Effectiveness of motivational incentives in stimulant abusing outpatients with different treatment histories.

Clinical Trials Network protocol CTN-0006 implemented motivational incentives in a large, randomized multicenter clinical trial conducted with over 400 patients at 8 psychosocial treatment programs in the U.S. Its findings showed that participants in the MI intervention group had more consecutive stimulant-free urine drug screens versus the usual care condition. Participants in the MI group also were retained in treatment for an average of 8 (+/= 4.2) weeks compared to 6.9 (+/- 4.4) weeks for the usual care group. This study examined the characteristics and outcomes of less versus more treatment experienced by participants in the trial in an attempt to determine if prize-based abstinence incentives would differentially affect substance abuse outcomes in patients with different treatment histories. Treatment-seeking outpatients with more or less prior treatment episodes were randomized to receive either prize-based incentives plus treatment as usual (TAU) or TAU alone. Outcome variables included longest sustained period of abstinence, number of negative urine drug screens (UDS), and retention in treatment.

Results of this study found that treatment-experienced participants were older, more likely to be female, African American, and unemployed, and with more severe cocaine and psychiatric problems. The effectiveness of incentives did not differ significantly between the two treatment history groups with regard to the outcome measures. This analysis begins to delineate the factors that are associated with response to MI interventions and extends the literature on differential treatment responsivity of drug abuse patients with different treatment histories.

Related protocols: CTN-0006