Reinforcement-based outpatient treatment for opiate and cocaine abusers

A reinforcement-based intensive outpatient treatment was delivered to 37 re cently detoxified, inner city, heroin and/or cocaine abusers who did not wa nt methadone treatment. Attendance was scheduled and urine collected daily for the first 2 weeks, four times weekly for the next 2 weeks, and then thr ice weekly for the final 8 weeks. As attendance incentives, patients receiv ed transportation assistance (bus tokens), and $28-$30 per week in vouchers to be spent on activities/items chosen and agreed upon with their counselo r. As abstinence incentives, patients received weekend supported recreation al activities, lunches, $42-$45 per week in vouchers, and rent or utilities payment ($150 over 4 weeks). Total potential earnings was $1,435 per patie nt; actual mean earnings was $583. Forty-three percent (n=16) completed 10 or more weeks of treatment. These 16 long-stay patients submitted 92% (SD=1 9) opiate- and cocaine-negative urines during their enrollment compared wit h 56% (SD=42) drug-negative urines submitted by 21 drop-outs, F(1,35)=9.99, p=0.003. Overall, 32% of clients became employed during their treatment ep isode; 94% of long-stay patients were employed at the end of their treatmen t episode. Patients who were drug-positive at intake were highly likely to drop out. Treatment outcomes compare favorably with those reported in the l iterature for outpatient nonmethadone treatment of opiate and cocaine abuse rs. Continued evaluation of this new treatment appears warranted. (C) 2001 Elsevier Science Inc. All rights reserved.