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Abstinence incentive effects in a short-term outpatient detoxification program
Elizabeth C Katz1, Mary Ann Chutuape, Hendree Jones
1Cornerstone Treatment Research Clinic, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ekatz@frisrc.org
Experimental and Clinical Psychopharmacology
|December 2, 2004
Summary
Contingent incentives, like vouchers, modestly improved abstinence rates during outpatient opiate detoxification. However, additional interventions are needed to maintain long-term drug abstinence for patients.
Area of Science:
- Addiction Medicine
- Behavioral Psychology
Background:
- Outpatient detoxification for opiate addiction has limited efficacy as a standalone treatment.
- Novel interventions are needed to enhance patient outcomes during detoxification.
Purpose of the Study:
- To investigate the effectiveness of abstinence-contingent incentives in improving outcomes for patients undergoing outpatient opiate detoxification.
- To determine if financial incentives improve drug abstinence rates during and immediately after detoxification.
Main Methods:
- A randomized controlled trial was conducted with 211 participants entering outpatient opiate detoxification.
- Participants received a $100 voucher, either contingent on opiate and cocaine abstinence or noncontingently.
- Urine samples were collected at multiple time points: intake, mid-detoxification, end of detoxification, and post-detoxification.
Main Results:
- A significantly higher proportion of participants receiving contingent vouchers were abstinent on the last day of detoxification (31%) compared to noncontingent controls (18%).
- Abstinence rates decreased by the follow-up Monday, with only 12-13% testing negative for drug use.
- Voucher-based incentives demonstrated a modest improvement in initiating abstinence during brief outpatient detoxification.
Conclusions:
- Abstinence-contingent incentives can produce modest improvements in drug abstinence initiation during outpatient detoxification.
- The positive effects of incentives on abstinence initiation may not be sustained post-detoxification.
- Additional therapeutic interventions are necessary to support long-term recovery and sustained abstinence in patients treated with outpatient detoxification.