title: Effects of a randomized contingency management intervention on opiate abstinence and retention in methadone maintenance treatment in China.
abstract: OBJECTIVE
  Methadone maintenance treatment has been made available in China in response to the rapid spread of human immunodeficiency virus (HIV), but high rates of dropout and relapse are problematic. The aim of this study was to apply and test if a contingency management (or motivational incentives) intervention can improve treatment retention and reduce drug use.
  
  
  METHODS
  Random assignment to usual care with (n = 160) or without (n = 159) incentives during a 12-week trial. Incentives participants earned draws for a chance to win prizes on two separate tracks targeting opiate-negative urine sample or consecutive attendance; the number of draws increased with continuous abstinence or attendance.
  
  
  METHODS
  Community-based methadone maintenance clinics in Shanghai and Kunming.
  
  
  METHODS
  The sample was 23.8% female, mean age was 38, mean years of drug use was 9.4 and 57.8% had injected drugs in the past 30 days.
  
  
  METHODS
  Treatment retention and negative drug urine.
  
  
  RESULTS
  Relative to the treatment-as-usual (control) group, better retention was observed among the incentive group in Kunming (75% versus 44%), but no difference was found in Shanghai (90% versus 86%). Submission of negative urine samples was more common among the incentive group than the usual care (74% versus 68% in Shanghai, 27% versus 18% in Kunming), as was the longest duration of sustained abstinence (7.7 weeks versus 6.5 in Shanghai, 2.5 versus 1.6 in Kunming). The average total prize amount was 371 Yuan (or $55) per participant (527 for Shanghai versus 216 in Kunming).
  
  
  CONCLUSIONS
  Contingency management improves treatment retention and drug abstinence in methadone maintenance treatment clinics in China, although there can be considerable site differences in magnitude of effects.
authors.affiliation: University of California, Los Angeles, CA 90025, USA. yhser@ucla.edu
authors.forename: Yih-Ing
authors.initials: YI
authors.lastname: Hser
authors.forename: Jianhua
authors.initials: J
authors.lastname: Li
authors.forename: Haifeng
authors.initials: H
authors.lastname: Jiang
authors.forename: Ruimin
authors.initials: R
authors.lastname: Zhang
authors.forename: Jiang
authors.initials: J
authors.lastname: Du
authors.forename: Congbin
authors.initials: C
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Evans
authors.forename: Fei
authors.initials: F
authors.lastname: Wu
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
authors.forename: Chinyi
authors.initials: C
authors.lastname: Peng
authors.forename: David
authors.initials: D
authors.lastname: Huang
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
authors.forename: John
authors.initials: J
authors.lastname: Roll
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002681:China; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation* / Q000652:urine; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012008:Recurrence; D012201:Reward; D015819:Substance Abuse, Intravenous / Q000523:psychology / Q000534:rehabilitation* / Q000652:urine; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D008691:Methadone