title: Rewarding early abstinence in Veterans Health Administration addiction clinics.
abstract: This study investigates the addition of a contingency management (CM) intervention to Veterans Health Administration substance use disorders treatment on during- and post-treatment outcomes for Veterans diagnosed with alcohol dependence only (n=191) or stimulant dependence (n=139). Participants were randomly assigned to 8weeks of usual care or usual care plus CM. Follow-up assessments occurred at 2, 6 and 12months. In the alcohol dependent subgroup, CM participants submitted significantly more negative samples (13 versus 11 samples, Cohen's d=0.54), were retained significantly longer (7 versus 6weeks, d=0.47), achieved significantly longer median durations of abstinence (16 versus 9 consecutive visits; median difference=7, 95% CI=4-8), and submitted significantly more negative samples at follow-ups (unstandardized effect size=0.669, se=0.2483) compared to usual care participants. Intervention effects were non-significant for the stimulant dependent subgroup. The study provides support for the effectiveness of CM interventions for alcohol dependent patients.
authors: Veterans Health Administration Substance Use Disorder Quality Enhancement Research Initiative, Minneapolis VA Healthcare System, Minneapolis, MN, 55417, USA. hildi.hagedorn@va.gov
authors: Hildi J
authors: HJ
authors: Hagedorn
authors: Siamak
authors: S
authors: Noorbaloochi
authors: Alisha Baines
authors: AB
authors: Simon
authors: Ann
authors: A
authors: Bangerter
authors: Maxine L
authors: ML
authors: Stitzer
authors: Cheryl B
authors: CB
authors: Stetler
authors: Daniel
authors: D
authors: Kivlahan
mesh_terms: D000437:Alcoholism / Q000534:rehabilitation*; D019969:Amphetamine-Related Disorders / Q000534:rehabilitation*; D019970:Cocaine-Related Disorders / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012201:Reward; D016320:Substance Abuse Treatment Centers; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans