the best approach to treating cocaine addiction?
Hypothesis
People taken off methadone treatment who continue their other treatments (CBT- cognitive-behavioral therapy and CM –contingency management) will have greater success at beating their addiction than people who continue with methadone alone.
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Sampling Method
According to the American Gastroenterological Association (2015), during patient sampling, the sample surveyed must represent the patient population under study. In this case, the first approach to sampling patients is identifying the patient characteristics. In this research, the patients under the study will be those who have continued their initial methadone treatment (1 year) and are off the treatment but placed under CBT and CM. The other group will comprise of patients who are continuing with methadone as a standalone treatment after one year. Information regarding such patients will be collected from three major hospitals dealing with cocaine addicts. Once a list of patients from the two groups is formed and their consent to participate in the research obtained, random sampling of each group of patients will take place. Random sampling is ideal because it ensures that variations between the selected sample and actual population are by chance, not selection bias. Stratified random sampling will be specifically used where potential patients are divided into the two groups and then select patients randomly from each sample.
Using the Survey Systems, an online calculator that determines sample size, this research will recruit 384 participants. This is based on a confidence level of 95%, confidence interval of + or -5%, the national population of cocaine addicts (not users), which is roughly 1,000,000. Hence, more potential participants from both groups should be obtained to allow random selection of 192 participants per group (American Gastroenterological Association, 2015).
Statistics Employed
The research study will employ both inferential and descriptive statistics. According to Banyard, and Grayson (2007), descriptive statistics tend to quantitatively describe major features of information or data obtained in the research. This simply means that descriptive statistics summarize the data collected in a research into more understandable language. In this case, using descriptive statistics in form of tables or graphs would be of benefit in quantifying the data collected in a manner that researchers or those reading the research can understand. Inferential statistics will be critical because this study because with only a small portion of the population being under study, it would be difficult to derive any parameters that provides the characteristics of the entire population of cocaine addicts. In this light, inferential statistics will be critical in generalization or drawing conclusions that will be able to tell whether CBT and CM is likely to benefit cocaine addicts after their initial methadone treatment when compared to cocaine addicts who continue using methadone. The T-Test will be particularly helpful when it comes to examining the differences between patients using methadone and those using CBT and CM to enable draw the conclusions.
Definition of variables
As Hayes (2002) notes, the independent variable is the condition that a researcher systematically manipulates. In this case, the independent variable is the drug treatment. This means that CBT and CM, as well as, methadone are independent variables. The dependent variable refers to outcomes measured in the research, and which change when the dependent variables undergo experimental manipulation. In this case, each person’s response from the drug treatment offered is the dependent variable. The control variable in this case is ensuring that each patient had undergone the initial methadone treatment (1 year and not more or less) to avoid biasing the application of the two treatments (continuation of methadone, and CBT and CM). Getting the initial treatment will ensure that each cocaine addict has received the same level of treatment prior to introducing the other two treatments. This will ensure that the two treatments introduced (continuation of methadone, and CBT and CM) give results that can be distinguished from the results of the initial methadone treatment, thus able to examine the efficacy of each treatment.
Operationalizing the Variables
Operationalizing variable implies finding quantifiable, valid index and measurable index for the variables. The methadone treatment will be measured in terms of mg/day where the standard dose of 60-120 mg/day required by most patients will be administered to patients. CBT and CM will be measured in the context of sessions. Typically, considering that the group has undergone the first-line of treatment with methadone, 3-5 sessions per week will be sufficient to yield the therapeutic effect needed to dissuade patients from relapsing. Considerably, for the control variable to work, urinalysis has to be conducted to determine the cocaine content in each of the patients. This will reveal whether the patient has relapsed and used cocaine within the treatment period; those who have relapsed will not qualify for the research study. In the case of effect of both methadone treatment, as well as, the combination of CBT and CM, in the 60-day period of conducting the research, different measures will be applied to detect which is the most effective. The below scale will be issued to cocaine users and they will be directed on how to use it (Markel, 2012).

| Symptom check | On Methadone(Tick if on methadone) | On CBT and CM(Tick if on CBT-CM) | Extend of symptom (rate from (1-5)1-not available2- slight3-serious4- severe-but containable5-severe -uncontainable | 1 | Thoughts of going back to using cocaine | | | | 2 | Irritability | | | | 3 | Paranoia | | | | 4. | Anxiety | | | | 5. | Restlessness | | | |

This scale will measure whether the treatments have been effective in controlling cocaine addiction to the extent of reducing relapses. The T-test will further be used to compare the effectiveness of the two modes of treatment.

References American Gastroenterological Association. (2015). A guide to patient sampling. Retrieved from https://www.gastro.org/practice/quality-initiatives/performance-measures/Instructions_for_Valid_Sample.pdf
Banyard, P., & Grayson, A. (2007). Introducing psychological research: Third edition. London. Palgrave Macmillan.
Center for Disease Control. (2002). Methadone maintenance treatment. Retrieved from http://www.cdc.gov/idu/facts/MethadoneFin.pdf
Hayes, N. (2002). Doing psychological research: Gathering and analysing data. New York, NY: Open University Press.
Markel, H. (2012). An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine. London: Vintage.
Rawson, R. A., Huber, A., McCann, M., Shoptaw, S., Farabee, D., Reiber, C., & Ling, W. (2002). A comparison of contingency management and cognitive-behavioral approaches during methadone maintenance treatment for cocaine dependence. Arch Gen Psychiatry, 59(9), 817-824