Effect of Prize-Based Incentives on Outcomes in Stimulant Abusers in Outpatient Psychosocial Treatment Programs

Petry, Nancy M.; Peirce, Jessica M.; Stitzer, Maxine L.; Blaine, Jack; Roll, John M.; Cohen, Adam S.; Obert, Jeanne L.; Killeen, Therese K.; Saladin, Michael E.; Cowell, Mark; Kirby, Kimberly C.; Sterling, Robert C.; Royer-Malvestuto, Charlotte; Hamilton, John A.; Booth, Robert E.; Macdonald, Marilyn J.; Liebert, Marc; Rader, Linda; Burns, Raynetta; DiMaria, Joan; Copersino, Marc L.; Stabile, Patricia Quinn; Kolodner, Ken; Li, Rui

doi:10.1001/archpsyc.62.10.1148

Cited by 349 publications

(367 citation statements)

References 54 publications

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“…Contingency management is a treatment method that pays drug users in treatment to abstain from using drugs and also for abstaining longer while in treatment. This paves the way for positive payment to enter and stay in treatment 3 (Peirce J. M. et al 2006;Petry et al 2005;Sindelar, Elbel, and Petry 2007).…”

Section: Discussionmentioning

confidence: 99%

“…The expense of this approach could be financed in part by the higher revenue from Ramsey pricing for paying patients. "Contingency management" approaches have been found to be effective in keeping clients in treatment and increasing the length of time abstinent (Petry et al 2005) These systems are often designed with escalating payments systems which increase the price of using of drugs over time and with 'booster payments' which helps to lengthen time in treatment. .…”

Section: Policy Implicationsmentioning

confidence: 99%

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Willingness to pay for drug rehabilitation: Implications for cost recovery

Bishai

Sindelar

Ricketts

et al. 2008

Journal of Health Economics

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Objectives-This study estimates the value that clients place on methadone maintenance and how this value varies with the effectiveness of treatment and availability of case management. We provide the first estimate of the price elasticity of the demand for drug treatment.Methods-We interviewed 241 heroin users who had been referred to, but had not yet entered, methadone maintenance treatment in Baltimore, Maryland. We asked each subject to state a preference among three hypothetical treatment programs that varied across 3 domains: weekly fee paid by the client out-of-pocket ($5 to $100), presence/absence of case management, and time spent heroin-free (3 to 24 months). Each subject was asked to complete 18 orthogonal comparisons. Subsequently each subject was asked if they likely would enroll in their preferred choice among the set of three. We computed the expected willingness to pay (WTP) as the probability of enrollment times the fee considered in each choice considered from a multivariate logistic model that controlled for product attributes. We also estimated the price elasticity of demand.Results-The median expected fee subjects were willing to pay for a program that offered 3 months of heroin-free time was $7.30 per week, rising to $17.11 per week for programs that offered 24 months of heroin-free time. The availability of case management increased median WTP by $5.64 per week. The price elasticity was −0.39 (SE 0.042).Conclusions-Clients will pay more for higher rates of treatment success and for the presence of case management. Clients are willing to pay for drug treatment but the median willingness to pay falls short of the estimated program costs of $82 per week. Thus a combined approach of user fees and subsidization may be the optimal financing strategy for the drug treatment system.

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Section: Discussionmentioning

confidence: 99%

Section: Policy Implicationsmentioning

confidence: 99%

Willingness to pay for drug rehabilitation: Implications for cost recovery

Bishai

Sindelar

Ricketts

et al. 2008

Journal of Health Economics

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“…In addition, long-term outcomes were not assessed in this study, so it is unclear if gains made during treatment were sustained. Other studies of substance use treatment have found retention and abstinence during treatment are significant predictors of long-term success (e.g., Bottlender, and Soyka, 2005;Petry et al, 2005a).…”

Section: Discussionmentioning

confidence: 99%

“…When used in conjunction with other therapies, CM has consistently been found to increase both treatment retention and continuous abstinence during treatment (Lussier et al, 2006). For example, in a recent eight site clinical trial, Petry et al (2005a) found stimulant abusers receiving CM in addition to usual care remained in treatment longer, attended more counseling sessions, and were significantly more likely to achieve 4, 8, and 12 weeks of continuous abstinence than participants in the usual care condition.…”

Section: Introductionmentioning

confidence: 99%

Regardless of psychiatric severity the addition of contingency management to standard treatment improves retention and drug use outcomes

Weinstock

Alessi

Petry

2007

Drug and Alcohol Dependence

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The relationship between psychiatric severity and substance use disorders treatment outcome was assessed in 393 individuals who received either standard treatment or standard treatment plus contingency management. The sample was divided into groups of low, moderate, and high psychiatric severity based upon baseline Addiction Severity Index psychiatric composite scores. Participants in the high psychiatric severity group reported a greater prevalence of psychiatric hospitalization, psychiatric medications, and suicide attempts, as well as poorer baseline psychosocial functioning. In terms of treatment outcome, a significant interaction between psychiatric severity and treatment modality was found in relation to treatment retention. Participants in the standard treatment condition were more likely to dropout of treatment earlier as psychiatric severity increased, while retention was similar across the psychiatric severity groups in the contingency management condition. Psychiatric severity was not linked to longest duration of abstinence achieved during treatment or adherence with contingency management procedures. Overall, these findings suggest contingency management is an efficacious and appropriate intervention for substance use disordered individuals across a range of psychiatric problems.

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“…Findings from these clinical trial protocols are now in press. They showed that the contingency management techniques tested in the CTN were associated with a greater likelihood of stimulant-free and alcohol-free urine tests and of multiple consecutive clean urines in methadone settings (Peirce et al, 2006), and they improved both drug use and retention in outpatient "drug-free" settings (Petry et al, 2005). Dissemination materials are now being developed by ATTCs for distribution to the field at large, and at least one case study documenting the successful adoption and adaptation of these techniques in a large hospital system as a result of CTN exposure has been published (Kellogg et al, 2005).…”

Section: Voucher-based Motivational Incentivesmentioning

confidence: 99%

Innovation adoption in substance abuse treatment: Exposure, trialability, and the Clinical Trials Network

Ducharme

Knudsen

Roman

et al. 2007

Journal of Substance Abuse Treatment

102

151

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Researchers and policymakers are increasingly focusing on factors that facilitate or impede the diffusion of evidence-based treatment techniques into routine clinical practice. One potentially fruitful avenue of research is the influence of involvement in research networks as a predictor of organizational innovation. The Clinical Trials Network (CTN) is examining a number of behavioral and pharmacological treatment techniques in controlled multisite studies. Using data from participating CTN treatment programs and large samples of programs outside the CTN, these analyses examine the influence of exposure to clinical trials on the subsequent adoption of buprenorphine and voucher-based motivational incentives. The analyses show that, controlling for a variety of organizational characteristics, direct exposure to buprenorphine clinical trials in the CTN significantly increased the odds of subsequent adoption. By contrast, the adoption of motivational incentives was entirely explained by organizational characteristics. The findings suggest that adoption of treatment innovations is a function of exposure, organizational resources, nature of innovations, and stage of the diffusion process.

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Effect of Prize-Based Incentives on Outcomes in Stimulant Abusers in Outpatient Psychosocial Treatment Programs

Abstract: 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.

Cited by 349 publications

References 54 publications

Willingness to pay for drug rehabilitation: Implications for cost recovery

Willingness to pay for drug rehabilitation: Implications for cost recovery

Regardless of psychiatric severity the addition of contingency management to standard treatment improves retention and drug use outcomes

Innovation adoption in substance abuse treatment: Exposure, trialability, and the Clinical Trials Network

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