The Use of Contingency Contracting to Improve Outcome in Methadone Maintenance

Abstract

Methadone programs today are faced with high rates of illicit drug use and patient attrition. Attempts to reduce illicit drug use and improve compliance have included the use of contingency contracting systems. Contingency contracting relies on the use of rewarding or aversive incentives to alter noncompliant behaviors. Their use has led to improvements in retention and compliance for a subgroup of otherwise noncompliant methadone maintenance program patients. Practical considerations in the implementation of contingency contracts, observations of their time-limited effects, and the need for more potent and efficacious incentives have become issues needing further research.

Key Words:

• methadone maintenance
• contingency contracting
• compliance