Objectives: Providing maintenance treatment for heroin users who also use cocaine presents special problems. Poly-drug use is prevalent among clients in the Swiss Program for the Medical Prescription of Heroin (1994-1996).
Methods: A formative evaluation examines whether cocaine use was associated with a higher drop-out rate from treatment, and how cocaine use changed among those who remained in treatment. Frequency of cocaine use before and during treatment was measured by self-report every six months and by urinalysis every two months.
Results: There was no significant difference between the drop-out rates for cocaine users vs. non-users (n = 995). A significant reduction in cocaine use over an 18-month period from 84 to 48% was found for a sample of clients (n = 266). Overall retention in programme was high and also the prevalence of factors associated with cocaine use such as criminality, prostitution, and contact with drug scene decreased.
Conclusions: The results suggest that prescribed heroin maintenance provides a treatment context that may help reduce consumption of other illicit drugs such as cocaine.