Day treatment for cocaine dependence: Incremental utility over outpatient counseling and voucher incentives

Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling ( n=39) or day treatment ( n=40). Participants in both conditions received equivalent individual cognitive–behavioral counseling and earned equivalent payment vouchers for providing cocaine-negativ...

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Bibliographic Details
Published in:Addictive behaviors 2003-03, Vol.28 (2), p.387-398
Main Authors: Marlowe, Douglas B, Kirby, Kimberly C, Festinger, David S, Merikle, Elizabeth P, Tran, Giao Q, Platt, Jerome J
Format: Article
Language:English
Subjects:
Addictive behaviors
Adult
Adult and adolescent clinical studies
Aged
Ambulatory Care - economics
Ambulatory Care - utilization
Biological and medical sciences
Cocaine
Cocaine-Related Disorders - economics
Cocaine-Related Disorders - therapy
Contingency management vouchers
Crack Cocaine
Day Care, Medical - economics
Day Care, Medical - utilization
Day treatment
Desintoxication. Drug withdrawal
Drug addiction
Female
Humans
Male
Medical sciences
Middle Aged
Patient Compliance
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Reimbursement, Incentive - economics
Reimbursement, Incentive - utilization
Substance abuse treatment
Treatments
Urban Health Services - economics
Urban Health Services - utilization
Urban Population
Vouchers
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Summary:Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling ( n=39) or day treatment ( n=40). Participants in both conditions received equivalent individual cognitive–behavioral counseling and earned equivalent payment vouchers for providing cocaine-negative urine samples. However, day treatment participants attended significantly more psychoeducational and recreational groups and received two meals per day. Prior to random assignment, more participants expressed a preference for day treatment and participants were more likely to return for an initial appointment following assignment to day treatment. However, no significant between-groups differences in tenure or abstinence were detected during the 3-month course of treatment. These null findings were attributable to an absence of a dose-response effect for the group interventions in the day treatment condition. In addition, there may have been a ceiling effect from the vouchers, which masked the influence of the additional day treatment components.
ISSN:0306-4603
1873-6327
DOI:10.1016/S0306-4603(01)00248-9