The abstinence-based incentive procedure, which provided a mean of 203 dollars in prizes per participant, was efficacious in improving retention and associated abstinence outcomes.

An abstinence incentive approach that paid 120 dollars in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

No abstract

Aim To review randomized controlled trials to assess efficacy of a prize-based contingency management procedure in reducing substance use (where a drug-free breath or urine sample provides a chance of winning a prize). Methods A meta-analysis was conducted on articles published from January 2000 to February 2013 to determine the effect size of studies comparing prize-based contingency management to a treatment-as-usual control condition (k=19 studies). Parallel analyses evaluated the efficacy of both short- (k=9 studies) and long-term outcomes (k=6 studies) of prize-based contingency management . Results The average end-of-treatment effect size (Cohen's d) was .46 [95% CI=0.37,0.54). This effect size decreased at the short-term (≤ 3-month) post-intervention follow-up to .33 (95% CI=0.12,0.54) and at the 6-month follow-up time point there was no detectable effect (d=-.09 (95% CI=−0.28,0.10)). Conclusion Adding prize-based contingency management to behavioral support for substance use disorders can increase short-term abstinence but the effect does not appear to persist to 6 months.

Three experiments assessed the likelihood that subjects with histories of equivalence class development would respond conditionally on new discriminations in the absence of differential consequences for responses. In the first two experiments, two groups of subjects with different experimental histories, but whose performances showed four equivalence classes, responded on trials without explicit reinforcement involving samples from two of the classes and comparisons from the other two classes, in a two-choice matching-to-sample format. Subjects consistently selected a particular comparison in the presence of a particular sample. Subsequent tests showed the emergence of equivalence relations between stimuli from classes linked by the unreinforced conditional selections. Subsequently, in Experiment II, the subjects' responses in the conditional selection trials were reinforced if the selection was reversed from that made previously. Although reversed selection was maintained, 2 of the 3 subjects continued to perform on equivalence relation trials according to their original unreinforced selections. In the third experiment, these 2 subjects responded on a series of conditional discriminations involving three new pairs of sample stimuli and one new pair of comparison stimuli. No explicit reinforcement followed responses on any trial in this experiment. Subsequent tests for equivalence between sample stimuli revealed the development of two equivalence classes.

ABSTRACT. Objective: There have been confl icting fi ndings in the literature concerning the risks to adolescents when parents provide them with alcohol. Studies have examined various ways in which parents directly affect adolescent alcohol consumption through provision (e.g., parental offers, parental allowance/supervision, parental presence while drinking, and parental supply). This review synthesizes fi ndings on the direct ways parental provision can infl uence a child's alcohol consumption and related problems in an effort to provide parents with sciencebased guidance. We describe potential mechanisms of the relationship between these parental infl uences and adolescent problems, suggest future directions for research, and discuss implications for parents. Method: Twenty-two studies (a mix of cross-sectional and longitudinal) that empirically examined the association between parental provision and adolescent drinking outcomes were reviewed. Results: Parental provision was generally associated with increased adolescent alcohol use and, in some instances, increased heavy episodic drinking as well as higher rates of alcohol-related problems. Data in support of the view that parental provision serves as a protective factor in the face of other risk factors were equivocal. Conclusions: The nature and extent of the risks associated with parental provision, and the potential mechanisms underlying this association, are complex issues. Although more rigorous studies with longitudinal designs are needed, parents should be aware of potential risks associated with providing adolescents with alcohol and a place to drink. It is recommended that parents discourage drinking until adolescents reach legal age. (J. Stud. Alcohol Drugs, 75, 590-605, 2014)

Cocaine dependence has proved difficult to treat, whether occurring alone or in combination with opiate dependence. No medication has been demonstrated to be uniquely effective. Fluoxetine was examined as a candidate in two randomized, double-blind, placebo-controlled trials, one with cocaine-dependent patients (study 1) and the other with patients both cocaine and opiate dependent (study 2). It was selected for known specific action, antidepressant effects, minimum side effects, and data showing reduced cocaine effect and self-administration. Clinic visit frequency requirement, a variable with implications for treatment and cost, was also examined in study 1. A total of 228 patients in study 1 and 21 patients in study 2 completed consent and intake procedures. Patients with serious medical or DSM-III-R diagnoses other than cocaine dependence (study 1) or opiate and cocaine dependence (study 2) were excluded. Study 1 patients were assigned to one of two visit frequency schedules (2 or 5 days/week) and one of three medication doses (0, 20, or 40 mg of fluoxetine/day). Study 2 patients received placebo or 20 mg of fluoxetine and 65 to 80 mg of methadone and attended the clinic 5 days/week. All patients participated in individual therapy sessions. Urine screens were conducted twice weekly. A fluoxetine dose response relationship emerged in study 1 for retention with groups from best to worst being placebo, 20 mg, and 40 mg. Dose effect order was the same for both visit conditions. Cocaine use persisted in all groups. The two visits/week condition was correlated with better retention than the five visits/week condition. A significant interaction emerged between intake urine and visit frequency; patients with benzoylecognine screens at intake used cocaine significantly less in the 5 days/week condition, while exhibiting no reduction in the 2 days/week condition. Patients cocaine positive at intake were better retained with infrequent visits. In study 2, a transient reduction in benzoylecognine-positive drug screens emerged for the fluoxetine group. These complementary studies demonstrate that fluoxetine is ineffective in reducing cocaine use or craving. Study 1 also points to setting conditions modulating treatment outcome.

No abstract