CONTINGENT METHADONE TAKE-HOME DOSES REINFORCE ADJUNCT THERAPY ATTENDANCE OF METHADONE-MAINTENANCE PATIENTS

Two studies utilized within-subjects designs to determine whether take -home methadone doses can reinforce adjunct therapy attendance of drug abuse patients. These studies varied the reinforcement density and th e schedule of methadone take-home doses. In Study 1, patients (n = 10) either could or could not receive a take-home following each therapy session. Study 2 patients (n = 15) could either earn take-homes follow ing each therapy session attended (i.e., 2 take-homes per week) or cou ld earn one take-home dose following each attendance to two consecutiv e sessions attended. In both studies experimental conditions alternate d during three-week blocks of time. Across studies, any reinforcement by take-home doses produced more attendance at therapy sessions than t hat observed in the no reinforcement condition. Take-home incentive ef fects were strongest when each of the two weekly therapy sessions was reinforced by a methadone take-home dose. Increased attendance was not associated with reduced drug use, due perhaps to high rates of pre-st udy drug use and limited therapy duration. Contemporary opioid abusers present with multiple problems that methadone was never intended to t reat. The present studies illustrate a method by which methadone treat ment can improve the likelihood of delivering other services that may prove effective in treating some of these problems.