Long-term benefits of adding incentives to the community reinforcement approach for cocaine dependence.

BACKGROUND

The community reinforcement approach (CRA) with vouchers is a well-established program developed for the treatment of cocaine addiction. It involves an incentive program in which patients earn vouchers that can be exchanged for goods or services contingent upon abstinence from cocaine use.

AIM

To examine the contributions of incentives to retention, abstinence, and psychosocial outcomes in the CRA+vouchers program at the 12-month follow-up.

METHODS

58 cocaine addicts were randomly assigned to CRA treatment with or without an added incentive program in a community setting for cocaine dependence in Spain.

RESULTS

65.5% of patients in the group with vouchers completed 12 months of treatment, versus 48.3% in the no-voucher group. In the CRA+vouchers group, mean percentage of cocaine-negative samples was 95.76%, versus 79.31% in the group without vouchers. There were significant improvements in psychosocial functioning in both treatments, but when differences were observed, they supported CRA with vouchers over CRA alone.

CONCLUSION

Combining CRA with incentives improves treatment outcomes in cocaine-dependent outpatients. Additive benefits of vouchers remain 6 months after the incentive program ends.