Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


33rd Annual Convention; San Diego, CA; 2007

Event Details

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Symposium #211
Abstinence Reinforcement Interventions in the Treatment of Drug Abuse
Sunday, May 27, 2007
1:30 PM–2:50 PM
Ford C
Area: BPH/CSE; Domain: Basic Research
Chair: Wendy Donlin Washington (Johns Hopkins University School of Medicine)
Discussant: Steven R. Hursh (Institutes for Behavior Resources, Inc. and Johns Hopkins University School of Medicine)
Abstract: Contingency management and specifically abstinence reinforcement contingencies have been successful in promoting drug abstinence across many drugs and for many populations. With roots in the Experimental Analysis of Behavior, abstinence reinforcement contingencies are designed to provide frequent consequences for engaging in drug use. This symposium will present data from human clinical trials demonstrating the effectiveness of abstinence interventions in cigarette smokers, unemployed methadone patients and in methamphetamine users.
Technological Innovations in Behavioral Treatment for Cigarette Smoking.
JESSE DALLERY (University of Florida), Steven E. Meredith (University of Florida)
Abstract: Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries. The limitations of current interventions for smoking highlight the urgent need for innovative, powerful, and community-friendly treatments. Abstinence reinforcement therapy is one such treatment. To circumvent obstacles associated with frequent monitoring of smoking status (e.g., making twice daily visits to a clinic), we developed and tested an internet-based monitoring system to verify and reinforce smoking abstinence by breath carbon monoxide (CO) output. We found that patients were highly compliant with the treatment (over 97% of the 1,120 scheduled CO samples were collected), and that voucher reinforcement produced high rates of sustained abstinence in a group of high-risk, heavy smokers. To offset the costs associated with treatment, we have developed a deposit contract treatment delivery model. Four participants deposited a small fee, which they earned back contingent on evidence of abstinence. Compared to a control, no-deposit group, these participants showed equivalent rates of abstinence and compliance with the treatment. The results also suggest that the costs associated with treatment can be partly offset with a deposit contract, which could aid in the dissemination and sustainability of the intervention.
Contingency Management for the Treatment of Methamphetamine Use Disorders: Efficacy and Optimization.
JOHN M. ROLL (Washington State University)
Abstract: Methamphetamine addiction is a growing public health concern in much of the United States. Developing effective treatments for this disorder has become an active area of research. This presentation will provide data from 4 completed trials and 2 ongoing trials designed to demonstrate the efficacy of contingency management approaches in the treatment of methamphetamine use disorders. The completed trials suggest that two common types of contingency management (voucher-based reinforcement therapy and variable magnitude of reinforcement procedures) are effective. Data form the two ongoing trails will provide information on the optimization of contingency management interventions for use in the treatment of methamphetamine use disorders. Specifically the trials are designed to examine the length of contingency management interventions and the reinforcement schedule employed in the interventions. Each of these clinical trials currently has in excess of 80 participants enrolled.
Sequential Cocaine and Opiate Abstinence Contingencies in Methadone Patients Working in the “Therapeutic Workplace”.
WENDY DONLIN WASHINGTON (Johns Hopkins University School of Medicine), Todd W. Knealing (Briarcliff University), Mick J. Needham (Johns Hopkins University), Conrad J. Wong (University of Kentucky), Kenneth Silverman (Johns Hopkins University)
Abstract: Employment-based reinforcement is effective in promoting cocaine abstinence in unemployed community methadone patients. This study evaluates the effectiveness of employment-based reinforcement by sequentially promoting abstinence from cocaine and then opiates using a multiple-baseline design. Welfare recipients enrolled in community methadone treatment and using cocaine (N=83) were invited to attend a therapeutic workplace for 6 months. Urine samples were tested three days per week for opiates and cocaine. Participants could earn vouchers for attendance and productivity. Initially, there were no abstinence contingencies, but once attending work at least 15 days over 4 weeks, the participant was required to show evidence of recent cocaine abstinence to work each day and to maintain maximum base pay. After 3 weeks of cocaine-negative urine samples, participants were also required to show evidence of recent opiate abstinence to work and maintain maximum pay. The percent of cocaine negative urine samples increased significantly and abruptly under the cocaine abstinence contingency. Fifty participants initiated cocaine abstinence and were exposed to the opiate contingency and provided increased opiate negative urine samples more frequently. The results show that the sequential implementation of employment-based reinforcement can be effective in promoting cocaine and opiate abstinence in unemployed community methadone patients.



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