title: Contingency management is efficacious and improves outcomes in cocaine patients with pretreatment marijuana use.
abstract: BACKGROUND
  Marijuana use is common in patients seeking treatment for cocaine use. Nevertheless, few studies have examined effects of marijuana use on treatment outcomes in general, and even fewer with respect to contingency management (CM) treatment, which has been criticized for potentially increasing non-reinforced drug use.
  
  
  METHODS
  Data from three randomized clinical trials of CM versus standard treatment (ST) in cocaine-abusing patients were examined (Petry et al., 2004, 2005a, 2006a; N=393) to assess effects of pretreatment marijuana use on outcomes. Patients were divided into two groups: (1) no self-reported marijuana use (No Pre-M; n=315) and (2) any self-reported marijuana use (Pre-M; n=78) in the 30 days pretreatment.
  
  
  RESULTS
  CM was especially efficacious in enhancing retention in Pre-M patients such that retention nearly doubled among Pre-M patients assigned to CM versus those assigned to ST. In contrast, CM exerted only modest benefits on retention in No Pre-M patients. Pretreatment marijuana use was not related to during-treatment abstinence from cocaine, opioids, and alcohol, or abstinence at a Month 9 follow-up. However, CM treatment and longest duration of abstinence achieved during treatment were significant predictors of Month 9 abstinence. Pre-M patients also evidenced more improvements in drug problems over time when randomized to CM.
  
  
  CONCLUSIONS
  CM was especially efficacious in facilitating retention and improving severity of drug-related problems in those who used marijuana in the month before initiating treatment.
authors: University of Connecticut Health Center, Calhoun Cardiology Center - Behavioral Health, 263 Farmington Avenue, Farmington, CT 06030-3944, USA. salessi@uchc.edu
authors: Sheila M
authors: SM
authors: Alessi
authors: Carla
authors: C
authors: Rash
authors: Nancy M
authors: NM
authors: Petry
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001521:Behavior Therapy / Q000379:methods*; D000697:Central Nervous System Stimulants / Q000652:urine; D003042:Cocaine / Q000652:urine; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000523:psychology* / Q000652:urine; D011569:Psychiatric Status Rating Scales; D012054:Reinforcement, Psychology; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation* / Q000652:urine; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D003042:Cocaine