title: Voucher reinforcement for heroin and cocaine abstinence in an outpatient drug-free program.
abstract: This study examined an abstinence-contingent voucher incentive program in opiate-dependent clients enrolled in outpatient drug-free (nonmethadone) treatment. Study participants were referred from local detoxification programs and randomly assigned to voucher (n = 29) or no-voucher (n = 23) conditions. Both groups received intensive cognitive-behavioral counseling; those in the voucher condition could earn up to $1,087.50 over 3 months for submitting urines negative for both opiates and cocaine. Voucher versus no-voucher groups did not differ significantly on mean days retained in treatment (35.9 vs. 39.3 days), mean number of opiate- and cocaine-negative urines submitted (8.3 vs. 6.2), longest duration of continuous abstinence (16.8 vs. 12.1 days), or percentage of participants abstinent for 4 weeks (20.7% voucher vs. 9% no voucher). Possible reasons for negative findings are discussed. Findings suggest that voucher programs must be better tailored to the clinical population and behavioral targets being addressed.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Katz
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Chutuape
authors.forename: Hendree E
authors.initials: HE
authors.lastname: Jones
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D019970:Cocaine-Related Disorders / Q000523:psychology* / Q000534:rehabilitation* / Q000652:urine; D005260:Female; D006556:Heroin Dependence / Q000523:psychology* / Q000534:rehabilitation* / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D012054:Reinforcement, Psychology; D015813:Substance Abuse Detection