Incentives Improve Outcome in Outpatient Behavioral Treatment of Cocaine Dependence

Higgins, Stephen T.; Budney, Alan J.; Bickel, Warren K.; Foerg, Florian E.; Donham, Robert T.; Badger, Gary J.

doi:10.1001/archpsyc.1994.03950070060011

Cited by 758 publications

(567 citation statements)

References 41 publications

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“…A related issue was the specificity of the results; that is, the effects of the behavioral treatment on opioid use were not reflected in urinalysis results for other drugs. This specificity of effect is consistent with other applications of contingency management procedures (e.g., Higgins, Budney, Bickel, Foerg, et al, 1994) and suggests that obtaining decreases in other drug use requires that these drugs be added to the imposed contingencies (Budney, Higgins, Delaney, Kent, & Bickel, 1991 ).…”

Section: Cost Of Behavioral Treatmentsupporting

confidence: 86%

Effects of adding behavioral treatment to opioid detoxification with buprenorphine.

Bickel¹,

Amass²,

Higgins³

et al. 1997

Journal of Consulting and Clinical Psychology

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175

108

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This trial assessed whether behavioral treatment improves outcome during a 26-week outpatient opioid detoxification. Thirty-nine opioid-dependent adults were assigned randomly to a buprenorphine dose-taper combined with either behavioral or standard treatment. Behavioral treatment included (a) a voucher incentive program for providing opioid-free urine samples and engaging in verifiable therapeutic activities and (b) the community reinforcement approach, a multicomponent behavioral treatment. Standard treatment included lifestyle counseling. Fifty-three percent of the patients receiving behavioral treatment completed treatment, versus 20% receiving standard treatment. The percentage of patients achieving 4, 8, 12, and 16 weeks of continuous opioid abstinence were 68, 47, 26, and 11 for the behavioral group and 55, 15, 5, and 0 for the standard group, respectively. Behavioral treatment improved outcomes during outpatient detoxification.

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Section: Cost Of Behavioral Treatmentsupporting

confidence: 86%

Effects of adding behavioral treatment to opioid detoxification with buprenorphine.

Bickel¹,

Amass²,

Higgins³

et al. 1997

Journal of Consulting and Clinical Psychology

Self Cite

175

108

View full text Add to dashboard Cite

show abstract

“…Rewards may take multiple forms, but the most common include vouchers that may be exchanged for goods or services, prizes, or the granting of some form of privilege. Contingency management approaches have been shown to improve retention and to increase abstinence with various substance-abusing populations, including those dependent on cocaine (Higgins et al, 1994), marijuana (Budney, Higgins, Radonovich, & Novy, 2000), alcohol (Petry, Martin, Cooney, & Kranzler, 2000), and opioids (Bickel, Amass, Higgins, Badger, & Esch, 1997;Silverman, Chutuape, Bigelow, & Stitzer, 1996).…”

Section: Voucher-based Motivational Incentivesmentioning

confidence: 99%

Innovation adoption in substance abuse treatment: Exposure, trialability, and the Clinical Trials Network

Ducharme

Knudsen

Roman

et al. 2007

Journal of Substance Abuse Treatment

103

151

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Researchers and policymakers are increasingly focusing on factors that facilitate or impede the diffusion of evidence-based treatment techniques into routine clinical practice. One potentially fruitful avenue of research is the influence of involvement in research networks as a predictor of organizational innovation. The Clinical Trials Network (CTN) is examining a number of behavioral and pharmacological treatment techniques in controlled multisite studies. Using data from participating CTN treatment programs and large samples of programs outside the CTN, these analyses examine the influence of exposure to clinical trials on the subsequent adoption of buprenorphine and voucher-based motivational incentives. The analyses show that, controlling for a variety of organizational characteristics, direct exposure to buprenorphine clinical trials in the CTN significantly increased the odds of subsequent adoption. By contrast, the adoption of motivational incentives was entirely explained by organizational characteristics. The findings suggest that adoption of treatment innovations is a function of exposure, organizational resources, nature of innovations, and stage of the diffusion process.

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“…By using behavioral principles to enhance participants' incentives for completing treatment and meeting clinical goals, substance abuse programs have increased completion rates from 30 to 80 percent and sobriety rates from 15 to 70 percent [15][16]. The efficacy of these approaches is now well documented in more than 24 clinical trials [13][14][17][18].…”

Section: Introductionmentioning

confidence: 99%

Adding contingency management intervention to vocational rehabilitation: Outcomes for dually diagnosed veterans

Drebing¹,

Ormer²,

Mueller³

et al. 2007

JRRD

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Abstract-In this random-assignment trial, we evaluated the efficacy of using a contingency management (CM) intervention to enhance job acquisition and tenure among participants of a vocational rehabilitation (VR) program. The CM intervention offered participants cash incentives up to $1,170 for completing tasks related to sobriety and job search and maintenance. Participants were 100 veterans with comorbid psychiatric disorders and substance dependence who were randomly assigned either to VR only or VR + CM. Relative to participants in the VR-only group, those in the VR + CM group showed more intense job searches and transitioned to competitive employment faster and at higher rates. No significant difference was found in job tenure, though this may be due to the limited follow-up period. Abstinence rates were significantly better in the VR + CM group during the first 16 weeks of follow-up but not significantly different in subsequent follow-ups. No relationship was found between relapse and employment. These results suggest that rehabilitation outcomes may be enhanced by adding CM to current programming or by restructuring traditional work-for-pay contingencies to include direct financial rewards for achievement of clinical goals.

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Incentives Improve Outcome in Outpatient Behavioral Treatment of Cocaine Dependence

Abstract: Incentives delivered contingent on submitting cocaine-free urine specimens significantly improve treatment outcome in ambulatory cocaine-dependent patients.

Cited by 758 publications

References 41 publications

Effects of adding behavioral treatment to opioid detoxification with buprenorphine.

Effects of adding behavioral treatment to opioid detoxification with buprenorphine.

Innovation adoption in substance abuse treatment: Exposure, trialability, and the Clinical Trials Network

Adding contingency management intervention to vocational rehabilitation: Outcomes for dually diagnosed veterans

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