BEHAVIORAL TREATMENT OF COCAINE-DEPENDENT PREGNANT-WOMEN AND TB-EXPOSED PATIENTS

Health-compromised drug-dependent patients require specialized treatme nt that addresses both drug use and health risks. This preliminary stu dy examines the efficacy of a contingency management procedure (shapin g) on decreasing cocaine use and increasing compliance with the prescr ibed treatment regimens in two health-compromised cocaine-dependent po pulations: (i) tuberculin (TB) exposed patients (n = 5) and (ii) pregn ant women (n = 7). A multiple-baseline across-subjects design was used . There were no contingencies on cocaine use during baseline. During t he contingent phase, patients received a monetary reinforcer for (a) s uccessive decreases in the quantity of cocaine and (b) cocaine-free sa mples. They received a weekly reinforcer if ail samples per week met c riteria for (a) or (b). During the contingent phase, there was a signi ficant decrease in cocaine metabolite levels and an increase in cocain e-free samples in both populations, with a more robust effect in the T B-exposed group. There was an increase in compliance with prenatal vis its among the pregnant women during the contingent phase. Implications for health care are discussed.