Extended voucher-based reinforcement therapy for long-term drug abstinence

Am J Health Behav. 2010 Nov-Dec;34(6):776-87. doi: 10.5993/ajhb.34.6.12.

Abstract

Objective: To determine whether longer durations of voucher-based reinforcement therapy (VBRT) increase long-term abstinence compared to standard durations.

Methods: Cocaine-abusing or dependent methadone-maintenance patients (N = 130) were randomized to receive either Standard (12-week; n = 62) or Extended (36-week; n = 68) VBRT. Participants provided 3 urine samples weekly during VBRT, and each cocaine-negative sample produced a voucher exchangeable for goods and services.

Results: Extended VBRT produced longer durations of self-reported continuous abstinence during study Year 1 (M = 74 vs. 46 days; F(1,128) = 5.23, P = 0.024), but not during Year 2. However, each week of abstinence during Year 1 was associated with an increase of 9.19 days of abstinence during Year 2, regardless of study condition (t(1) = 4.92, P < 0.001).

Conclusions: Longer-duration VBRT can increase abstinence during VBRT, but may not maintain it afterwards. However, longer during-treatment abstinence begets later abstinence suggesting that further research regarding this relationship is needed.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Behavior Therapy / methods*
  • Cocaine / urine
  • Cocaine-Related Disorders / prevention & control*
  • Cocaine-Related Disorders / therapy*
  • Cocaine-Related Disorders / urine
  • Community Health Services / methods
  • Female
  • Humans
  • Male
  • Secondary Prevention
  • Time Factors
  • Token Economy*

Substances

  • Cocaine