Cocaine use by clients in methadone programs: significance, scope and behavioral interventions

FRANÇAIS :
L'extension de l'usage de cocaïne chez les patients des programmes méthadone américains diminue la capacité de ces programmes à réduire l'usa de drogues illicites, la criminalité et la transmission du sida. L'article donne une revue de la littérature sur la signification et les objectifs de l'usage de cocaïne chez les patients sous méthadone, décrit quelques interventions de type comportemental mises en place pour lutter contre ce problème et souligne les difficultés de l'évaluation de leur efficacité auprès de cette population en particulier.
ENGLISH :
Widespread use of cocaine by methadone clients is undermining the effectiveness of methadone treatment programs in reducing illicit drug use, decreasing criminal behavior, and slowing the spread of the human immunodefiency virus(HIV). In response, methadone programs are implementing a range of behavioral interventions to manage this growing problem. Many of these interventions, however, have yet to be evaluated for effectiveness for reducing cocaine use among methadone clients. Interventions that are effective for cocaine use in the general population may not be as effective with cocaine users in methadone programs because these clients differ from other cocaine users in ways that are likely to affect how they respond to the interventions. This paper reviews the litterature on the significance and scope of the problem of cocaine use by methadone clients and on the behavioral interventions that have been evaluated for these clients.(Author's abstract)