Low-Cost Contingency Management for Hispanic Outpatients - 3

The purpose of this study is to evaluate the effectiveness of a lower-cost contingency management (CM) procedure in Hispanic substance abusing outpatients. Thirty individuals meeting DSM-IV criteria for substance dependence receive one of two conditions: (a) standard treatment, or (b) standard treatment plus prize CM. Using a cross-over design, CM is implemented in a community-based outpatient clinic and compared with non-CM in the same clinic. The participating clinic is randomly assigned to receive either the CM or non-CM phase first; 15 weeks after the final participant in one phase is enrolled, a one-week washout period occurs, followed by a switch to the other phase. Patients initiating outpatient treatment during the non-CM phase receive standard treatment and submit urine and breath samples 2/week during Weeks 1-6 and 1/week during Weeks 7-12. Patients initiating treatment during the CM phase also receive standard treatment and the same breath and urine monitoring. In addition, they earn the opportunity to win prizes for coming to treatment and for submitting negative breath and urine samples. Follow-up interviews are conducted at 1,3,6 and 9 months following intake during which substance use and psychosocial functioning are assessed.

Inclusion criteria: age > 18 years current DSM-IV substance dependence. Exclusion criteria: have a serious, uncontrolled psychiatric illness (e.g., acute schizophrenia, bipolar disorder, severe or psychotic major depression, or suicide risk) on the basis of history or medical examination have dementia (<23 on the Mini Mental State Exam; Folstein et al. 1975) DSM-IV diagnosis of pathological gambling plans to move from the Hartford are within 9 months.