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Extended Voucher-based Reinforcement Therapy for Long-term Drug Abstinence

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Objective : To determine whether longer durations of voucher-based reinforcement therapy (VBRT) increase long-term abstinence compared to standard durations.

Methods : Cocaine-abusing or dependent methadone-maintenance patients (N 130) were randomized to receive either Standard (12-week; N 62) or Extended (36-week; N 68) VBRT. Participants provided 3 urine samples weekly during VBRT, and each cocaine-negative sample produced a voucher exchangeable for goods and services.

Results : Extended VBRT produced longer durations of self-reported continuous abstinence during study Year 1 (M 74 vs. 46 days; F(1,128) 5.23, P 0.024), but not during Year 2. However, each week of abstinence during Year 1 was associated with an increase of 9.19 days of abstinence during Year 2, regardless of study condition (t(1) 4.92, P < 0.001).

Conclusions : Longer-duration VBRT can increase abstinence during VBRT, but may not maintain it afterwards. However, longer during-treatment abstinence begets later abstinence suggesting that further research regarding this relationship is needed.

Keywords: cocaine abuse; contingency management; long-term maintenance; substance abuse; voucher-based reinforcement therapy

Document Type: Research Article


Affiliations: 1 Project Coordinator, Treatment Research Institute, Philadelphia, PA.

Publication date: November 1, 2010

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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