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Rewards coupled with naltrexone effective in treating heroin and other opioid addictions

Rewarding drug users with vouchers that they exchange for food, clothing, or, as one did, a robe for singing in a church choir, was effective in keeping patients drug free and on a medication regimen, according to research at Yale University.

The principal investigator of the study funded by the National Institute on Drug Abuse, Kathleen Carroll, professor of psychiatry at Yale School of Medicine, said the intent was to evaluate the best way to encourage patients addicted to opioids, among them, codeine, morphine and heroin, to take naltrexone regularly.

Naltrexone is an opioid antagonist that blocks the effect of opioids in the brain. Unlike methadone, it is non-addicting and does not have to be dispensed daily in a clinic setting.

"When patients take methadone, they stop feeling sick," Carroll said. "Naltrexone doesnt have that kind of immediate reinforcement. It is, though, a very important tool because, if patients use it consistently, it will block the opioid receptors in the brain so that they dont experience euphoria if they use heroin."

The researchers tested the strategy of using specific behavioral therapies to enhance pharmacotherapies and encourage patients to take naltrexone regularly.

The study included 127 patients who sought treatment for opioid dependence and who completed outpatient detoxification. Each patient received naltrexone three times a week and attended a group therapy session once a week. A second group of patients also received vouchers redeemable for goods and services contingent on targeted behaviors. Yet another group was offered, in addition to the vouchers and naltrexone, family therapy sessions with a non-substance abusing relative or friend.

The study targeted two behaviors: taking the naltrexone and submitting a drug-free urine specimen. The patients were given a voucher equivalent to 80 cents for the first drug-free urine test. The vouchers were increased by 40 cents for each co
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Contact: Karen N. Peart
karen.peart@yale.edu
203-432-1326
Yale University
14-Aug-2001


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