Kenneth Silverman, Conrad J. Wong, Mick Needham, Karly N. Diemer, Todd Knealing, Darlene Crone-Todd, Michael Fingerhood, Paul Nuzzo, & Kenneth Kolodner (2007).
A randomized trial of employment-based reinforcement of cocaine abstinence in injection drug users.
Journal of Applied Behavior Analysis,
40, 387-410.
High-magnitude and long-duration abstinence reinforcement can
promote drug abstinence but can be difficult to finance. Employment
may be a vehicle for arranging high-magnitude and long-duration
abstinence reinforcement. This study determined if employment-based
abstinence reinforcement could increase cocaine abstinence in
adults who inject drugs and use cocaine during methadone
treatment. Participants could work 4 hr every weekday in a workplace
where they could earn about $10.00 per hour in vouchers; they were
required to provide routine urine samples. Participants who attended
the workplace and provided cocaine-positive urine samples during the
initial 4 weeks were invited to work 26 weeks and were randomly
assigned to an abstinence-and-work (n = 28) or work-only (n = 28)
group. Abstinence-and-work participants had to provide urine samples
showing cocaine abstinence to work and maintain maximum pay.
Work-only participants could work independent of their urinalysis
results. Abstinence-and-work participants provided more (p = .004; OR =
5.80, 95% CI = 2.03-16.56) cocaine-negative urine samples (29%) than
did work-only participants (10%). Employment-based abstinence
reinforcement can increase cocaine abstinence.
DESCRIPTORS: contingency management, abstinence reinforcement, cocaine addiction, methadone, drug abuse treatment, employment