AIMS: To conduct a randomized, controlled trial of abstinence-contingent recovery housing delivered with or without intensive day treatment among individuals exiting residential opioid detoxification. DESIGN: Random assignment to one of three conditions: recovery housing alone (RH), abstinence-contingent recovery housing with reinforcement-based treatment RBT (RH + RBT) or usual care (UC). RH and RH + RBT participants received 12 weeks of paid recovery housing contingent upon drug abstinence. RH + RBT participants also received 26 weeks of RBT, initiated concurrently with recovery housing. Assessments were conducted at 1, 3 and 6 months after treatment enrollment. SETTING: Out-patient drug-free substance abuse treatment program in Baltimore, Maryland. PARTICIPANTS: Patients (n = 243) who completed medication-assisted opioid detoxification. MEASUREMENTS: Primary outcome was drug abstinence (opioid- and cocaine-negative urine and no self-reported opioid or cocaine use in the previous 30 days). Secondary outcomes included abstinence at all time-points (1, 3 and 6 months), days in recovery housing and employment. FINDINGS:Overall rates of drug abstinence were 50% for RH + RBT, 37% for RH and 13% for UC (P < 0.001). At 6 months, RH + RBT participants remained more likely to meet abstinence criteria than UC participants (37% versus 20%, P = 0.016). Length of stay in recovery housing mediated abstinence outcomes and was longer in RH + RBT (49.5 days) than in RH (32.2 days; P < 0.002). CONCLUSIONS:Abstinence-contingent recovery housing improves abstinence in opioid-dependent adults following medication-assisted detoxification. The addition of intensive 'reinforcement-based treatment' behavioural counseling further improves treatment outcomes, in part by promoting longer recovery house stays.
RCT Entities:
AIMS: To conduct a randomized, controlled trial of abstinence-contingent recovery housing delivered with or without intensive day treatment among individuals exiting residential opioid detoxification. DESIGN: Random assignment to one of three conditions: recovery housing alone (RH), abstinence-contingent recovery housing with reinforcement-based treatment RBT (RH + RBT) or usual care (UC). RH and RH + RBT participants received 12 weeks of paid recovery housing contingent upon drug abstinence. RH + RBT participants also received 26 weeks of RBT, initiated concurrently with recovery housing. Assessments were conducted at 1, 3 and 6 months after treatment enrollment. SETTING: Out-patient drug-free substance abuse treatment program in Baltimore, Maryland. PARTICIPANTS: Patients (n = 243) who completed medication-assisted opioid detoxification. MEASUREMENTS: Primary outcome was drug abstinence (opioid- and cocaine-negative urine and no self-reported opioid or cocaine use in the previous 30 days). Secondary outcomes included abstinence at all time-points (1, 3 and 6 months), days in recovery housing and employment. FINDINGS: Overall rates of drug abstinence were 50% for RH + RBT, 37% for RH and 13% for UC (P < 0.001). At 6 months, RH + RBT participants remained more likely to meet abstinence criteria than UC participants (37% versus 20%, P = 0.016). Length of stay in recovery housing mediated abstinence outcomes and was longer in RH + RBT (49.5 days) than in RH (32.2 days; P < 0.002). CONCLUSIONS: Abstinence-contingent recovery housing improves abstinence in opioid-dependent adults following medication-assisted detoxification. The addition of intensive 'reinforcement-based treatment' behavioural counseling further improves treatment outcomes, in part by promoting longer recovery house stays.
Authors: Hendrik G Roozen; Jiska J Boulogne; Maurits W van Tulder; Wim van den Brink; Cor A J De Jong; Ad J F M Kerkhof Journal: Drug Alcohol Depend Date: 2004-04-09 Impact factor: 4.492
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: Michael D Stein; Jessica N Flori; Megan M Risi; Micah T Conti; Bradley J Anderson; Genie L Bailey Journal: Subst Abus Date: 2017-07-10 Impact factor: 3.716
Authors: Jennifer Miles; Jason Howell; Dave Sheridan; George Braucht; Amy Mericle Journal: Am J Drug Alcohol Abuse Date: 2020-02-24 Impact factor: 3.829
Authors: Thomas F Northrup; Angela L Stotts; Charles Green; Jennifer S Potter; Elise N Marino; Robrina Walker; Roger D Weiss; Madhukar Trivedi Journal: Addict Behav Date: 2014-09-28 Impact factor: 3.913