Contingency management in outpatient methadone treatment: a meta-analysis

Griffith, James D.; Rowan-Szal, Grace A.; Roark, Ryan R.; Simpson, D. Dwayne

doi:10.1016/s0376-8716(99)00068-x

Cited by 262 publications

(220 citation statements)

References 38 publications

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“…However, the beneficial effects of CM often are quite short, tend to decline quickly after rewards for desired behaviors are discontinued, and do not usually extend to other indices of outcome; for example, providing rewards for abstinence from cocaine increases abstinence from cocaine, but not from other drugs. These findings indicate that simply rewarding individuals for being substance-free is not likely to be sufficient to maintain longterm abstinence (Griffith et al, 2000;Lussier et al, 2006;Prendergast et al, 2006;Petry et al, 2005).…”

Section: Rationale and Effectivenessmentioning

confidence: 92%

Theory-based active ingredients of effective treatments for substance use disorders

Moos

2007

Drug and Alcohol Dependence

262

240

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This paper describes four related theories that specify common social processes that protect individuals from developing substance use disorders and may underlie effective psychosocial treatments for these disorders: social control theory, behavioral economics and behavioral choice theory, social learning theory, and stress and coping theory. It then provides an overview of the rationale and evidence for four effective psychosocial treatments for substance use disorders: motivational interviewing and motivational enhancement therapy, 12-step facilitation treatment, cognitive-behavioral treatment and behavioral family counseling, and contingency management and community reinforcement approaches. The presumed active ingredients of these treatments are described in terms of how they exemplify the social processes highlighted by the four theories. The identified common components of effective treatment include support, goal direction, and structure; an emphasis on rewards that compete with substance use, a focus on abstinence-oriented norms and models, and attempts to develop self-efficacy and coping skills. Several issues that need to be addressed to enhance our understanding of the active ingredients involved in effective treatment are discussed, including how to develop measures of these ingredients, how well the ingredients predict outcomes and influence conceptually comparable aspects of clients' life contexts, and how much their influence varies depending upon clients' demographic and personal characteristics.

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Section: Rationale and Effectivenessmentioning

confidence: 92%

Theory-based active ingredients of effective treatments for substance use disorders

Moos

2007

Drug and Alcohol Dependence

262

240

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“…Strengths of CM as a behavioral platform include, in particular, compelling evidence for its potency in a number of populations, and settings (DeRubeis and Crits-Christoph, 1998;Griffith et al, 2000), as well as its flexibility and specificity. That is, CM has the unique advantage in that it can be used to target very specific goals and thus can be used in pharmacotherapy trials to address specific weaknesses of medications.…”

Section: Contingency Managementmentioning

confidence: 99%

“…Griffith et al (Griffith et al, 2000) conducted a meta-analysis of the CM studies done in methadone treatment settings focusing on urine toxicology outcomes and found a modest effect size of 0.25 based on 30 studies. This effect size is smaller than that reported for CM studies with primary cocaine dependence.…”

Section: And Bupropion For Depressed Cocaine Abusing Methadone Patmentioning

confidence: 99%

Choosing a behavioral therapy platform for pharmacotherapy of substance users

Carroll

Kosten

Rounsaville

2004

Drug and Alcohol Dependence

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Behavioral therapy platforms have become virtual requirements in pharmacotherapy trials due to their utility in reducing noise variability, preventing differential medication adherence and protocol attrition, enhancing statistical power and addressing ethical issues in placebo-controlled trials. Selecting an appropriate behavioral platform for a particular trial requires study-specific tailoring, taking into account both the stage of development of the medication being evaluated, as well as the specific strengths and weaknesses of a broad array of available empirically supported behavioral therapies and the range of their possible targets (e.g., enhancing medication adherence, preventing attrition, addressing co-morbid problems, fostering abstinence, and targeting specific weaknesses of the pharmacologic agent). Choosing a suitable behavioral platform also requires consideration of the characteristics of the population to be treated, stage of scientific knowledge regarding the medication's effects, appropriate balance of internal and external validity, and consideration of potential ceiling effects. Available manualized behavioral treatments are reviewed, noting their strengths and limitations as behavioral therapy platforms for pharmacotherapy trials and as potential concomitant therapies in clinical practice.

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“…A substantial number of high quality efficacy studies have now been published that focus on reinforcing abstinence from specific drugs of abuse, ranging from opiates and cocaine through alcohol, marijuana and smoked tobacco. Complementing this growth in the volume of treatment outcome literature, there are now three published meta-analyses [1][2][3], one of which appears in this issue, that provide a perspective on the overall efficacy of the contingency management approach and examine potential moderators of CM efficacy.…”

mentioning

confidence: 99%

“…Thus, for example, an early analysis by Griffith et al [1] included 30 studies and focused only on abstinence incentives in methadone maintained drug abusers. The more recent analysis of Lussier et al [2] also included 30 studies but focused only on those that had employed a particular type of reinforcement technique, voucher-based reinforcement.…”

mentioning

confidence: 99%

Contingency management and the addictions

Stitzer

2006

Addiction

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Contingency management in outpatient methadone treatment: a meta-analysis

Cited by 262 publications

References 38 publications

Theory-based active ingredients of effective treatments for substance use disorders

Theory-based active ingredients of effective treatments for substance use disorders

Choosing a behavioral therapy platform for pharmacotherapy of substance users

Contingency management and the addictions

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