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

nsecutive drug-free test. Vouchers of the same value were given each time the patient took naltrexone. Each time a patient either failed the drug test or missed a visit to take naltrexone, the value of the voucher went back to 80 cents.

Patients who complied perfectly could earn up to $561 worth of items during the 12-week treatment. Most patients on average earned $200. The money was not given directly to the patients; instead they were able to redeem their vouchers for items consistent with a drug-free lifestyle, such as gift certificates for food and clothing.

"One man had pawned his mothers jewelry, and he used the vouchers to get her jewelry back," Carroll said. "Others had inconsistent involvement in their childrens lives, so they used the vouchers to pay for their childs birthday party or Christmas presents. There were some very touching ways in which they used this program to help them stop using and move out of drug-using patterns."

The researchers found that use of the vouchers significantly improved treatment retention and naltrexone compliance. Family therapy did not improve retention in the program, but did improve family functioning. One session with a significant other, in addition to vouchers, had an effect on treatment retention, naltrexone compliance and opioid use.

"Many people who are addicted to opioids such as heroin think that all that is available to help them is methadone maintenance, which is very effective, but its not for everyone," Carroll said. "New Haven has one of the relatively few established and successful naltrexone programs in the United States."

"Research suggests that the usual level of compliance with any medication is around 50 percent," Carroll added. "Its possible these types of strategies also could be used with any other medications."


Contact: Karen N. Peart
Yale University

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