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Related Experiment Videos

Shaping cocaine abstinence by successive approximation.

K L Preston1, A Umbricht, C J Wong

  • 1Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland 21224, USA. kpreston@intra.nida.nih.gov

Journal of Consulting and Clinical Psychology
|September 12, 2001
PubMed
Summary

A novel contingency management approach, the shaping group, better prepared cocaine-using patients for abstinence compared to standard methods. This suggests improved practical application for addiction treatment maintenance.

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Area of Science:

  • Addiction Medicine
  • Behavioral Psychology
  • Clinical Research

Background:

  • Cocaine use remains a significant challenge in methadone maintenance treatment.
  • Effective behavioral interventions are crucial for improving treatment outcomes.

Purpose of the Study:

  • To compare a standard contingency management (CM) approach with a novel "shaping" CM strategy for cocaine-using patients.
  • To assess the efficacy of CM in promoting and maintaining cocaine abstinence.

Main Methods:

  • Randomized trial with two groups: standard CM (abstinence-focused) and shaping CM (gradual reduction focus).
  • Both groups received escalating vouchers for thrice-weekly urinalyses over 8 weeks.
  • Shaping group initially rewarded decreased cocaine metabolite levels, then abstinence.

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Main Results:

  • The shaping group showed lower cocaine use in the final 5 weeks when requirements were identical.
  • This suggests the shaping contingency better prepared patients for sustained abstinence.
  • Induced abstinence with escalating vouchers could be maintained by non-escalating schedules.

Conclusions:

  • A shaping contingency management approach may be more effective in preparing patients for cocaine abstinence.
  • Contingency management shows potential as a practical maintenance treatment for addiction.