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A Behavioral Model for Maintenance of Drug Abstinence DA 017444

TRI. science. addiction. A Behavioral Model for Maintenance of Drug Abstinence DA 017444. Kimberly C. Kirby, Ph.D. Lois A. Benishek , Ph.D. James R. McKay, Ph.D. MaryLouise Kerwin , Ph.D. A. Thomas McLellan , Ph.D. Tanya Christoffel, M.Ed. Douglas B. Marlowe , J.D., Ph.D

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A Behavioral Model for Maintenance of Drug Abstinence DA 017444

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  1. TRI science addiction A Behavioral Model for Maintenance of Drug AbstinenceDA 017444 Kimberly C. Kirby, Ph.D. Lois A. Benishek , Ph.D. James R. McKay, Ph.D. MaryLouise Kerwin , Ph.D. A. Thomas McLellan , Ph.D. Tanya Christoffel, M.Ed. Douglas B. Marlowe , J.D., Ph.D Treatment Research Institute and the University of Pennsylvania Population: Opiate-dependent, cocaine-using adults Setting: Methadone Maintenance Clinic

  2. TRI science addiction Primary Research Questions • Do longer durations of contingency management (CM) result in a greater abstinence 2 yrs post-tx? • Does a longer duration of CM result in increases in non-drug using activities? • Do increases in the number of non-drug using activities predict better long-term drug abstinence? • Are better long-term outcomes associated with more natural contingencies of reinforcement for non-drug using activities?

  3. TRI science addiction Contingency Management • Escalating Schedule of Reinforcement • Base value = $ 2.50 3 row bonus = $10 • Increments + $ 1.25 Pos. urine => reset $2.50 • Max. value = $40.00 5 row neg => return • Patients Randomly Assigned to: • Usual CM (3 mo) Extended CM (9 mo) • Both Groups then Receive Aftercare for 3 mo • $1 lottery ticket/clean urine

  4. TRI science addiction Logic Model Reinforce drug-free urines Longer-term abstinence & less relapse Increased abstinence during treatment Contact natural contingencies of reinforcement? Type? Type 1 Yes More likely to relapse Increase non-drug using activities Type 2 No

  5. TRI science addiction Outcome Measures • ComQol=Comprehensive Quality of Life Scale • Q-LES-Q=Quality of Life Enjoyment/Satisfaction PES= Pleasant/Unpleasant Events • Life Changes=Lifestyle Changes Questionnaire

  6. TRI science addiction Cross-Cutting Activities Investigator groups on common themes: • Similar populations • Mediators or moderators of change • Similar intervention elements Advising/problem-solving methodological issues: • Maintaining follow-up • Monitoring treatment fidelity • Data analysis challenges (e.g., missing data, mediating variables)

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