Broad beneficial effects of cocaine abstinence reinforcement among methadone patients

Kenneth Silverman, Conrad J. Wong, Annie Umbricht-Schneiter, Ivan D. Montoya, Charles R. Schuster, Kenzie L. Preston

Research output: Contribution to journalArticlepeer-review

163 Scopus citations


Escalating reinforcement for sustained abstinence has been effective in treating cocaine abuse. Under this schedule, patients receive vouchers for cocaine-free urine samples; vouchers have monetary values that increase with the number of consecutive cocaine-free urine samples. Cocaine-abusing methadone patients were randomly assigned to receive vouchers for 12 weeks under (a) an escalating schedule (n = 20), (b) an escalating schedule with start-up bonuses (n = 20), or (c) a noncontingent schedule (n = 19). Start- up bonuses were designed to provide added reinforcement for initiating abstinence; however, they did not improve outcomes. Both contingent interventions significantly increased cocaine abstinence. In addition, the contingent interventions increased abstinence from opiates and decreased reports of cocaine craving. These results replicate the efficacy of cocaine abstinence reinforcement and show that it can have broad beneficial effects.

Original languageEnglish (US)
Pages (from-to)811-824
Number of pages14
JournalJournal of Consulting and Clinical Psychology
Issue number5
StatePublished - Oct 1998

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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