NCJ Number
186460
Journal
Journal of Psychoactive Drugs Volume: 32 Issue: 3 Dated: July-September 2000 Pages: 311-319
Date Published
July 2000
Length
9 pages
Annotation
This article reviews contingency contracting and systematic desensitization for heroin addicts in methadone maintenance programs.
Abstract
Both contingency contracting and systematic desensitization can be practically implemented in methadone maintenance programs to supplement methadone pharmacotherapy. Contingency contracting involves formal agreements between planners and clients, with behavioral expectations clearly spelled out in advance. It has been effectively used to reduce illicit drug use and to manage patients in the clinic. Systematic desensitization attempts to reduce maladaptive anxiety. It has less effect on actual heroin use yet effectively reduces the fear of withdrawal and general anxiety, while improving self-image, assertiveness, and adjustment to the community. The article proposes a clinic protocol that incorporates all three therapies -- methadone maintenance, contingency contracting, and systematic desensitization. It also suggests further studies to evaluate the effects of this approach on reducing heroin use during methadone maintenance and at a long term follow-up. It concludes that heroin addiction is a multifaceted disorder that requires a multifaceted treatment approach. Tables, references