Abstinence-contingent reinforcement and engagement in non-drug-related activities among illicit drug abusers.
Methadone-maintained cocaine abusers (N = 78) were randomly assigned to 1 of the following 52-week interventions: (a) usual care only (UC), (b) take-home methadone doses contingent on cocaine- and opiate-negative results (THM), or (c) take-home methadone doses for cocaine- and opiate-negative results and monetary-based vouchers contingent on cocaine-negative urinalysis results (THM + V). Cocaine use was assessed by urinalysis on a thrice-weekly schedule. Frequency and enjoyability of non-drug-related activities were assessed with the Pleasant Events Schedule (PES) at baseline, midtreatment, and end of treatment. The THM + V condition achieved the greatest abstinence from cocaine and opiate use, followed by the THM and UC conditions. The THM + V condition had the highest PES frequency ratings at midtreatment and at the end of treatment, followed by the THM and UC conditions. There were significant differences between the THM + V and UC conditions on 10 of 12 PES-derived subscales. Analyses revealed that abstinence mediated the effects of treatment condition on frequency ratings. There were no significant differences in enjoyability ratings. These results suggest that when contingency-management interventions increase abstinence from drug abuse, they also increase engagement in non-drug-related activities in naturalistic settings.
Rogers
Randall E
RE
Department of Psychiatry, University of Vermont, USA. rrogers@uvm.edu
Higgins
Stephen T
ST
Silverman
Kenneth
K
Thomas
Colleen S
CS
Badger
Gary J
GJ
Bigelow
George
G
Stitzer
Maxine
M
D000293:Adolescent; D000328:Adult; D015142:Baltimore; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007899:Leisure Activities; D008297:Male; D008691:Methadone / Q000008:administration & dosage; D008875:Middle Aged; D009042:Motivation; D009294:Narcotics / Q000008:administration & dosage; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012646:Self Administration / Q000523:psychology; D015813:Substance Abuse Detection; D014040:Token Economy
D013287:Illicit Drugs; D009294:Narcotics; D008691:Methadone