title: A reinforcement-based therapeutic workplace for the treatment of drug abuse: six-month abstinence outcomes.
abstract: This study evaluated a novel drug abuse treatment, the Therapeutic Workplace. In this treatment, patients are paid to perform jobs or to participate in job training. Salary is linked to abstinence by requiring patients to provide drug-free urine samples to gain access to the workplace. Pregnant and postpartum drug abuse patients (N = 40) were randomly assigned to a Therapeutic Workplace or usual care control group. Therapeutic Workplace participants were invited to work 3 hr every weekday for 6 months and could earn up to $4,030 in vouchers for abstinence, workplace attendance, and performance. On average, 45% of participants attended the workplace per day. Relative to controls, the Therapeutic Workplace nearly doubled patients' abstinence from opiates and cocaine (33% vs. 59% of thrice-weekly urine samples drug negative, respectively, p < .05). The Therapeutic Workplace can effectively treat heroin and cocaine abuse in pregnant and postpartum women.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. ksilverm@jhmi.edu
authors.forename: K
authors.initials: K
authors.lastname: Silverman
authors.forename: D
authors.initials: D
authors.lastname: Svikis
authors.forename: E
authors.initials: E
authors.lastname: Robles
authors.forename: M L
authors.initials: ML
authors.lastname: Stitzer
authors.forename: G E
authors.initials: GE
authors.lastname: Bigelow
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000534:rehabilitation / Q000652:urine; D005260:Female; D006556:Heroin Dependence / Q000534:rehabilitation / Q000652:urine; D006801:Humans; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D011247:Pregnancy; D012050:Rehabilitation, Vocational / Q000523:psychology*; D012054:Reinforcement, Psychology; D015813:Substance Abuse Detection; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000534:rehabilitation* / Q000652:urine; D016896:Treatment Outcome; D017132:Workplace / Q000523:psychology*
chemical_list: D009294:Narcotics; D008691:Methadone