Use of methadone take-home contingencies with persistent opiate and cocaine abusers

Research output: Contribution to journalArticle

Abstract

This study investigated conditions under which methadone patients with urinalysis evidence of persistent multiple drug abuse would respond to take- home incentive procedures. Study subjects submitted ≥80% opiate and/or cocaine positive urines during a 5-week baseline period (M, W, F urine testing) while maintained on 60 mg methadone. Doses were raised to 80-100 mg methadone under blind conditions and subjects were randomly assigned to receive methadone take-home doses under one of three conditions: (a) earn a 1-day take-home privilege for each opiate and cocaine-free test delivered (daily contingent condition), (b) three negative test results required for the first take-home privilege, with each subsequent negative test earning one take-home dose; a positive test reset the contingency back to three again (weekly contingent condition), or (c) a control group that did not receive take-home privileges (no take-home control). Five of 21 subjects (24%) assigned to a contingent take-home intervention (2 from condition a, 3 from condition b) showed marked reductions in drug use and delivered 4 or more consecutive weeks of drug-free urines during a 16-week intervention. No subject in the control group met these criteria. Percent positive urines decreased by 14% and 18% from baseline in daily and weekly contingency groups, respectively, compared to a decline of 2% in the no take-home control group (planned contrast of means p <.07 and .05, respectively). Thus, the study demonstrated that take-home incentives can be effective for reducing during-treatment use of opiates and cocaine in methadone patients with a poor prognosis related to their persistent multiple drug use.

Original languageEnglish (US)
Pages (from-to)23-30
Number of pages8
JournalJournal of Substance Abuse Treatment
Volume16
Issue number1
DOIs
StatePublished - Jan 1 1999

Keywords

  • Cocaine
  • Contingency management
  • Methadone
  • Opiates
  • Take-homes

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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