Metacognitive Awareness in Cocaine Addiction (MACA): Rationale and Feasibility of an Integrated Intervention Program

Abstract

Introduction

Systematic reviews and meta-analyses report low-quality evidence to suggest a significant differential effectiveness between standard psychosocial interventions in reducing substance consumption. They highlight the presence of several types of treatments that usually integrate different approaches in a multimodal manner. CBT-based interventions seem to be the most effective ones in terms of dropouts and relapse prevention, particularly in cocaine addiction.

Objectives

We discuss recent advances in experimental and clinical studies on cocaine addiction. We especially try to integrate emerging cognitive neuroscience evidences and results of the meta-analyses of the effectiveness of psychosocial interventions.

Aims

The primary aim of this study is to explore the feasibility of a new multimodal intervention for cocaine addiction, namely MACA (Metacognitve Awareness in Cocaine Addiction). Secondary aims are to discuss: (i) rationale of integrating different approaches; (ii) preliminary results of a previous pilot-study; (iii) feasibility of present study using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework.

Methods

We describe and evaluate our model that comprises:

– an individual short intervention based on dilemma-focused therapy;

– a psycho-educational group based on standard CBT treatments;

– a relapse-prevention group based on mindfulness protocols for addiction;

– a follow-up online self-administered course and automatic personalized feedback.

Results

Existing literature seems to support the need for new integrated programs. RE-AIM feasibility analysis shows promising results in integrating the proposed approaches in terms of symptoms reduction, relapse prevention and cost-benefit ratio.

Conclusions

Preliminary evidence supports potential for the MACA program in treating cocaine addiction. The research design of a wait-list controlled trial with pre- and post-treatment assessment is discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.