The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: A randomized controlled trial

PREVENTIVE MEDICINE

卷:68

Article

Holtyn, August F.¹  Koffarnus, Mikhail N.²  DeFulio, Anthony¹  Sigurdsson, Sigurdur O.^1,3  Strain, Eric C.¹  Schwartz, Robert P.⁴  Leoutsakos, Jeannie-Marie S.¹  Silverman, Kenneth¹ 

[1] Johns Hopkins Univ, Sch Med, Baltimore, MD 21224 USA

[2] Virginia Tech, Carillon Res Inst, Blacksburg, VA 24061 USA

[3] Florida Inst Technol, Melbourne, FL 32901 USA

[4] Friends Res Inst, Baltimore, MD 21201 USA

关键词: Methadone;    Contingency management;    Financial incentives;    Cocaine;    Opiate;    Employment;    Injection drug use;    Out-of-treatment injection drug user;   

DOI  :  10.1016/j.ypmed.2014.02.021

来源: Elsevier

【 摘 要 】

Objective: Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method: This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N = 98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results: Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion: The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. (C) 2014 Elsevier Inc. All rights reserved.

【 授权许可】

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