This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (27)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Substance Abuse/ Alcoholism  • Public Health  • Alert me on articles by topic

A National Drug Abuse Treatment Clinical Trials Network Study

Jessica M. Peirce, PhD; Nancy M. Petry, PhD; Maxine L. Stitzer, PhD; Jack Blaine, MD; Scott Kellogg, PhD; Frank Satterfield; Marion Schwartz, MSW; Joe Krasnansky, CSW; Eileen Pencer, MSW; Lolita Silva-Vazquez, MA; Kimberly C. Kirby, PhD; Charlotte Royer-Malvestuto, MEd; John M. Roll, PhD; Allan Cohen, MA, MFT; Marc L. Copersino, PhD; Ken Kolodner, ScD; Rui Li, MS

Arch Gen Psychiatry. 2006;63:201-208.

Background  Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings.

Objective  To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings.

Design  Random assignment to usual care with (n = 198) or without (n = 190) abstinence incentives during a 12-week trial.

Setting  Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States.

Participants  Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years.

Intervention  Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time.

Main Outcome Measures  Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance.

Results  Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95% confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was $120 per participant.

Conclusion  An abstinence incentive approach that paid $120 in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

Author Affiliations: Mid Atlantic Node, The Johns Hopkins University School of Medicine, Baltimore, Md (Drs Peirce, Stitzer, and Kolodner, Mr Satterfield, and Ms Li); New England Node, University of Connecticut School of Medicine, New Haven (Dr Petry); Biopharmaceutical Research Consultants, Inc, Ann Arbor, Mich (Dr Blaine); New York Node, New York University and Rockefeller University, New York (Dr Kellogg, Mss Schwartz, Pencer and Silva-Vazquez, and Mr Krasnansky); Delaware Valley Node, University of Pennsylvania and Treatment Research Institute, Philadelphia (Dr Kirby and Ms Royer-Malvestuto); Pacific Node, Washington Institute for Mental Illness Research and Training, Washington State University, Spokane (Dr Roll); University of California, Los Angeles (Mr Cohen); and National Institute on Drug Abuse Intramural Research Program, Baltimore, Md (Dr Copersino).
Deceased.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Voucher-Based Incentives for Naltrexone Treatment Attendance in Schizophrenia and Alcohol Use Disorders
Leontieva et al.
Psychiatr. Serv. 2008;59:310-314.
ABSTRACT | FULL TEXT  

Direct Care Workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs
McCarty et al.
Psychiatr. Serv. 2007;58:181-190.
ABSTRACT | FULL TEXT  

Extending Contingency Management to the Treatment of Methamphetamine Use Disorders
Higgins
Am. J. Psychiatry 2006;163:1870-1872.
FULL TEXT  

Contingency Management for the Treatment of Methamphetamine Use Disorders
Roll et al.
Am. J. Psychiatry 2006;163:1993-1999.
ABSTRACT | FULL TEXT  

Contingency management treatments
Petry
Br. J. Psychiatry 2006;189:97-98.
ABSTRACT | FULL TEXT  

Abstinence incentives improve stimulant abusers' compliance with community-based psychosocial treatments.
Sorensen
Evid. Based Ment. Health 2006;9:55-55.
FULL TEXT