Voucher Purchases in Contingency Management Interventions for Women with Cocaine Dependence

Engagement of pleasant activities in patients with substance use disorders: a correlational study

BACKGROUND

There is a growing awareness that the treatment of patients with substance use disorders (SUDs) should target increasing patients' involvement in alternative pleasant reinforcers that compete with the reinforcing effects of substance use. The present cross-sectional study sought to identify factors that promote or impede engaging in pleasant activities.

METHODS

Patients with SUDs (N = 265) were assessed at treatment entry on sociodemographic characteristics, primary type of substance (ie, alcohol or illicit drugs), addiction severity, craving, personality factors, and psychiatric distress.

RESULTS

Regression analyses identified dissimilar predictor sets underlying frequency, enjoyability, and cross-product ratings, highlighting the multifaceted behavioral nature of activity engagement. Personality measures showed the strongest associations with patients' activity engagement, with extraversion as the key predictor.

CONCLUSIONS

The present findings emphasize the complexity of patients' involvement in pleasant non-substance-related activities and further investigation is necessary to gain more insight into the underlying mechanisms of activity engagement.

Monetary-based consequences for drug abstinence: methods of implementation and some considerations about the allocation of finances in substance abusers

Conceptualizing drug abuse within the framework of behavioral theories of choice highlights the relevance of environmental variables in shifting behavior away from drug-related purchases. Choosing to use drugs results in immediate and certain consequences (e.g., drug high and relief from withdrawal), whereas choosing abstinence typically results in delayed, and often uncertain, consequences (e.g., improved health, interpersonal relationships, money).

METHODS

This is a selective review of the literature on Contingency management (CM).

RESULTS

We highlight a variety of methods to deliver CM in practical, effective, and sustainable ways. We consider a number of parameters that are critical to the success of monetary-based CM, and the role of the context in influencing CM's effects. To illustrate the broad range of applications of CM, we also review different methods for arranging contingencies to promote abstinence and other relevant behavior. Finally, we discuss some considerations about how drug-dependent individuals allocate their finances in the context of CM interventions.

CONCLUSIONS

Contingency management (CM) increases choice for drug abstinence via the availability of immediate, financial-based gains, contingent on objective evidence of abstinence.