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Effects of a randomized contingency management intervention on opiate abstinence and retention in methadone maintenance treatment in China
Author(s) -
Hser YihIng,
Li Jianhua,
Jiang Haifeng,
Zhang Ruimin,
Du Jiang,
Zhang Congbin,
Zhang Bo,
Evans Elizabeth,
Wu Fei,
Chang YenJung,
Peng Chinyi,
Huang David,
Stitzer Maxine L.,
Roll John,
Zhao Min
Publication year - 2011
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2011.03490.x
Subject(s) - contingency management , methadone maintenance , abstinence , methadone , medicine , attendance , randomized controlled trial , incentive , opiate substitution treatment , intervention (counseling) , demography , psychiatry , buprenorphine , opioid , economics , microeconomics , receptor , sociology , economic growth
Aims Methadone maintenance treatment has been made available in China in response to the rapid spread of human immunodeficiency virus (HIV), but high rates of dropout and relapse are problematic. The aim of this study was to apply and test if a contingency management (or motivational incentives) intervention can improve treatment retention and reduce drug use. Design Random assignment to usual care with ( n = 160) or without ( n = 159) incentives during a 12‐week trial. Incentives participants earned draws for a chance to win prizes on two separate tracks targeting opiate‐negative urine sample or consecutive attendance; the number of draws increased with continuous abstinence or attendance. Setting Community‐based methadone maintenance clinics in Shanghai and Kunming. Participants The sample was 23.8% female, mean age was 38, mean years of drug use was 9.4 and 57.8% had injected drugs in the past 30 days. Measurements Treatment retention and negative drug urine. Findings Relative to the treatment‐as‐usual (control) group, better retention was observed among the incentive group in Kunming (75% versus 44%), but no difference was found in Shanghai (90% versus 86%). Submission of negative urine samples was more common among the incentive group than the usual care (74% versus 68% in Shanghai, 27% versus 18% in Kunming), as was the longest duration of sustained abstinence (7.7 weeks versus 6.5 in Shanghai, 2.5 versus 1.6 in Kunming). The average total prize amount was 371 Yuan (or $55) per participant (527 for Shanghai versus 216 in Kunming). Conclusions Contingency management improves treatment retention and drug abstinence in methadone maintenance treatment clinics in China, although there can be considerable site differences in magnitude of effects.