A Bridge to Treatment: The Therapeutic Workplace and Methadone Treatment

Not Applicable

Completed

Interventions: Behavioral: methadone contingency
Behavioral: Methadone & Abstinence Contingency

Brief Summary: The purpose of this study is to evaluate the effectiveness of the Therapeutic Workplace in promoting methadone treatment and increasing abstinence in unemployed, out-of-treatment injection heroine users.

Detailed Description: A randomized study is planned for 5 years to evaluate the effectiveness of the Therapeutic Workplace in promoting methadone treatment and abstinence in unemployed injection drug users. Participants will be recruited through street outreach, at agencies that serve the target populations, and informal word-of-mouth referrals. Participants will be invited to attend the workplace and to enroll in the methadone treatment. To engage participants in the workplace, they will be allowed to work independent of whether they enroll in methadone treatment and independent of their drug use. The workplace participants (N=162) will be randomly assigned to three groups. The "Usual Care Control" participants will be allowed to work independent of their methadone use or urinalysis results. The "Methadone Contingency" participants will be required to take methadone to attend work, and will receive a brief pay decrease for failing to take their medication. The "Methadone \& Abstinence Contingency" participants will be required to take their medication in order to attend work, as well as receive a brief pay decrease for any positive urine samples for both cocaine and methadone.

Recruitment & Eligibility

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
Methadone & Abstinence Contingency	Methadone & Abstinence Contingency	Participants in this group were able to access work if they enrolled in the methadone treatment and consistently took their medication, but they also received a decrease in base pay if they test positive for opiates or cocaine on the drug screens (employment-based reinforcement).
Methadone Contingency Group	methadone contingency	Participants in this group were allowed to work and earn wages as long as they enrolled in the methadone treatment and continued to take does of methadone consistently (employment-based reinforcement).
Methadone & Abstinence Contingency	methadone contingency	Participants in this group were able to access work if they enrolled in the methadone treatment and consistently took their medication, but they also received a decrease in base pay if they test positive for opiates or cocaine on the drug screens (employment-based reinforcement).

Primary Outcome Measures

Name	Time	Method
Percentage of Months in Methadone Treatment	6 months	The percentage of months in which participants were enrolled in methadone treatment during the 6-month intervention evaluation period?
Percentage of Monthly Urine Sample Negative for Opiates	6 months	Percentage of urine sample negative for opiates at each of the six 30-day assessments scheduled throughout the intervention evaluation
Percentage of Monthly Urine Samples Negative for Cocaine	6 months	Was the participant's urine sample negative for cocaine at each of the six 30-day assessments scheduled throughout the intervention evaluation period?

Secondary Outcome Measures

Name	Time	Method
Percentage of M,W,F Urine Samples Negative for Cocaine	6 months	Was each participant's urine sample negative for cocaine at each of the Monday, Wednesday, Friday urine samples scheduled throughout the intervention evaluation period?
Percentage of M,W,F Urine Samples Negative for Opiates	6 months	Was each participant's urine sample negative for opiates at each of the Monday, Wednesday, Friday urine samples scheduled throughout the intervention evaluation period?

Locations (1): Center for Learning and Health, Johns Hopkins Bayview Medical Campus, 5200 Eastern Ave., Suite W142
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Baltimore, Maryland, United States