The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: A randomized controlled trial

August F. Holtyn; Mikhail N. Koffarnus; Anthony DeFulio; Sigurdur O. Sigurdsson; Eric C. Strain; Robert P. Schwartz; Jeannie Marie S. Leoutsakos; Kenneth Silverman

doi:10.1016/j.ypmed.2014.02.021

The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: A randomized controlled trial

August F. Holtyn, Mikhail N. Koffarnus, Anthony DeFulio, Sigurdur O. Sigurdsson, Eric C. Strain, Robert P. Schwartz, Jeannie Marie S. Leoutsakos, Kenneth Silverman

Family and Community Medicine

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

Objective: Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method: This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N. =. 98) could work and earn pay for 26. weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results: Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion: The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users.

Original language	English
Pages (from-to)	62-70
Number of pages	9
Journal	Preventive Medicine
Volume	68
DOIs	https://doi.org/10.1016/j.ypmed.2014.02.021
State	Published - Nov 1 2014

Bibliographical note

Publisher Copyright:
© 2014 Elsevier Inc.

Funding

This research was supported by grants R01DA023864, K24DA023186, and T32DA07209 from the National Institute on Drug Abuse (NIDA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The authors wish to thank Jeanne Harrison for her assistance with data management and study coordination, Jackie Hampton for participant recruitment and assessment, and David Pierce for his help with data analyses.

Funders	Funder number
National Institute on Drug Abuse	R01DA023864, K24DA023186

Keywords

Cocaine
Contingency management
Employment
Financial incentives
Injection drug use
Methadone
Opiate
Out-of-treatment injection drug user

ASJC Scopus subject areas

Epidemiology
Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ypmed.2014.02.021

Cite this

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title = "The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: A randomized controlled trial",

abstract = "Objective: Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method: This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N. =. 98) could work and earn pay for 26. weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results: Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion: The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users.",

keywords = "Cocaine, Contingency management, Employment, Financial incentives, Injection drug use, Methadone, Opiate, Out-of-treatment injection drug user",

author = "Holtyn, {August F.} and Koffarnus, {Mikhail N.} and Anthony DeFulio and Sigurdsson, {Sigurdur O.} and Strain, {Eric C.} and Schwartz, {Robert P.} and Leoutsakos, {Jeannie Marie S.} and Kenneth Silverman",

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doi = "10.1016/j.ypmed.2014.02.021",

language = "English",

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T2 - A randomized controlled trial

AU - Holtyn, August F.

AU - Koffarnus, Mikhail N.

AU - DeFulio, Anthony

AU - Sigurdsson, Sigurdur O.

AU - Strain, Eric C.

AU - Schwartz, Robert P.

AU - Leoutsakos, Jeannie Marie S.

AU - Silverman, Kenneth

PY - 2014/11/1

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N2 - Objective: Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method: This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N. =. 98) could work and earn pay for 26. weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results: Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion: The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users.

AB - Objective: Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method: This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N. =. 98) could work and earn pay for 26. weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results: Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion: The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users.

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KW - Contingency management

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KW - Methadone

KW - Opiate

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The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: A randomized controlled trial

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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