Contingent Access to Methadone Maintenance Treatment: Effects on Cocaine Use of Mixed Opiate-Cocaine Abusers

This study tested contingent access to methadone treatment as an incentive. Forty-four mixed opiate-cocaine abusers participated in a 90-day premaintenance probationary program. They were stabilized on 50 mg of methadone and assigned to 1 of 2 treatment groups. Contingent treatment patients were required to submit 2 consecutive weeks of cocaine-free urines during their first 7 weeks of treatment to gain entry into 2 years of methadone maintenance. For noncontingent patients, access to methadone maintenance was based on a yoked control procedure. Patients not accepted to methadone maintenance received a 6-week detoxification. Patients in the contingent group were more likely to submit 2 consecutive weeks of cocaine-free urines than patients in the comparison group. Results demonstrate that contingent access to a longer duration of methadone treatment provides a practical and effective incentive for short-term cocaine abstinence.