Reinforcement-based intensive outpatient treatment for inner city opiate abusers: A short-term evaluation

Karin Gruber, Mary Ann Chutuape, Maxine L. Stitzer

Research output: Contribution to journalArticlepeer-review

Abstract

We evaluated 3-month outcomes for reinforcement-based intensive outpatient treatment (RBT), a new relapse prevention behavior therapy for inner city opiate abusers. The therapy provides abstinence-contingent partial support of housing, food and recreational activities, abstinence-contingent access to social skills and job finding group therapy and non-contingent individual counseling, all in the context of a day treatment program. Heroin abusers (n=52), contacted at a 3-day detoxification unit, were randomly assigned to RBT (n=28) or referred to community treatment resources (n=24) after a staff escort from the detoxification unit. For RBT patients, treatment began on the day of discharge; 61% received partial rent support in a recovery house based on the need for drug-free housing; the remainder were eligible for partial support of utility payments where they lived. Abstinence-based contingencies were in effect for 1 month with three times per week counseling available for an additional 2 months. One month after detoxification, 61% of RBT versus 17% of referral patients were enrolled in outpatient treatment (P<0.01); RBT patients were significantly less likely than controls to have returned to any drug use; and 50% of RBT versus 21% of controls reported 30 days of abstinence from heroin and cocaine with confirmatory negative urine (P<0.05). RBT patients had significantly lower scores on the Beck Depression Inventory at 1 month (M=9.0 versus 17.6 for controls; P<0.05) and showed evidence of less alcohol use and higher rates of employment. These results establish the short-term efficacy for RBT and support continued development and evaluation of this new outpatient behavioral treatment.

Original languageEnglish (US)
Pages (from-to)211-223
Number of pages13
JournalDrug and alcohol dependence
Volume57
Issue number3
DOIs
StatePublished - Jan 1 2000

Keywords

  • Aftercare
  • Cocaine
  • Contingency management
  • Drug abuse treatment
  • Employment
  • Heroin
  • Housing
  • Outpatient treatment

ASJC Scopus subject areas

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

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