Contingent reinforcement of abstinence with individuals abusing cocaine and marijuana.
Two males diagnosed with cocaine dependence received a behavioral intervention comprised of contingency management and the community reinforcement approach. During the initial phase of treatment, reinforcement was delivered contingent on submitting cocaine-free urine specimens. The community reinforcement approach involved two behavior therapy sessions each week. Almost complete cocaine abstinence was achieved, but regular marijuana use continued. During a second phase, reinforcement magnitude was reduced, but remained contingent on submitting cocaine-free specimens. Behavior therapy was reduced to once per week. Cocaine abstinence and regular marijuana use continued. Next, reinforcement was delivered contingent on submitting cocaine- and marijuana-free specimens. This modified contingency resulted in an abrupt increase in marijuana abstinence and maintenance of cocaine abstinence. One- and 5-month follow-ups indicated that cocaine abstinence continued, but marijuana smoking resumed. These results indicate that the behavioral intervention was efficacious in achieving abstinence from cocaine and marijuana; maintenance, however, was achieved for cocaine only.
Budney
A J
AJ
University of Vermont, Burlington 05401.
Higgins
S T
ST
Delaney
D D
DD
Kent
L
L
Bickel
W K
WK
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003042:Cocaine; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology / Q000534:rehabilitation*; D012055:Reinforcement Schedule; D012056:Reinforcement, Social; D012944:Social Support; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*
D003042:Cocaine