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Contingency contracting with polydrug-abusing methadone patients.

S Magura1, C Casriel, D S Goldsmith

  • 1Narcotic and Drug Research, Inc., New York, NY 10027.

Addictive Behaviors
|January 1, 1988
PubMed
Summary
This summary is machine-generated.

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Contingency contracting for methadone patients showed a temporary positive effect on reducing polydrug use, particularly for those not using cocaine. Further research is needed to explore stronger reinforcement strategies.

Area of Science:

  • Addiction Medicine
  • Behavioral Psychology
  • Clinical Research

Background:

  • Polydrug use is a significant challenge in methadone maintenance treatment.
  • Contingency contracting is a behavioral intervention used to modify patient behavior.

Purpose of the Study:

  • To evaluate the impact of contingency contracting for medication take-home privileges on polydrug use in methadone patients.
  • To compare the effectiveness of different types of contracts (drug-related vs. non-drug-related, cocaine vs. non-cocaine).

Main Methods:

  • A within-subjects reversal design was employed.
  • Participants included methadone patients with varying substance use patterns (cocaine, other illicit drugs, other noncompliance).
  • Urine drug screens were used to monitor polydrug use throughout pre-contingency, contingency, and post-contingency periods.

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Main Results:

  • No significant overall difference in positive urines was found between pre-contingency and contingency periods, or pre- and post-contingency.
  • During the first month of contracting, some patients eliminated drug use, while others showed an increase in positive urines, possibly due to intensified urinalysis.
  • Non-drug-related contracts and contracts not targeting cocaine were more successful than drug-related and cocaine-targeting contracts, respectively.

Conclusions:

  • Contingency contracting demonstrated a favorable, albeit transient, effect on polydrug use, primarily in methadone patients not abusing cocaine.
  • The findings suggest that contract type influences effectiveness.
  • Further investigation into stronger or multiple reinforcement strategies is recommended.