The efficacy of escalating and fixed contingency management reinforcement on illicit drug use in opioid-dependent pregnant women

Melissa L. Hutchinson, Margaret S Chisolm, Michelle Tuten, Jeannie-Marie S Leoutsakos, Hendrée E. Jones

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Contingency management (CM), long known to be efficacious in the treatment of substance-dependent men and women, has also been found to be efficacious for substance-dependent pregnant women. However, the specific CM reinforcement parameters in the special population of opioid-dependent pregnant women have been less fully and systematically studied. The Drug Abuse Incentive Systems (DAISY) study, a randomized controlled trial (RCT) of opioid-dependent pregnant patients, found that escalating reinforcement was not superior to a fixed reinforcement CM schedule after a 13-week intervention. To further examine CM's reinforcement parameters in this population, this study aims to test the hypothesis that there is an early treatment response showing an escalating reinforcement schedule to be significantly more efficacious than a fixed schedule after 5 weeks of intervention in opioid-dependent pregnant patients. METHODS: Nine measures of opioid and cocaine abstinence among fixed and escalating CM schedule participants in the DAISY RCT (N=90) were compared over the initial 5 weeks of the intervention. RESULTS: No statistically significant difference in the opioid and cocaine abstinence measures was found between escalating and fixed conditions after 5 weeks (14 opportunities for each participant to leave a urine sample). The mean (SD) number of drug-negative urine samples was 8.1 (4.5) and 7.4 (4.3), for escalating and fixed groups, respectively (P=0.46). CONCLUSIONS: These results further the scientific knowledge regarding CM treatment in opioid-dependent pregnant women by supporting the finding that the escalating and fixed CM schedules produce similar amounts of drug-negative urine samples early in treatment.

Original languageEnglish (US)
Pages (from-to)150-153
Number of pages4
JournalAddictive Disorders and their Treatment
Volume11
Issue number3
DOIs
StatePublished - Sep 2012

Fingerprint

Street Drugs
Opioid Analgesics
Pregnant Women
Appointments and Schedules
Urine
Cocaine
Substance-Related Disorders
Motivation
Randomized Controlled Trials
Reinforcement Schedule
Therapeutics
Pharmaceutical Preparations
Population
Reinforcement (Psychology)

Keywords

  • contingency management
  • pregnancy
  • substance use disorders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

The efficacy of escalating and fixed contingency management reinforcement on illicit drug use in opioid-dependent pregnant women. / Hutchinson, Melissa L.; Chisolm, Margaret S; Tuten, Michelle; Leoutsakos, Jeannie-Marie S; Jones, Hendrée E.

In: Addictive Disorders and their Treatment, Vol. 11, No. 3, 09.2012, p. 150-153.

Research output: Contribution to journalArticle

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