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An Analysis of Relapse Prevention Factors and Their Ability to Predict Sustained Abstinence Following Treatment Completion

Authors

  • David Farabee PhD,

    Corresponding author
    • Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Michael McCann MA,

    1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Mary-Lynn Brecht PhD,

    1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Sarah J. Cousins MPH,

    1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Valerie P. Antonini MPH,

    1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Anne B. Lee MSW,

    1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Jordana Hemberg MPH,

    1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Mitch Karno PhD,

    1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California
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  • Richard A. Rawson PhD


Address correspondence to Dr. Farabee, UCLA Integrated Substance Abuse Programs, 11075 Santa Monica Blvd., Suite 100, Los Angeles, CA 90025. E-mail: dfarabee@ucla.edu.

Abstract

Background & Objectives

This study assessed the role of 14 specific relapse-prevention activities and their underlying factors in maintaining abstinence among subjects (N = 302) completing outpatient treatment for stimulant dependence.

Methods

We examined what broader dimensions might subsume the 14 items constituting the Drug Avoidance Activities checklist (Farabee et al. J Subst Abuse Treat 2002;23:343–350), and how well these derived factors predicted concurrent drug use at baseline and again 3 and 12 months later.

Results

Although four factors were identified consistently for the three time points, only avoidance strategies had sufficient internal consistency to be retained for further analysis. Controlling for age, gender, and ethnicity, the avoidance subscale was a significant predictor of UA results at all time periods: a one-point increase in the avoidance strategies scale was associated with an 86% increase in odds of a negative UA at baseline (OR = 1.86, 95% CI = 1.37–2.53, p < .001), a 77% increase at 3-month follow-up (OR=1.77, CI = 1.37–2.29, p < .001), and a 37% increase at 12-month follow-up (OR = 1.37, CI = 1.04–1.81, p = .026).

Conclusions

Although correlations of individual items with UA results showed statistically significant (p <.05) results for 8 of 14 items at one or more observation points, avoidance-related behaviors showed the strongest associations with sustained abstinence. (Am J Addict 2013; 22:206–211)

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