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Evaluating the reinforcement value of clinic-based privileges through a multiple choice procedure
M Kidorf1, M L Stitzer, R R Griffiths
1Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA.
Drug and Alcohol Dependence
|October 1, 1995
Summary
Methadone take-home doses were most valued by patients, demonstrating their high reinforcement potential. This study provides a method to assess the value of incentives in addiction treatment programs.
Area of Science:
- Addiction Medicine
- Behavioral Economics
- Clinical Psychology
Background:
- Methadone maintenance treatment (MMT) is a cornerstone of opioid use disorder management.
- Clinic-based incentives may enhance patient engagement and treatment adherence in MMT.
- Understanding the relative value of different incentives is crucial for optimizing treatment protocols.
Purpose of the Study:
- To evaluate the reinforcement value of three clinic-based incentives: methadone take-homes, dose increases, and extra counseling.
- To establish a monetary valuation for these incentives using a novel multiple-choice procedure.
- To compare the desirability of different incentives among patients in MMT.
Main Methods:
- A multiple-choice procedure was used with 14 MMT patients not currently receiving incentives.
- Patients made choices between pairs of incentives and between incentives and monetary values.
- Choice behavior was intermittently reinforced with randomly awarded preferences.
Main Results:
- Methadone take-homes were assigned the highest monetary value (US$20.24).
- Dose increases were valued at US$13.89, and extra counseling at US$7.47.
- Take-homes were rated as significantly more desirable than dose increases and extra counseling.
Conclusions:
- Methadone take-homes represent a potent reinforcer in MMT.
- The developed methodology allows for the monetary valuation and comparison of clinic-based incentives.
- This approach can inform the design of effective incentive-based treatment programs and explore individual differences in reinforcer preferences.
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