Employment-based abstinence reinforcement promotes opiate and cocaine abstinence in out-of-treatment injection drug users

August F. Holtyn, Mikhail N. Koffarnus, Anthony DeFulio, Sigurdur O. Sigurdsson, Eric C. Strain, Robert P. Schwartz, Kenneth Silverman

Research output: Contribution to journalArticlepeer-review

Abstract

We examined the use of employment-based abstinence reinforcement in out-of-treatment injection drug users, in this secondary analysis of a previously reported trial. Participants (N = 33) could work in the therapeutic workplace, a model employment-based program for drug addiction, for 30 weeks and could earn approximately $10 per hr. During a 4-week induction, participants only had to work to earn pay. After induction, access to the workplace was contingent on enrollment in methadone treatment. After participants met the methadone contingency for 3 weeks, they had to provide opiate-negative urine samples to maintain maximum pay. After participants met those contingencies for 3 weeks, they had to provide opiate- and cocaine-negative urine samples to maintain maximum pay. The percentage of drug-negative urine samples remained stable until the abstinence reinforcement contingency for each drug was applied. The percentage of opiate- and cocaine-negative urine samples increased abruptly and significantly after the opiate- and cocaine-abstinence contingencies, respectively, were applied. These results demonstrate that the sequential administration of employment-based abstinence reinforcement can increase opiate and cocaine abstinence among out-of-treatment injection drug users.

Original languageEnglish (US)
Pages (from-to)681-693
Number of pages13
JournalJournal of applied behavior analysis
Volume47
Issue number4
DOIs
StatePublished - Dec 1 2014

Keywords

  • abstinence reinforcement
  • cocaine addiction
  • contingency management
  • employment
  • opiate addiction

ASJC Scopus subject areas

  • Philosophy
  • Applied Psychology
  • Sociology and Political Science

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