Maxine L. Stitzer, PhD (Johns Hopkins University School of Medicine, MA Node), Jessica M. Peirce, PhD (Johns Hopkins University School of Medicine, MA Node), Nancy M. Petry, PhD (University of Connecticut School of Medicine), Kimberly C. Kirby, PhD (University of Pennsylvania, DV Node), John M. Roll, PhD (University of California, Los Angeles, PR Node), Joseph Krasnansky, CSW (Lower Eastside Service Center, NY Node), Allan J. Cohen (University of California, Los Angeles, PR Node), Jack Blaine, PhD (Biopharmaceutical Research Consultants, Inc.), Ryan Vandrey, PhD (Johns Hopkins University School of Medicine, MA Node), Ken B. Kolodner, ScD (Johns Hopkins University School of Medicine, MA Node), Rui Li (Johns Hopkins University School of Medicine, MA Node).

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Baseline drug use detected in urine toxicology has been shown to predict drug abuse treatment outcome, including response to contingency management interventions with drug abstinence as their target. This study examined the association between baseline urine test result and treatment outcome in stabilized methadone maintenence patients with ongoing stimulant use to determine whether abstinence incentives were differentially effective in those testing stimulant negative versus positive at study entry.

Participants were 386 methadone-maintained patients who took part in the National Drug Abuse Treatment Clinical Trials Network multisite study aimed at reducing stimulant abuse during treatment (CTN-0007, "Motivational Incentives for Enhanced Drug Abuse Recovery: Methadone Clinics"). At study intake, 24% of participants tested stimulant negative and 76% tested positive. Those testing negative at entry submitted 82% negative urines during the study, versus 36% for those testing positive at entry. Compared with those receiving usual care, the addition of absintence incentives resulted in a significant increase in stimulant-negative urine samples submitted during the study both for those testing negative at study entry and for those testing positive. These findings suggest that abstinence incentives have significant clinical benefits independent of initial drug use severity among methadone maintenance patients with ongoing stimulant drug use. (Article (Peer-Reviewed), PDF, English, 2007)

Keywords: Behavior therapy | Contingency management (CM) | CTN outcomes | Methadone maintenance | MIEDAR | Motivational incentives | Stimulant abuse | Experimental and Clinical Psychopharmacology (journal)

Document No: 238

Submitted by CTN Dissemination Librarians, 9/19/2007.