INCREASING EMPLOYMENT OF OPIOID DEPENDENT OUTPATIENTS - AN INTENSIVE BEHAVIORAL INTERVENTION

The impact of a new, mandatory employment requirement in a community-b ased methadone treatment program was evaluated. All patients who had b een in the methadone substitution program for at least 1 year but who were not currently employed (n = 36) were required to enhance their tr eatment with 20 h of employment (paid or volunteer). Patients with sig nificant psychiatric or medical disabilities were excluded from the ro utine treatment requirement. Patients were informed by counseling staf f that they had 2 months to secure employment. Those who did not accom plish the goal within that time period were transferred to more intens ive weekly counseling (i.e. up to 8 h/week) for 10 weeks, with the enh anced counseling focusing primarily on resistance to the employment go al. Patients who remained resistant to the treatment plan were eventua lly started on a 21 day methadone taper until employment was verified. Seventy-five percent of the patients secured employment and maintaine d the position for at least 1 month. Positions were found in an averag e of 60 days. Most patients (78%) continued working throughout the B-m onth follow-up. Those who failed to find work or maintain employment e ngaged in more illicit drug use. These results demonstrate that behavi oral contingencies can motivate many methadone maintenance patients to obtain verified employment in the community. (C) 1998 Elsevier Scienc e Ireland Ltd. All rights reserved.