Prize reinforcement contingency management for treating cocaine users: how low can we go, and with whom?
OBJECTIVE
This study evaluated the efficacy of a low-cost, prize reinforcement contingency management (CM) intervention for reducing cocaine use.


METHODS
Community-based treatment centers.


METHODS
Cocaine-abusing out-patients (n = 120) were assigned randomly to one of three 12-week conditions: standard treatment, standard treatment plus CM with an expected maximum of $80 of reinforcement or standard treatment plus CM with an expected maximum of $240 of reinforcement.


METHODS
In the CM conditions, patients earned the opportunity to win prizes for submitting negative urine samples and completing goal-related activities.


METHODS
Drug use was measured at intake and throughout a 3-month treatment period.


RESULTS
Patients in the $240 CM condition achieved more abstinence than patients in the standard condition. Patients who initiated treatment with positive urinalysis results were most responsive to the CM intervention, with the $240 CM condition engendering the best effects in this subgroup. In contrast, patients who initiated treatment with negative urinalysis results generally remained abstinent during treatment, regardless of treatment assignment. On average, patients in the two CM conditions earned $36 and $68 in prizes.


CONCLUSIONS
This study suggests that prize reinforcement CM may be suitable for community-based settings, and beneficial effects may be magnitude-dependent in more severe patients.
Petry
Nancy M
NM
University of Connecticut Health Center, Farmington, CT, USA. petry@psychiatry.uchc.edu
Tedford
Jacqueline
J
Austin
Mark
M
Nich
Charla
C
Carroll
Kathleen M
KM
Rounsaville
Bruce J
BJ
D000328:Adult; D000704:Analysis of Variance; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012055:Reinforcement Schedule; D014040:Token Economy; D016896:Treatment Outcome