|Motivational Incentive Program is an Effective Treatment for
Stimulant Drug Abuse
The chance to win even small rewards in a prize-based Motivational Incentive
(MI) program can motivate cocaine and methamphetamine abusers to stay in treatment
and be drug-free for a longer period, according to a new study funded by the
National Institute on Drug Abuse (NIDA), National Institutes of Health.
The study, led by Dr. Nancy Petry of the University of Connecticut School of
Medicine and Dr. Maxine Stitzer of Johns Hopkins University School of Medicine,
was published in the October 2005 issue of the Archives of General Psychiatry.
This is the first publication of results from a protocol related to NIDA’s Clinical
Trials Network (CTN). The CTN is a research infrastructure that tests the effectiveness
and usefulness of new and improved interventions in community-based treatment
settings with diverse populations. Consisting of 17 research "nodes," the CTN
assists NIDA in establishing and maintaining partnerships with drug abuse researchers
and community treatment providers. This study included participants from eight
“Behavioral and psychosocial techniques are important components of effective
drug abuse and addiction therapies,” says NIDA Director Dr. Nora D. Volkow. “A
comprehensive and integrated treatment plan can address a broad range of social
problems, skills deficits, and co-occurring psychiatric problems that together
increase a person’s vulnerability to substance abuse. In addition, there are
no approved medications for treating certain forms of drug dependence, so behavioral
interventions, such as those employed in this study, are essential.”
In traditional MI, participants receive vouchers for items or services for staying
in treatment and remaining off illicit drugs. But clinics must purchase the vouchers,
which can make the therapy costly and increase the difficulty of implementing
it into community practice. However, the scientists who conducted the study indicate
that the opportunity to win prizes worth as little as $1 offers a successful
and economical alternative to both voucher reward programs and those that employ
A total of 415 cocaine or methamphetamine abusers participated in this 12-week
study. Approximately half were randomly assigned to receive usual care, which
consisted of group counseling, and sometimes individual and family sessions.
The rest were assigned to the MI program, in which they received counseling plus
opportunities to win prizes. The scientists monitored drug abstinence by means
Members of the usual care group were congratulated when their urinalysis results
showed they had not abused cocaine, methamphetamine, and alcohol. But members
of the MI group could draw from a container of chips that offered a 50-percent
chance of winning a prize ranging in value from $1 to $100. In this study, the
average direct costs of the prizes were $203 per participant. According to Dr.
Petry, patients in voucher MI programs may earn as much as $600.
The scientists observed that participants in the MI group remained in treatment
for a longer period and attended more counseling sessions than those in the usual
care group. At the end of 12 weeks, 49 percent of the MI group remained, compared
with 35 percent of the usual care group. They also noted that MI members submitted
a significantly greater number of negative stimulant and alcohol urine samples.
The MI group also was more likely to achieve sustained, continuous abstinence.
Almost 19 percent of the MI group achieved 12 weeks of continued abstinence compared
with almost 5 percent of the usual care group.
“This study showed that drawing for prizes, even when most of the rewards are
worth very little, offered a more cost-effective means of improving abstinence
and retention in psychosocial drug treatment programs,” notes Dr. Petry. “However,
additional research is needed to address the long-term efficacy of this MI program,
especially as applied in community settings.”
The National Institute on Drug Abuse is a component of the National Institutes
of Health, U.S. Department of Health and Human Services. NIDA supports more
than 85 percent of the world’s research on the health aspects of drug abuse
and addiction. The Institute carries out a large variety of programs to ensure
the rapid dissemination of research information and its implementation in policy
and practice. Fact sheets on the health effects of drugs of abuse and information
on NIDA research and other activities can be found on the NIDA home page at
The National Institutes of Health (NIH) — The Nation's Medical Research
Agency — includes 27 Institutes and Centers and is a component of
the U. S. Department of Health and Human Services. It is the primary Federal
agency for conducting and supporting basic, clinical, and translational medical
research, and it investigates the causes, treatments, and cures for both common
and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.