Contingent methadone take-home doses reinforce adjunct therapy attendance of methadone maintenance patients.
Two studies utilized within-subjects designs to determine whether take-home methadone doses can reinforce adjunct therapy attendance of drug abuse patients. These studies varied the reinforcement density and the schedule of methadone take-home doses. In Study 1, patients (n = 10) either could or could not receive a take-home following each therapy session. Study 2 patients (n = 15) could either earn take-homes following each therapy session attended (i.e., 2 take-homes per week) or could earn one take-home dose following each attendance to two consecutive sessions attended. In both studies experimental conditions alternated during three-week blocks of time. Across studies, any reinforcement by take-home doses produced more attendance at therapy sessions than that observed in the no reinforcement condition. Take-home incentive effects were strongest when each of the two weekly therapy sessions was reinforced by a methadone take-home dose. Increased attendance was not associated with reduced drug use, due perhaps to high rates of pre-study drug use and limited therapy duration. Contemporary opioid abusers present with multiple problems that methadone was never intended to treat. The present studies illustrate a method by which methadone treatment can improve the likelihood of delivering other services that may prove effective in treating some of these problems.
Kidorf
M
M
Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD.
Stitzer
M L
ML
Brooner
R K
RK
Goldberg
J
J
D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D011613:Psychotherapy; D012055:Reinforcement Schedule; D012646:Self Administration / Q000523:psychology; D015813:Substance Abuse Detection; D014040:Token Economy
D008691:Methadone