Abstinence reinforcement maintenance contingency and one-year follow-up

Kenzie L. Preston, Annie Umbricht, David H. Epstein

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)125-137
Number of pages13
JournalDrug and alcohol dependence
Volume67
Issue number2
DOIs
StatePublished - Jul 1 2002

Keywords

  • Abstinence reinforcement
  • Contingency management
  • Methadone

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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