OBJECTIVE: The effects of cognitive-behavioral relapse prevention (RP), contingency management (CM), and their combination (CM + RP) were evaluated in a randomized trial with 100 cocaine-dependent patients (58% female, 89% African American) who were engaged in treatment for at least 2 weeks and had an average of 44 days of abstinence at baseline. METHOD: The participants were from intensive outpatient programs, which provide 10 hr per week of group counseling. The CM protocol provided gift certificates (maximum value $1,150; mean received = $740) for cocaine-free urines over 12 weeks on an escalating reinforcement schedule, and weekly individual RP sessions were offered for up to 20 weeks. Average number of RP sessions attended was 3 in RP and 13 in CM + RP. RESULTS: Generalizing estimation equation analyses over 18 months postrandomization showed significant effects for CM (but not RP) on urine toxicology and self-reported cocaine use (p = .05), with no significant CM x RP interactions. Secondary analyses indicated CM + RP produced better cocaine urine toxicology outcomes at 6 months than treatment as usual, odds ratio [OR] = 3.96 (1.33, 11.80), p < .01, and RP, OR = 4.89 (1.51, 15.86), p < .01, and produced better cocaine urine toxicology outcomes at 9 months than treatment as usual, OR = 4.21 (1.37, 12.88), p < .01, and RP, OR = 4.24 (1.32, 13.65), p < .01. Trends also favored CM + RP over CM at 6 months, OR = 2.93 (0.94, 9.07), p = .06, and 9 months, OR = 2.93 (0.94, 9.10), p = .06. Differences between the conditions were not significant after 9 months. CONCLUSIONS: These results suggest CM can improve outcomes in cocaine-dependent patients in intensive outpatient programs who have achieved initial engagement, particularly when it is combined with RP.
RCT Entities:
OBJECTIVE: The effects of cognitive-behavioral relapse prevention (RP), contingency management (CM), and their combination (CM + RP) were evaluated in a randomized trial with 100 cocaine-dependent patients (58% female, 89% African American) who were engaged in treatment for at least 2 weeks and had an average of 44 days of abstinence at baseline. METHOD: The participants were from intensive outpatient programs, which provide 10 hr per week of group counseling. The CM protocol provided gift certificates (maximum value $1,150; mean received = $740) for cocaine-free urines over 12 weeks on an escalating reinforcement schedule, and weekly individual RP sessions were offered for up to 20 weeks. Average number of RP sessions attended was 3 in RP and 13 in CM + RP. RESULTS: Generalizing estimation equation analyses over 18 months postrandomization showed significant effects for CM (but not RP) on urine toxicology and self-reported cocaine use (p = .05), with no significant CM x RP interactions. Secondary analyses indicated CM + RP produced better cocaine urine toxicology outcomes at 6 months than treatment as usual, odds ratio [OR] = 3.96 (1.33, 11.80), p < .01, and RP, OR = 4.89 (1.51, 15.86), p < .01, and produced better cocaine urine toxicology outcomes at 9 months than treatment as usual, OR = 4.21 (1.37, 12.88), p < .01, and RP, OR = 4.24 (1.32, 13.65), p < .01. Trends also favored CM + RP over CM at 6 months, OR = 2.93 (0.94, 9.07), p = .06, and 9 months, OR = 2.93 (0.94, 9.10), p = .06. Differences between the conditions were not significant after 9 months. CONCLUSIONS: These results suggest CM can improve outcomes in cocaine-dependent patients in intensive outpatient programs who have achieved initial engagement, particularly when it is combined with RP.
Authors: K M Carroll; C Nich; R L Sifry; K F Nuro; T L Frankforter; S A Ball; L Fenton; B J Rounsaville Journal: Drug Alcohol Depend Date: 2000-01-01 Impact factor: 4.492
Authors: Jesse B Milby; Joseph E Schumacher; Dennis Wallace; Sonja Frison; Cecelia McNamara; Stuart Usdan; Max Michael Journal: J Consult Clin Psychol Date: 2003-06
Authors: Stephen T Higgins; Stacey C Sigmon; Conrad J Wong; Sarah H Heil; Gary J Badger; Robert Donham; Robert L Dantona; Stacey Anthony Journal: Arch Gen Psychiatry Date: 2003-10
Authors: Lissa Dutra; Georgia Stathopoulou; Shawnee L Basden; Teresa M Leyro; Mark B Powers; Michael W Otto Journal: Am J Psychiatry Date: 2008-01-15 Impact factor: 18.112
Authors: Richard A Rawson; Alice Huber; Michael McCann; Steven Shoptaw; David Farabee; Chris Reiber; Walter Ling Journal: Arch Gen Psychiatry Date: 2002-09
Authors: Laura A Schmidt; Traci Rieckmann; Amanda Abraham; Todd Molfenter; Victor Capoccia; Paul Roman; David H Gustafson; Dennis McCarty Journal: J Stud Alcohol Drugs Date: 2012-05 Impact factor: 2.582
Authors: Dennis McCarty; Lisa Braude; D Russell Lyman; Richard H Dougherty; Allen S Daniels; Sushmita Shoma Ghose; Miriam E Delphin-Rittmon Journal: Psychiatr Serv Date: 2014-06-01 Impact factor: 3.084
Authors: Michelle Tuten; Heather Fitzsimons; Margaret S Chisolm; Paul A Nuzzo; Hendree E Jones Journal: Addiction Date: 2012-06-21 Impact factor: 6.526
Authors: Paul Crits-Christoph; Steven Wadden; Averi Gaines; Agnes Rieger; Robert Gallop; James R McKay; Mary Beth Connolly Gibbons Journal: J Subst Abuse Treat Date: 2018-06-21
Authors: Mark D Godley; Susan H Godley; Michael L Dennis; Rodney R Funk; Lora L Passetti; Nancy M Petry Journal: J Consult Clin Psychol Date: 2013-12-02
Authors: Mark D Godley; Lora L Passetti; Geetha A Subramaniam; Rodney R Funk; Jane Ellen Smith; Robert J Meyers Journal: Drug Alcohol Depend Date: 2017-02-22 Impact factor: 4.492