Employment-based Reinforcement of Naltrexone Compliance in Unemployed Heroin-dependent Adults
Presentation
Overview
Overview
Description
Naltrexone is an opiate antagonist that effectively prevents relapse to opioid use; however rates of compliance are notoriously poor. In a randomized controlled trial of employment-based contingencies to promote naltrexone compliance, heroin-dependent injection drug users were randomly assigned to a Naltrexone Contingency (NC) or Work Only (WO) group. NC participants are required to ingest oral naltrexone thrice weekly to gain entry into the workplace and WO participants receive a take-home prescription and can work independently of naltrexone compliance. In the workplace participants earn hourly wages and productivity pay. Outcome measures include monthly naltrexone, opioid and cocaine urinalysis results. Data show access to the workplace successfully reinforces compliance with naltrexone. Mean percent naltrexone-positive samples are 74% and 28% in the NC and WO groups, respectively. Mean opiate-positive samples are also lower among NC versus WO participants (74% and 58%, respectively); however no effect is observed on cocaine use. Overall, this study provides evidence that an employment-based behavioral treatment can successfully reinforce compliance with a medication and has important implications for use with other medications.
