The aims of this study were to assess whether voucher magnitude improved cocaine abstinence and retention in an outpatient treatment for cocaine dependence, and to determine the effectiveness of a contingency management intervention in a European cultural context. A randomized controlled trial was conducted in which 96 participants who were randomly assigned to 1 of 3 treatment conditions in a community setting: standard outpatient treatment, community reinforcement approach (CRA) plus low monetary value vouchers (each point earned was equivalent to 0.125 Euro, US$ 0.18), and CRA plus high monetary value vouchers (each point was worth 0.25 Euro, US$ 0.36). In the standard treatment group, mean percentage of cocaine-negative samples was 88.45%, versus 96.09% in the CRA plus low-vouchers group, and 97.07% in the CRA plus high-vouchers group. Retention rate at 6 months was 36.5% in the standard treatment group, 53.3% in the CRA plus low-vouchers group, and 69.0% in the CRA plus high-vouchers group. The CRA plus vouchers groups obtained better results than the standard program. This study showed that treating cocaine addiction by combining CRA with vouchers was more effective than standard treatment in community outpatient programs in Spain.

Low participation rates constitute a serious problem faced by family drug abuse prevention programs. In this study we analyse the factors related to participation in a Life Skills Training program implemented in three schools in Spain. Participants in the study were 485 pupils aged 12 - 14 years and their respective parents. The variables that predicted participation in the program were: number of children and educational level of parents, children's drug use, family conflict, parental rearing style, relationships between parents and children and family communication. The results from Spain are similar to those found in international studies, and indicate that the families most at risk of drug use are those least likely to participate in prevention programs. There is a need for strategies to increase participation in prevention programs of the families most at risk.

El objetivo de este estudio es analizar las diferencias entre heroinómanos y cocainómanos en las áreas que mide el EuropA-SI. Se pretende, a su vez, elaborar un perfil de usuario para cada uno de los grupos con las características psicosociales de estos pacientes. La muestra se compuso de 373 pacientes extraídos de forma aleatoria de entre todas las personas que solicitaron tratamiento por su adicción a la cocaína o a la heroína durante el año 2003 en los centros de Proyecto Hombre en España. Los resultados muestran que, en general, los usuarios del programa de heroína presentan mayor gravedad en su patrón de consumo y padecen más problemas asociados que los usuarios del programa de cocaína. Esta tendencia se ve reflejada prácticamente en todas las áreas que mide el EuropASI: estado de salud, educación y empleo, situación legal y relaciones sociales/familiares. El estado psiquiátrico es el único área en el que no se encuentran diferencias entre ambos grupos. Se discuten los resultados y se analizan las implicaciones clínicas de los mismos.

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