Abstract
Background: Relapse to drug use is often seen when contingencies designed to reduce drug use are discontinued. This paper reports on a stepdown maintenance contingency and 1-year follow-up in 110 patients who were maintained on methadone (50 or 70 mg/day) and who had completed a contingency management trial targeted to decreasing their opiate use. In the prior study (induction phase, 8 weeks) participants received vouchers for each opiate-negative urine screen or noncontingently. Methods: In this study (maintenance phase, 12 weeks), participants were rerandomized to receive vouchers and take-home methadone doses contingent on providing opiate-negative urine specimens (N=55) or noncontingently (N=55). Since participants had been rerandomized from induction-phase contingencies, most study data were analyzed as if from a 2×2 (induction x maintenance) design. Follow-up interviews were conducted at 3, 6, and 12 months after study participation. Results: Patients who received the maintenance contingency following an 8-week induction contingency had better outcomes than those who received noncontingent incentives in either the maintenance or induction phases of the trial. Good outcome at follow-up was predicted by enrollment in methadone maintenance after the study. Significantly more participants in the maintenance contingency group transferred directly to another methadone program. Conclusion: These findings support the therapeutic value of extending the duration of contingency management and long-term methadone maintenance.
Original language | English (US) |
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Pages (from-to) | 125-137 |
Number of pages | 13 |
Journal | Drug and alcohol dependence |
Volume | 67 |
Issue number | 2 |
DOIs | |
State | Published - Jul 1 2002 |
Externally published | Yes |
Keywords
- Abstinence reinforcement
- Contingency management
- Methadone
ASJC Scopus subject areas
- Toxicology
- Pharmacology
- Psychiatry and Mental health
- Pharmacology (medical)