Abstinence reinforcement maintenance contingency and one-year follow-up

Drug Alcohol Depend. 2002 Jul 1;67(2):125-37. doi: 10.1016/s0376-8716(02)00023-6.


Background: Relapse to drug use is often seen when contingencies designed to reduce drug use are discontinued. This paper reports on a stepdown maintenance contingency and 1-year follow-up in 110 patients who were maintained on methadone (50 or 70 mg/day) and who had completed a contingency management trial targeted to decreasing their opiate use. In the prior study (induction phase, 8 weeks) participants received vouchers for each opiate-negative urine screen or noncontingently.

Methods: In this study (maintenance phase, 12 weeks), participants were rerandomized to receive vouchers and take-home methadone doses contingent on providing opiate-negative urine specimens (N=55) or noncontingently (N=55). Since participants had been rerandomized from induction-phase contingencies, most study data were analyzed as if from a 2 x 2 (inductionxmaintenance) design. Follow-up interviews were conducted at 3, 6, and 12 months after study participation.

Results: Patients who received the maintenance contingency following an 8-week induction contingency had better outcomes than those who received noncontingent incentives in either the maintenance or induction phases of the trial. Good outcome at follow-up was predicted by enrollment in methadone maintenance after the study. Significantly more participants in the maintenance contingency group transferred directly to another methadone program.

Conclusion: These findings support the therapeutic value of extending the duration of contingency management and long-term methadone maintenance.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Methadone / therapeutic use
  • Middle Aged
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / rehabilitation*
  • Opioid-Related Disorders / urine
  • Reinforcement, Psychology*
  • Statistics, Nonparametric
  • Treatment Outcome


  • Methadone