Rewarding early abstinence in Veterans Health Administration addiction clinics |
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| Authors: | Hildi J Hagedorn Siamak Noorbaloochi Alisha Baines Simon Ann Bangerter Maxine L Stitzer Cheryl B Stetler Daniel Kivlahan |
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| Institution: | 1. Veterans Health Administration Substance Use Disorder Quality Enhancement Research Initiative, Minneapolis VA Healthcare System, Minneapolis, MN, 55417, USA;2. Veterans Health Administration Health Services Research and Development Center of Excellence, Minneapolis VA Healthcare System, Minneapolis, MN, 55417, USA;3. University of Minnesota, Minneapolis, MN, 55455, USA;4. Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA;5. Health Services Department, Boston University School of Health and Independent Consultant, Amherst, MA, 01002, USA;6. Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Healthcare System, Seattle, WA, 98108, USA;g University of Washington School of Medicine, Seattle, WA, 98185, USA |
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| Abstract: | This study investigates the addition of a contingency management (CM) intervention to Veterans Health Administration substance use disorders treatment on during- and post-treatment outcomes for Veterans diagnosed with alcohol dependence only (n = 191) or stimulant dependence (n = 139). Participants were randomly assigned to 8 weeks of usual care or usual care plus CM. Follow-up assessments occurred at 2, 6 and 12 months. In the alcohol dependent subgroup, CM participants submitted significantly more negative samples (13 versus 11 samples, Cohen's d = 0.54), were retained significantly longer (7 versus 6 weeks, d = 0.47), achieved significantly longer median durations of abstinence (16 versus 9 consecutive visits; median difference = 7, 95% CI = 4–8), and submitted significantly more negative samples at follow-ups (unstandardized effect size = 0.669, se = 0.2483) compared to usual care participants. Intervention effects were non-significant for the stimulant dependent subgroup. The study provides support for the effectiveness of CM interventions for alcohol dependent patients. |
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| Keywords: | Alcohol dependence Stimulant dependence Contingency management Substance use disorders treatment Effectiveness |
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