As reported by the Boston Globe, October 3, 2006.

Rewards Work with Drug Abusers, Study Finds

By John Christoffersen

Several hundred dollars worth of rewards can keep a drug abuser clean for nearly two weeks longer than a user who doesn't receive incentives, a new study has found.

Researchers at the Yale School of Medicine and the University of Connecticut were the latest to find such incentive programs work and were among the first to assess what it costs a clinic to run an effective prize system to keep addicts off drugs.

"Many studies have already shown that prize-based incentives are very effective at improving drug use outcomes among a wide range of substance abusing populations," said Todd A. Olmstead, author of the new study. "However, one of the reasons we haven't seen greater adoption of these tools in practice is that not much was known about their implementation costs."

The study could lead to greater use of rewards programs for drug addicts, said Stephen T. Higgins, a professor of psychiatry at the University of Vermont who has found that rewards work for cocaine addicts.

"There's overwhelming scientific evidence that it's an effective therapy," Higgins said. "Cost has been a significant concern."

The study comes amid a growing body of research that finds paying people to stay clean can help keep addicts off drugs.

Smokers in a two-year study at the University of Florida can get vouchers redeemable at Target, Wal-Mart or Amazon.com if they pass tests on whether they have had cigarettes.

The new study was based on 415 drug abusers who were treated at eight clinics around the country for use of cocaine, amphetamines and methamphetamines. All the participants received standard treatment, such as counseling, while about half were randomly assigned prizes for abstaining from drugs.

Participants who tested negative for drugs were invited to draw plastic chips marked with rewards up to $100 that could be exchanged for prizes such as CD players and televisions. The number of draws increased each week they stayed clean.

Nearly 19 percent of participants eligible for prizes abstained from drugs for the 12-week program, compared with 4.9 percent of those who only received standard treatment, the study found.

The prize system cost $438 per patient and extended the average time off drugs by 1.7 weeks compared with those who did not receive prizes, the study found.

"The early weeks of abstinence are the hardest ones," Olmstead said Tuesday. "The benefit to society is probably going to be well worth it in terms of the reduced likelihood of crime."

Olmstead acknowledged that some clinics are opposed to the idea of providing financial rewards to drug addicts. That concern and lack of funds have limited the implementation of prize systems, he said.

The study did not analyze the drug abusers after they left the 12-week treatment program. But Higgins agreed that keeping addicts off drugs in the initial weeks is a key indicator of long-term success.

"Incentives can sort of build a healthy bridge to the more natural realistic rewards for living a drug-free lifestyle," Higgins said.