Effect of methadone dose contingencies on urinalysis test results of polydrug-abusing methadone-maintenance patients.

Drug abuse outcomes were examined during 2 contingency management procedures in which the size of the methadone dose was determined by recent urinalysis test results. Twenty polydrug-abusing methadone-maintenance patients were exposed to one of two specific altered dose consequences: a positive incentive procedure in which dose could only increase above baseline levels as a result of drug-free urines and a negative incentive procedure in which dose could only decrease below original baseline levels as a result of drug-positive urines. About 13% of urinalysis test results were drug-free during a 10-week pre-study baseline period while about 40-50% of urines were drug-free for both treatment groups during an 18-week intervention period. About half of the subjects in each study condition showed marked improvement during the intervention, while the other half failed to improve their urine test results. Treatment failures in the dose decrease as compared with the dose increase condition were more likely to drop out of the study. The study showed that size of the methadone dose can be effectively used as a consequence to influence illicit drug use during treatment. The study suggests that positive reinforcement as compared with aversive control procedures can produce an equivalent number of successful cases while avoiding dropout among patients who fail to respond to treatment.

RCT Entities:   Population Interventions Outcomes