BROAD BENEFICIAL-EFFECTS OF COCAINE ABSTINENCE REINFORCEMENT AMONG METHADONE PATIENTS

Escalating reinforcement for sustained abstinence has been effective i n treating cocaine abuse. Under this schedule, patients receive vouche rs for cocaine-free urine samples; vouchers have monetary values that increase with the number of consecutive cocaine-free urine samples. Co caine-abusing methadone patients were randomly assigned to receive vou chers for 12 weeks under (a) an escalating schedule (n = 20), (b) an e scalating schedule with start-up bonuses (n = 20), or (c) a nonconting ent schedule (n = 19). Start-up bonuses were designed to provide added reinforcement for initiating abstinence; however, they did not improv e outcomes. Both contingent interventions significantly increased coca ine abstinence. In addition, the contingent interventions increased ab stinence from opiates and decreased reports of cocaine craving. These results replicate the efficacy of cocaine abstinence reinforcement and show that it can have broad beneficial effects.