Exploring the limits and utility of operant conditioning in the treatment of drug addiction

Professional demeanor of chronically unemployed cocaine-dependent methadone patients in a therapeutic workplace

This study assesses the frequency that users of illicit drugs display unprofessional behaviors in an employment setting. This research was conducted in the therapeutic workplace, a model employment-based treatment program for chronically unemployed adults with long histories of illicit drug use in 2003. Fifty-three unemployed adults in methadone treatment, who were opiate and cocaine dependent, showed signs of injection drug use, and recently used cocaine were hired to work for 4 hours every weekday for 7 months. Results show that while the overall incidence of many undesirable behaviors is low, a small percentage of participants had serious workplace behavior problems that might limit their success in community workplaces. This study suggests that unprofessional behavior in the workplace could contribute to chronic unemployment in this population. The study's limitations are noted and future needed research is suggested.

Contingency management for treatment of substance use disorders: a meta-analysis

AIMS

To examine the effectiveness of contingency management (CM) techniques in treating substance use disorders (i.e. illicit drugs, alcohol, tobacco).

DESIGN

Meta-analysis was used to determine the average effect size and potential moderators in 47 comparisons of the effectiveness of CM from studies based on a treatment-control group design and published between 1970 and 2002.

FINDINGS

The mean effect size (ES) of CM was positive, with a magnitude of d = 0.42 using a fixed effects model. The magnitude of the ES declined over time, following treatment. CM was more effective in treating opiate use (d = 0.65) and cocaine use (d = 0.66), compared with tobacco (d = 0.31) or multiple drugs (d = 0.42). Larger effect sizes were associated with higher researcher involvement, earlier studies and shorter treatment duration.

CONCLUSIONS

Study findings suggest that CM is among the more effective approaches to promoting abstinence during the treatment of substance use disorders. CM improves the ability of clients to remain abstinent, thereby allowing them to take fuller advantage of other clinical treatment components.