Downey, Helmus, and Schuster (2000) hypotesized that by targeting poly-drug users by using contingency management procedure would result to an improved outcomes. Contingency management procedures demonstrated an efficacy in targeting a variety of problematic behaviors among drug abuser. Voucher-based contingency management strategies where the use of urinalysis result which is immediately available through an on-site toxicology laboratory provides a quick feedback test result to both patients and therapists.
This process is effective whereby the urinalysis results are used in a contingency management process which is designed to “increase reinforcement density” from non-drug sources and second, the deduction of availability of positive reinforcement when “drug is used (Downey, Helmus, and Schuster, 2000). Moreover the use of reinforcement strategies that minimize access to alcohol and other illicit drugs would be expected to decrease the likelihood that the heroin-dependent will find him in a very high risk situation in which the drug is available.
The tandem of Higgins and Silverman (1999 as cited by Downey, Helmus, and Schuster, 2000) and other experts have effectively used voucher-based reinforcement therapy in treating cocaine and opiate dependents. It must be noted that VBRT has been used with great result in treating cocaine dependence. Meanwhile this kind of therapy when applied to opiate addicts gives a good result in terms of drug treatment outcome as well as positive psychosocial results.
The study done by Downey, Helmus, and Schuster (2000) states that baseline levels of cocaine and heroin use are significant indicators and predictors of the treatment outcome. This is irregardless of treatment assignment. In the study performed by the triad, there were no significant group differences concerning the treatment outcome. Yet, among the subsample VBRT participants there is significantly increased cocaine use and no heroin and poly-drug abstinence.
Though this results are in the predicted direction of the study expected by the three. Nevertheless, the result of their study suggests that for those who achieve poly-drug abstinence, VBRT may optimized a positive result of the treatment. However, Downey, Helmus, and Schuster (2000) suggest that improved interventions, probably targeting single-drug abstinence, or increase reinforcement magnitude or both, may be necessary if not important to promote initial poly-drug abstinence among heroin users.
References:
Downey, K. K. , Helmus, T. C. and Schuster, C. R. (2000). Treatment of Heroin-dependent Poly-drug Abusers with Contingency Management and Buprenorphine Maintenance. Experimental and Clinical Psychopharmacology. Vol 8(2), 176-184 Louria, D. B. (1968). The Drug Scene. McGraw Hill, Michigan Moraes, F. Jr. (2000). The Little Book of Heroin. Ronin Publishing, Berkeley “Statistics,” (n. d. ). in the know zone. Retrieved April 26, 2008 from http://www. intheknowzone. com/heroin/stats. htm