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Compliance with tuberculosis treatment in methadone-maintained patients: behavioral interventions
R Elk1, J Grabowski, H Rhoades
1Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston 77030.
Journal of Substance Abuse Treatment
|July 1, 1993
Summary
This study achieved 100% compliance with tuberculosis (TB) treatment in opiate users by linking methadone dispensing to isoniazid (INH) ingestion. Contingency management also reduced cocaine use in some participants.
Area of Science:
- Public Health
- Infectious Diseases
- Addiction Medicine
Background:
- Tuberculosis (TB) incidence is rising in the US, with high treatment noncompliance.
- Intravenous drug users represent a high-risk group for TB and treatment challenges.
Purpose of the Study:
- To improve adherence to prophylactic TB treatment.
- To reduce illicit drug use among opiate users undergoing TB treatment.
Main Methods:
- Two studies utilized contingency management, dispensing methadone based on isoniazid (INH) ingestion.
- Study 1 involved 9 opiate users in an A-B design.
- Study 2 used a multiple baseline design with 2 patients, reinforcing reduced cocaine use.
Main Results:
- Study 1: 100% INH compliance in 8/9 patients; cocaine use remained high.
- Study 2: Over 40% cocaine-free urine samples during contingency, compared to 0% at baseline.
- High INH compliance was observed across both studies.
Conclusions:
- Contingency management is an effective model for ensuring TB treatment adherence in opiate users.
- This approach shows promise for simultaneously addressing substance use disorders.