TY - JOUR
T1 - Reinforcing integrated psychiatric service attendance in an opioid-agonist program
T2 - A randomized and controlled trial
AU - Kidorf, Michael
AU - Brooner, Robert K.
AU - Gandotra, Neeraj
AU - Antoine, Denis
AU - King, Van L.
AU - Peirce, Jessica
AU - Ghazarian, Sharon
N1 - Funding Information:
This study was supported by research grant DA028154-02 (P.I., Dr. Kidorf) from the National Institute of Health - National Institute on Drug Abuse (NIH-NIDA). NIH-NIDA had no other role other than financial support. We gratefully acknowledge the research support staff whose effort and diligence were instrumental to both the quality and integrity of the study, especially Kori Kindbom, M.A. (Research Coordinator), Michael Sklar, M.A., Rachel Burns, B.A., Jennifer Mucha, M.A., and Mark Levinson, M.A.
Funding Information:
Funding for this study was provided by NIH Grant DA028154-02 . The NIH had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
PY - 2013/11/1
Y1 - 2013/11/1
N2 - Background: The benefits of integrating substance abuse and psychiatric care may be limited by poor service utilization. This randomized clinical trial evaluated the efficacy of using contingency management to improve utilization of psychiatric services co-located and integrated within a community-based methadone maintenance treatment program. Methods: Opioid-dependent outpatients (n= 125) with any current psychiatric disorder were randomly assigned to: (1) reinforced on-site integrated care (ROIC), with vouchers (worth $25.00) contingent on full adherence to each week of scheduled psychiatric services; or (2) standard on-site integrated care (SOIC). All participants received access to the same schedule of psychiatrist and mental health counseling sessions for 12-weeks. Results: ROIC participants attended more overall psychiatric sessions at month 1 (M= 7.53 vs. 3.97, p< .001), month 2 (M= 6.31 vs. 2.81, p<. .001), and month 3 (M= 5.71 vs. 2.44, p< .001). Both conditions evidenced reductions in psychiatric distress (p< .001) and similar rates of drug-positive urine samples. No differences in study retention were observed. Conclusions: These findings suggest that contingency management can improve utilization of psychiatric services scheduled within an on-site and integrated treatment model. Delivering evidenced-based mental health counseling, or modifying the contingency plan to include illicit drug use, may be required to facilitate greater changes in psychiatric and substance abuse outcomes.
AB - Background: The benefits of integrating substance abuse and psychiatric care may be limited by poor service utilization. This randomized clinical trial evaluated the efficacy of using contingency management to improve utilization of psychiatric services co-located and integrated within a community-based methadone maintenance treatment program. Methods: Opioid-dependent outpatients (n= 125) with any current psychiatric disorder were randomly assigned to: (1) reinforced on-site integrated care (ROIC), with vouchers (worth $25.00) contingent on full adherence to each week of scheduled psychiatric services; or (2) standard on-site integrated care (SOIC). All participants received access to the same schedule of psychiatrist and mental health counseling sessions for 12-weeks. Results: ROIC participants attended more overall psychiatric sessions at month 1 (M= 7.53 vs. 3.97, p< .001), month 2 (M= 6.31 vs. 2.81, p<. .001), and month 3 (M= 5.71 vs. 2.44, p< .001). Both conditions evidenced reductions in psychiatric distress (p< .001) and similar rates of drug-positive urine samples. No differences in study retention were observed. Conclusions: These findings suggest that contingency management can improve utilization of psychiatric services scheduled within an on-site and integrated treatment model. Delivering evidenced-based mental health counseling, or modifying the contingency plan to include illicit drug use, may be required to facilitate greater changes in psychiatric and substance abuse outcomes.
KW - Contingency management
KW - Methadone maintenance
KW - Psychiatric comorbidity
KW - Treatment adherence
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U2 - 10.1016/j.drugalcdep.2013.06.005
DO - 10.1016/j.drugalcdep.2013.06.005
M3 - Article
C2 - 23866988
AN - SCOPUS:84884416160
VL - 133
SP - 30
EP - 36
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
SN - 0376-8716
IS - 1
ER -