title: Employment-based abstinence reinforcement promotes opiate and cocaine abstinence in out-of-treatment injection drug users.
abstract: We examined the use of employment-based abstinence reinforcement in out-of-treatment injection drug users, in this secondary analysis of a previously reported trial. Participants (N = 33) could work in the therapeutic workplace, a model employment-based program for drug addiction, for 30 weeks and could earn approximately $10 per hr. During a 4-week induction, participants only had to work to earn pay. After induction, access to the workplace was contingent on enrollment in methadone treatment. After participants met the methadone contingency for 3 weeks, they had to provide opiate-negative urine samples to maintain maximum pay. After participants met those contingencies for 3 weeks, they had to provide opiate- and cocaine-negative urine samples to maintain maximum pay. The percentage of drug-negative urine samples remained stable until the abstinence reinforcement contingency for each drug was applied. The percentage of opiate- and cocaine-negative urine samples increased abruptly and significantly after the opiate- and cocaine-abstinence contingencies, respectively, were applied. These results demonstrate that the sequential administration of employment-based abstinence reinforcement can increase opiate and cocaine abstinence among out-of-treatment injection drug users.
authors.affiliation: Johns Hopkins University School of Medicine.
authors.forename: August F
authors.initials: AF
authors.lastname: Holtyn
authors.forename: Mikhail N
authors.initials: MN
authors.lastname: Koffarnus
authors.forename: Anthony
authors.initials: A
authors.lastname: DeFulio
authors.forename: Sigurdur O
authors.initials: SO
authors.lastname: Sigurdsson
authors.forename: Eric C
authors.initials: EC
authors.lastname: Strain
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schwartz
authors.forename: Kenneth
authors.initials: K
authors.lastname: Silverman
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D019970:Cocaine-Related Disorders / Q000188:drug therapy / Q000628:therapy*; D003131:Combined Modality Therapy; D055030:Drug Users / Q000523:psychology*; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000628:therapy*; D012054:Reinforcement, Psychology; D017132:Workplace / Q000523:psychology; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: abstinence reinforcement; cocaine addiction; contingency management; employment; opiate addiction