title: Effects of urine testing frequency on outcome in a methadone take-home contingency program.
abstract: We examined the effects of urine testing frequency on treatment outcome in a contingent methadone take-home program. Study patients who submitted<80% opiate and/or cocaine positive urines during a 5-week baseline received 60 mg methadone throughout the study, submitted urine samples on Monday, Wednesday, and Friday, and were randomized into one of three take-home incentive conditions. Study patients could receive three take-home doses per week if one urine sample randomly selected each week (Weekly; n=16) or each month (Monthly; n=18) was negative for opiates and cocaine. Take-homes for Random Drawing control patients (n=19) were determined weekly independent of urine test results. Subjects in the Weekly group showed an immediate increase from baseline in percentage of drug-free urines; those in the Monthly group showed a gradual increase over the first 3 months; and those in Random Drawings showed a decline in percentage of drug-free urines over time. The percentage of patients with sustained (8 or more weeks) opiate and cocaine abstinence was 56.6, 38.9 and 10.5% for Weekly, Monthly and Random Drawing groups, respectively (P<0.002). These results confirm that methadone take-homes contingent on drug-free urines prevent a decline in treatment performance over time and suggest that abstinence can be sustained with urine testing conducted as infrequently as once a month.
authors.affiliation: Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. chutuape@jhmi.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Chutuape
authors.forename: K
authors.initials: K
authors.lastname: Silverman
authors.forename: M L
authors.initials: ML
authors.lastname: Stitzer
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000628:therapy* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation* / Q000652:urine; D012646:Self Administration; D015813:Substance Abuse Detection / Q000379:methods / Q000523:psychology*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D008691:Methadone