TY - JOUR
T1 - The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users
T2 - A randomized controlled trial
AU - Holtyn, August F.
AU - Koffarnus, Mikhail N.
AU - DeFulio, Anthony
AU - Sigurdsson, Sigurdur O.
AU - Strain, Eric C.
AU - Schwartz, Robert P.
AU - Leoutsakos, Jeannie Marie S.
AU - Silverman, Kenneth
N1 - Publisher Copyright:
© 2014 Elsevier Inc.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective: Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method: This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N. =. 98) could work and earn pay for 26. weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results: Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion: The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users.
AB - Objective: Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method: This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N. =. 98) could work and earn pay for 26. weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results: Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion: The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users.
KW - Cocaine
KW - Contingency management
KW - Employment
KW - Financial incentives
KW - Injection drug use
KW - Methadone
KW - Opiate
KW - Out-of-treatment injection drug user
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U2 - 10.1016/j.ypmed.2014.02.021
DO - 10.1016/j.ypmed.2014.02.021
M3 - Article
C2 - 24607365
AN - SCOPUS:84921899350
SN - 0091-7435
VL - 68
SP - 62
EP - 70
JO - Preventive Medicine
JF - Preventive Medicine
ER -