Abstract
We report the 12 and 18-month results of a clinical trial designed to evaluate the effectiveness of Community Reinforcement Approach (CRA) and Relapse Prevention (RP) in the treatment of opiate-dependent patients maintained on methadone. This is a follow-up to our 6-month outcome study that reported only CRA results. Patients (n = 181) were randomized to three groups: standard (n = 67), CRA (n = 52), and CRA and RP (n = 62). All patients improved as measured by the Addiction Severity Index (ASI), self-report scales, Risk Assessment Battery (RAB) and urine drug screens collected at specific follow-up intervals: 3, 6, 9, 12, and 18 months. The CRA-RP group showed the most sustained improvement with regard to drug use and psychiatric status as measured by the ASI. There were no other between group differences. Further, treatment engagement and retention rates were equivalent across groups. In this population of opiate-dependent patients maintained on methadone we found some benefit of adding Relapse Prevention to the overall intervention package.