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Alcohol and Alcoholism (Oxford, Oxfordshire) (1)
Journal of Applied Behavior Analysis (1)
Fingerhood, Michael (2)
Needham, Mick (2)
Silverman, Kenneth (2)
Bigelow, George E. (1)
Crone-Todd, Darlene (1)
Diemer, Karly (1)
Diemer, Karly N (1)
Hampton, Jacqueline (1)
Knealing, Todd (1)
Koffarnus, Mikhail N. (1)
Kolodner, Kenneth (1)
Nuzzo, Paul (1)
Svikis, Dace S. (1)
Wong, Conrad J (1)
Wong, Conrad J. (1)
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A Randomized Clinical Trial of a Therapeutic Workplace for Chronically Unemployed, Homeless, Alcohol-Dependent Adults
Koffarnus, Mikhail N.
Wong, Conrad J.
Svikis, Dace S.
Bigelow, George E.
Alcohol and Alcoholism (Oxford, Oxfordshire)
Aims: To assess the efficacy of the Therapeutic Workplace, a substance abuse intervention that promotes abstinence while simultaneously addressing the issues of poverty and lack of job skills, in promoting abstinence from alcohol among homeless alcoholics. Methods: Participants (n = 124) were randomly assigned to conditions either requiring abstinence from alcohol to engage in paid job skills training (Contingent Paid Training group), offering paid job skills training with no abstinence contingencies (Paid Training group) or offering unpaid job skill training with no abstinence contingencies (Unpaid Training group). Results: Participants in the Contingent Paid Training group had significantly fewer positive (blood alcohol level ≥ 0.004 g/dl) breath samples than the Paid Training group in both randomly scheduled breath samples collected in the community and breath samples collected during monthly assessments. The breath sample results from the Unpaid Training group were similar in absolute terms to the Contingent Paid Training group, which may have been influenced by a lower breath sample collection rate in this group and fewer reported drinks per day consumed at intake. Conclusion: Overall, the results support the utility of the Therapeutic Workplace intervention to promote abstinence from alcohol among homeless alcoholics, and support paid training as a way of increasing engagement in training programs.
A Randomized Trial of Employment-Based Reinforcement of Cocaine Abstinence in Injection Drug Users
Wong, Conrad J
Journal of Applied Behavior Analysis
High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hr every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n = 28) or work-only (n = 28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p = .004; OR = 5.80, 95% CI = 2.03–16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence.
contingency management; abstinence reinforcement; cocaine addiction; methadone; drug abuse treatment; employment
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