ArticleAddiction (Abingdon, England)2017
Effects of incentives for naltrexone adherence on opiate abstinence in heroin-dependent adults.
Article in Addiction (Abingdon, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Extended-release injectable naltrexone for opioid use disorder: a systematic review.Addiction (Abingdon, England) · 2018Pooled it
- Adjunctive Medication Management and Contingency Management to enhance adherence to acamprosate for alcohol dependence: the ADAM trial RCT.Health technology assessment (Winchester, England) · 2023Trial
- The effects of extended-release injectable naltrexone and incentives for opiate abstinence in heroin-dependent adults in a model therapeutic workplace: A randomized trial.Drug and alcohol dependence · 2019Trial
- Enhancing translation: A need to leverage complex preclinical models of addictive drugs to accelerate substance use treatment options.Pharmacology, biochemistry, and behavior · 2024Review
- Contingency Management for Drug Use Disorders: Meta-Analysis and Application of Tolin's Criteria.Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association · 2024Article
- The effectiveness of abstinence-based and harm reduction-based interventions in reducing problematic substance use in adults who are experiencing homelessness in high income countries: A systematic review and meta-analysis: A systematic review.Campbell systematic reviews · 2024Review
- Nalmefene Hydrochloride: Potential Implications for Treating Alcohol and Opioid Use Disorder.Substance abuse and rehabilitation · 2024Review
- Dissemination of Contingency Management for the Treatment of Opioid Use Disorder.Perspectives on behavior science · 2023Article
- Behavior-Analytic Approaches to the Management of Diabetes Mellitus: Current Status and Future Directions.Behavior analysis in practice · 2021Review
- Monitoring and Improving Naltrexone Adherence in Patients with Substance Use Disorder.Patient preference and adherence · 2021Review
- Adapting treatment length to opioid-dependent individuals' needs and preferences: A 2-year follow-up to a 1-year study of extended-release naltrexone.Addiction (Abingdon, England) · 2020Article
- Misalignment of Stakeholder Incentives in the Opioid Crisis.International journal of environmental research and public health · 2020Review
- Lorcaserin maintenance fails to attenuate heroin vs. food choice in rhesus monkeys.Drug and alcohol dependence · 2020Article
- Building a Group-Based Opioid Treatment (GBOT) blueprint: a qualitative study delineating GBOT implementation.Addiction science & clinical practice · 2019Article
- Multi-View Cluster Analysis with Incomplete Data to Understand Treatment Effects.Information sciences · 2019Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
aimTo test whether an incentive-based intervention that increased adherence to naltrexone also increased opiate abstinence.
designPost-hoc combined analysis of three earlier randomized controlled trials that showed individually that incentives for adherence to oral and to extended-release injection naltrexone dosing schedules increased naltrexone adherence, but not opiate abstinence.
settingOut-patient therapeutic work-place in Baltimore, MD, USA.
participantsOne hundred and forty unemployed heroin-dependent adults participating from 2006 to 2010.
interventionsParticipants were hired in a model work-place for 26 weeks and randomized to a contingency (n = 72) or prescription (n = 68) group. Both groups were offered naltrexone. Contingency participants were required to take scheduled doses of naltrexone in order to work and earn wages. Prescription participants could earn wages independent of naltrexone adherence. MEASURES: Thrice-weekly and monthly urine samples tested for opiates and cocaine and measures of naltrexone adherence (percentage of monthly urine samples positive for naltrexone or percentage of scheduled injections received). All analyses included pre-randomization attendance, opiate use and cocaine use as covariates. Additional analyses controlled for cocaine use and naltrexone adherence during the intervention.
findingsContingency participants had more opiate abstinence than prescription participants (68.1 versus 52.9% opiate-negative thrice-weekly urine samples, respectively; and 71.9 versus 61.7% opiate-negative monthly urine samples, respectively) based on initial analyses [thrice-weekly samples, odds ratio (OR) = 3.3, 95% confidence interval (CI) = 1.7-6.5, P < 0.01; monthly samples, OR = 2.6, 95% CI = 1.0-7.1, P = 0.06] and on analyses that controlled for cocaine use (thrice-weekly samples, OR = 3.9, 95% CI = 3.3-4.5, P < 0.01; monthly samples, OR = 3.4, 95% CI = 1.1-11.1, P = 0.04), which was high and associated with opiate use. The difference in opiate abstinence rates between contingency and prescription participants was reduced when controlling for naltrexone adherence (monthly samples, OR = 1.1, 95% CI = 0.7-1.7, P = 0.84).
conclusionsIncentives for naltrexone adherence increase opiate abstinence in heroin-dependent adults, an effect that appears to be due to increased naltrexone adherence produced by the incentives.
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Registered trials
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