title: Treatment of heroin-dependent poly-drug abusers with contingency management and buprenorphine maintenance.
abstract: This study targeted poly-drug (cocaine plus heroin) abstinence among buprenorphine-maintained participants with a 12-week voucher-based reinforcement therapy (VBRT) phase versus a yoked control condition. Baseline levels of cocaine and heroin use were significant predictors of treatment outcome, regardless of treatment assignment. Overall, there were no significant group differences on treatment outcome. However, among the subsample that produced one or more poly-drug-free urine results, VBRT participants had significantly increased cocaine-but not heroin and poly-drug-abstinence, although all results were in the predicted direction. Results suggest that for those who achieve poly-drug abstinence, VBRT may enhance treatment outcome. However, improved interventions, perhaps targeting single-drug abstinence, increasing reinforcement magnitude, or both, may be necessary to promote initial poly-drug abstinence in this population.
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan 48207, USA. kdowney@med.wayne.edu
authors.forename: K K
authors.initials: KK
authors.lastname: Downey
authors.forename: T C
authors.initials: TC
authors.lastname: Helmus
authors.forename: C R
authors.initials: CR
authors.lastname: Schuster
mesh_terms: D000293:Adolescent; D000328:Adult; D001944:Breath Tests; D002047:Buprenorphine / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000523:psychology / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D006556:Heroin Dependence / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine