Substance abuse is a big problem here in this country and being able to help those with this condition is critical for their recovery and so that they can lead normal lives. The patient that you describe has a cocaine and alcohol disorder along with depression. Several reasons for this relapse and drop-out have been documented; one reason might be the profile of personality traits in substance use disorder (SUD) patients and the high comorbidity rates of personality disorders in patients with SUD (Boog, 2018). Basically, clients who have a substance use disorder tend to also have a mood or personality disorder which makes it even more difficult to treat them. These are some of the patients that get involuntary treatment, are stabilized, and discharged with a follow up community clinic plan and medication management. They never follow up or continue to take medications, they go back to using. This is a big problem. Unlike substance use disorders involving alcohol, nicotine, or opioids for which FDA-approved medications are available, no FDA-approved medications exist to treat CoCUD (Aharonovich, 2021). There is some evidence that transcranial magnetic stimulation works for certain addictions and can be looked up as an alternative treatment.  At present, the combination of pharmacotherapy and psychosocial intervention is the most effective management strategy in preventing relapse to reduce dropout rates and promote abstinence in SUD patients (Antonelli, 2021). Thus, a number of studies currently confirm the potential efficacy of rTMS in the treatment of AUD when applied at high frequency, both in the short and long term, although contrasting data have been also reported on the effectiveness of this method (Antonelli, 2021).
Aharonovich, E. S. (2021). The relationship of frequency of cocaine use to substance and psychiatric disorders in the US General population. Drug and Alcohol Dependence, 227. https://doi.org/10.1016/j.drugalcdep.2021.108933.
Antonelli, M. F. (2021). Transcranial Magnetic Stimulation: A review about its efficacy in the treatment of alcohol, tobacco and cocaine addiction. Addictive Behaviors, 114. https://doi.org/10.1016/j.addbeh.2020.106760.
Boog, M. v. (2018). Schema modes and personality disorder symptoms in alcohol-dependent and cocaine-dependent patients. European Addiction Research, 24(5), 226–233. https://doi.org/10.1159/000493644.

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