Contingent methadone take-home doses reinforce adjunct therapy attendance of methadone maintenance patients

Abstract

Two studies utilized within-subjects designs to determine whether take-home methadone doses can reinforce adjunct therapy attendance of drug abuse patients. These studies varied the reinforcement density and the schedule of methadone take-home doses. In Study 1, patients ( n = 10) either could or could not receive a take-home following each therapy session. Study 2 patients ( n = 15) could either earn take-homes following each therapy session attended (i.e., 2 take-homes per week) or could earn one take-home dose following each attendance to two consecutive sessions attended. In both studies experimental conditions alternated during three-week blocks of time. Across studies, any reinforcement by take-home doses produced more attendance at therapy sessions than that observed in the no reinforcement condition. Take-home incentive effects were strongest when each of the two weekly therapy sessions was reinforced by a methadone take-home dose. Increased attendance was not associated with reduced drug use, due perhaps to high rates of pre-study drug use and limited therapy duration. Contemporary opioid abusers present with multiple problems that methadone was never intended to treat. The present studies illustrate a method by which methadone treatment can improve the likelihood of delivering other services that may prove effective in treating some of these problems.