Abstinence-contingent Recovery Housing and Reinforcement-based Treatment Following Opioid Detoxification

Overview

Journal Addiction

Specialty Psychiatry

Date 2011 Dec 14

PMID 22151478

Citations 18

Authors

Michelle Tuten

Anthony DeFulio

Hendree E Jones

Maxine Stitzer

Affiliations

Soon will be listed here.

Abstract

Aims: To conduct a randomized, controlled trial of abstinence-contingent recovery housing delivered with or without intensive day treatment among individuals exiting residential opioid detoxification.

Design: Random assignment to one of three conditions: recovery housing alone (RH), abstinence-contingent recovery housing with reinforcement-based treatment RBT (RH + RBT) or usual care (UC). RH and RH + RBT participants received 12 weeks of paid recovery housing contingent upon drug abstinence. RH + RBT participants also received 26 weeks of RBT, initiated concurrently with recovery housing. Assessments were conducted at 1, 3 and 6 months after treatment enrollment.

Setting: Out-patient drug-free substance abuse treatment program in Baltimore, Maryland.

Participants: Patients (n = 243) who completed medication-assisted opioid detoxification.

Measurements: Primary outcome was drug abstinence (opioid- and cocaine-negative urine and no self-reported opioid or cocaine use in the previous 30 days). Secondary outcomes included abstinence at all time-points (1, 3 and 6 months), days in recovery housing and employment.

Findings: Overall rates of drug abstinence were 50% for RH + RBT, 37% for RH and 13% for UC (P < 0.001). At 6 months, RH + RBT participants remained more likely to meet abstinence criteria than UC participants (37% versus 20%, P = 0.016). Length of stay in recovery housing mediated abstinence outcomes and was longer in RH + RBT (49.5 days) than in RH (32.2 days; P < 0.002).

Conclusions: Abstinence-contingent recovery housing improves abstinence in opioid-dependent adults following medication-assisted detoxification. The addition of intensive 'reinforcement-based treatment' behavioural counseling further improves treatment outcomes, in part by promoting longer recovery house stays.

Citing Articles

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Establishing Quality and Outcome Measures for Recovery Housing: A Tiered Approach Supporting Service Evolution.

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Bastien G, McAnulty C, Ledjiar O, Socias M, Le Foll B, Lim R Can J Psychiatry. 2022; 68(8):572-585.

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