Behavioral treatment of cocaine-dependent pregnant women and TB-exposed patients

Ronith Elk, Joy Schmitz, Ralph Spiga, Howard Rhoades, Robert Andres, John Grabowski

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37 Scopus citations


Health-compromised drug-dependent patients require specialized treatment that addresses both drug use and health risks. This preliminary study examines the efficacy of a contingency management procedure (shaping) on decreasing cocaine use and increasing compliance with the prescribed treatment regimens in two health-compromised cocainedependent populations: (i) tuberculin (TB) exposed patients (n = 5) (ii) pregnant women (n = 7). A multiple-baseline across-subjects design was used. There were no contingencies on cocaine use during baseline. During the contingent phase, patients received a monetary reinforcer for (a) successive decreases in the quantity of cocaine and (b) cocaine-free samples. They received a weekly reinforcer if all samples per week met criteria for (a) or (b). During the contingent phase, there was a significant decrease in cocaine metabolite levels and an increase in cocaine-free samples in both populations, with a more robust effect in the TB-exposed group. There was an increase in compliance with prenatal visits among the pregnant women during the contingent phase. Implications for health care are discussed.

Original languageEnglish (US)
Pages (from-to)533-542
Number of pages10
JournalAddictive Behaviors
Issue number4
StatePublished - 1995

Bibliographical note

Funding Information:
This study was supported by NIDA Treatment Demonstration Grant DA06143; Grant FC-32057 from the City of Houston, funded by the Centers for Disease Control; and funds from Dr. Robert Guynn, Chair, Department of Psychiatry and Behavioral Sciences. The authors acknowledge the systematic and outstanding efforts of the staff of the Addictive Behaviors Clinic.


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