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Published on: January 22, 2016
Difficulties in a clinical application of methadone-dose contingency contracting
1Addiction Research and Treatment Service, University of Colorado Health Sciences Center, Denver.
Journal of Substance Abuse Treatment
|January 1, 1990
Summary
A contingency contract for methadone-maintenance patients temporarily reduced drug abuse in 55% of cases. While some patients stabilized their methadone dose, others reduced it to zero, highlighting the need for consistent treatment protocols.
Area of Science:
- Addiction Medicine
- Clinical Psychology
Background:
- Methadone maintenance is a key treatment for opioid use disorder.
- Managing patients who continue to abuse drugs while on methadone presents challenges.
- The AIDS epidemic necessitates effective strategies for this patient population.
Purpose of the Study:
- To evaluate the effectiveness of a methadone-dose contingency contract for patients with ongoing drug abuse.
- To explore treatment options for methadone-maintenance patients with continued substance use.
Main Methods:
- A review of 14 methadone-maintenance patients.
- Offered a choice between administrative discharge or a contingency contract for continued drug abuse.
- Monitored urine drug screens before and during a three-month intervention period.
Main Results:
- Drug-free urines increased from 38% pre-intervention to 55% during the intervention.
- Nine patients reduced or stopped drug abuse, maintaining or fluctuating their methadone dose.
- Five patients continued drug abuse, ultimately reducing their methadone dose to zero.
- The intervention showed temporary reduction in drug abuse, potentially weakened by inconsistent contingency application.
Conclusions:
- Contingency contracts can temporarily reduce drug abuse in methadone-maintenance patients.
- Inconsistent application of treatment protocols may limit effectiveness.
- Further research and standardized protocols are needed for managing patients with ongoing substance use in methadone maintenance.
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