Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment

A National Drug Abuse Treatment Clinical Trials network study

Jessica M Peirce, Nancy M. Petry, Maxine L Stitzer, Jack Blaine, Scott Kellogg, Frank Satterfield, Marion Schwartz, Joe Krasnansky, Eileen Pencer, Lolita Silva-Vazquez, Kimberly C. Kirby, Charlotte Royer-Malvestuto, John M. Roll, Allan Cohen, Marc L. Copersino, Ken Kolodner, Rui Li

Research output: Contribution to journalArticle

Abstract

Background: Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings. Objective: To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings. Design: Random assignment to usual care with (n=198) or without (n=190) abstinence incentives during a 12-week trial. Setting: Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States. Participants: Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years. Intervention: Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time. Main Outcome Measures: Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance. Results: Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95% confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was $120 per participant. Conclusion: An abstinence incentive approach that paid $120 in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

Original languageEnglish (US)
Pages (from-to)201-208
Number of pages8
JournalArchives of General Psychiatry
Volume63
Issue number2
DOIs
StatePublished - Feb 2006

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Methadone
Substance-Related Disorders
Motivation
Clinical Trials
Costs and Cost Analysis
Alcohols
Counseling
Therapeutics
Odds Ratio
Outcome Assessment (Health Care)
Confidence Intervals
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment : A National Drug Abuse Treatment Clinical Trials network study. / Peirce, Jessica M; Petry, Nancy M.; Stitzer, Maxine L; Blaine, Jack; Kellogg, Scott; Satterfield, Frank; Schwartz, Marion; Krasnansky, Joe; Pencer, Eileen; Silva-Vazquez, Lolita; Kirby, Kimberly C.; Royer-Malvestuto, Charlotte; Roll, John M.; Cohen, Allan; Copersino, Marc L.; Kolodner, Ken; Li, Rui.

In: Archives of General Psychiatry, Vol. 63, No. 2, 02.2006, p. 201-208.

Research output: Contribution to journalArticle

Peirce, JM, Petry, NM, Stitzer, ML, Blaine, J, Kellogg, S, Satterfield, F, Schwartz, M, Krasnansky, J, Pencer, E, Silva-Vazquez, L, Kirby, KC, Royer-Malvestuto, C, Roll, JM, Cohen, A, Copersino, ML, Kolodner, K & Li, R 2006, 'Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: A National Drug Abuse Treatment Clinical Trials network study', Archives of General Psychiatry, vol. 63, no. 2, pp. 201-208. https://doi.org/10.1001/archpsyc.63.2.201
Peirce, Jessica M ; Petry, Nancy M. ; Stitzer, Maxine L ; Blaine, Jack ; Kellogg, Scott ; Satterfield, Frank ; Schwartz, Marion ; Krasnansky, Joe ; Pencer, Eileen ; Silva-Vazquez, Lolita ; Kirby, Kimberly C. ; Royer-Malvestuto, Charlotte ; Roll, John M. ; Cohen, Allan ; Copersino, Marc L. ; Kolodner, Ken ; Li, Rui. / Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment : A National Drug Abuse Treatment Clinical Trials network study. In: Archives of General Psychiatry. 2006 ; Vol. 63, No. 2. pp. 201-208.
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abstract = "Background: Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings. Objective: To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings. Design: Random assignment to usual care with (n=198) or without (n=190) abstinence incentives during a 12-week trial. Setting: Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States. Participants: Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years. Intervention: Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time. Main Outcome Measures: Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance. Results: Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95{\%} confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was $120 per participant. Conclusion: An abstinence incentive approach that paid $120 in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.",
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