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Related Experiment Videos

Do noncontingent vouchers increase drug use?

Jennifer R Schroeder1, Anne E Gupman, David H Epstein

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

Experimental and Clinical Psychopharmacology
|August 28, 2003
PubMed
Summary

This study examined if free vouchers for drug users unintentionally increased substance use. Results suggest that receiving vouchers unrelated to drug test outcomes did not cause more drug use, except for a slight increase in cocaine use.

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Area of Science:

  • Addiction research
  • Behavioral economics
  • Psychopharmacology

Background:

  • Contingency management (CM) is an evidence-based intervention for substance use disorders.
  • A key component of CM involves providing tangible rewards (vouchers) for verified abstinence.
  • Concerns exist that noncontingent provision of rewards might inadvertently reinforce drug use.

Purpose of the Study:

  • To investigate whether noncontingent voucher provision inadvertently reinforces drug use in individuals undergoing treatment for opiate or cocaine dependence.
  • To assess the dose-response and temporal associations between noncontingent voucher receipt and drug-positive urinalysis results.

Main Methods:

  • Analysis of data from two randomized controlled trials targeting opiate and cocaine use.

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  • Control groups received vouchers independent of urinalysis outcomes, matched in value and frequency to experimental groups.
  • Voucher delivery occurred thrice weekly for 8 weeks (opiates) or 12 weeks (cocaine).

    • Main Results:

    • Overall, drug use was not significantly associated with the frequency of noncontingent voucher delivery or receipt.
    • An exception was observed in the cocaine study, where a small but statistically significant increase in cocaine use was linked to noncontingent voucher receipt (RR=1.05).
    • When drug-positive results were unassociated with subsequent risk, noncontingent voucher receipt did not correlate with increased drug use.

    Conclusions:

    • The findings do not support a causal relationship between noncontingent voucher receipt and increased drug use in the context of these trials.
    • While a slight association was noted for cocaine use, the overall evidence suggests noncontingent vouchers are unlikely to inadvertently reinforce drug use.
    • Further research may be warranted to explore the specific mechanisms and contexts influencing voucher reinforcement.