Opioid abstinence reinforcement delays heroin lapse during buprenorphine dose tapering.
A positive reinforcement contingency increased opioid abstinence during outpatient dose tapering (4, 2, then 0 mg/day during Weeks 1 through 3) in non-treatment-seeking heroin-dependent volunteers who had been maintained on buprenorphine (8 mg/day) during an inpatient research protocol. The control group (n=12) received $4.00 for completing assessments at each thrice-weekly visit during dose tapering; 10 of 12 lapsed to heroin use 1 day after discharge. The abstinence reinforcement group (n=10) received $30.00 for each consecutive opioid-free urine sample; this significantly delayed heroin lapse (median, 15 days).
Greenwald
Mark K
MK
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan 48207, USA. mgreen@med.wayne.edu
D000328:Adult; D000553:Ambulatory Care; D002047:Buprenorphine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009294:Narcotics / Q000008:administration & dosage*; D010351:Patient Discharge; D012055:Reinforcement Schedule; D055502:Secondary Prevention; D015813:Substance Abuse Detection; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D014040:Token Economy
D009294:Narcotics; D002047:Buprenorphine