Palm Trees

Making Drug Rehab Stick: Incentives for Abstinence

When someone struggling with drug dependence enrolls in a rehabilitation program, it is a big step toward a healthier lifestyle. Many who begin treatment, however, drop out before it is complete or relapse after completion.

A recent study examined factors that may help treatment programs ensure effectiveness in making the rehabilitation permanent. McKay et al., 2010, evaluated the impact of two incentives for remaining drug-free on those completing an outpatient program for cocaine dependence.

The study examined the effects of contingency management (CM), which offered incentives for abstinence and relapse prevention (RP), which trains patients to avoid high-risk situations.

The researchers studied 100 participants. The participants were adults with a current diagnosis of cocaine dependence. They had each been enrolled in an intensive outpatient program for at least two weeks. The participants averaged 41years of age and 14 years of regular cocaine use. They averaged four prior drug abuse treatments, and reported being cocaine-free for 44 days at baseline.

Each participant participated in standard treatment, including a 12-step approach, for up to four months. In addition, the participants were split into four groups. The first group employed treatment as usual. The second group, or CM group, was given a gift certificate for each clean urine sample provided three times per week over twelve weeks.

The third group, or RP group, was offered a 20-week program focused on identifying, anticipating, and coping with high-risk situations that may provide an opportunity for cocaine use. The fourth group, or CM+RP group, participants received both the gift certificates and the training for handling high-risk situations.

The results of the study show that there was a significant impact seen in the two groups offered CM. Participants receiving CM were less likely to provide cocaine-positive urine samples than those enrolled in the other two groups. The groups offered RP alone, or no additional training or incentive, did not show a decreased rate of cocaine-positive urine samples than those in a standard outpatient program.

The study shows that monetary incentives may be powerful in helping those with substance abuse disorders complete treatment and remain abstinent after treatment is finished.

The study also supports other programs employing the strategy that providing monetary incentives can help individuals make healthier choices for life. For example, the NYC Center for Economic Opportunity is attempting to help reduce poverty by offering cash for improvement in academic performance and good parenting choices. The research provided by McKay offers support for these types of programs that offer material incentive for healthy lifestyles.