{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:11:10Z","timestamp":1790086270365,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T00:00:00Z","timestamp":1486080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T00:00:00Z","timestamp":1486080000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2017,5]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n To test whether an incentive\u2010based intervention that increased adherence to naltrexone also increased opiate abstinence.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \n Post\u2010hoc<\/jats:italic>\n combined analysis of three earlier randomized controlled trials that showed individually that incentives for adherence to oral and to extended\u2010release injection naltrexone dosing schedules increased naltrexone adherence, but not opiate abstinence.\n <\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Out\u2010patient therapeutic work\u2010place in Baltimore, MD, USA.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n One hundred and forty unemployed heroin\u2010dependent adults participating from 2006 to 2010.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n \n Participants were hired in a model work\u2010place for 26\u00a0weeks and randomized to a contingency (\n n<\/jats:italic>\n \u00a0=\u00a072) or prescription (\n n<\/jats:italic>\n \u00a0=\u00a068) group. Both groups were offered naltrexone. Contingency participants were required to take scheduled doses of naltrexone in order to work and earn wages. Prescription participants could earn wages independent of naltrexone adherence.\n <\/jats:p>\n <\/jats:sec>\n \n Measures<\/jats:title>\n Thrice\u2010weekly and monthly urine samples tested for opiates and cocaine and measures of naltrexone adherence (percentage of monthly urine samples positive for naltrexone or percentage of scheduled injections received). All analyses included pre\u2010randomization attendance, opiate use and cocaine use as covariates. Additional analyses controlled for cocaine use and naltrexone adherence during the intervention.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n Contingency participants had more opiate abstinence than prescription participants (68.1 versus 52.9% opiate\u2010negative thrice\u2010weekly urine samples, respectively; and 71.9 versus 61.7% opiate\u2010negative monthly urine samples, respectively) based on initial analyses [thrice\u2010weekly samples, odds ratio (OR)\u00a0=\u00a03.3, 95% confidence interval (CI)\u00a0=\u00a01.7\u20136.5,\n P<\/jats:italic>\n \u00a0<\u00a00.01; monthly samples, OR\u00a0=\u00a02.6, 95% CI\u00a0=\u00a01.0\u20137.1,\n P<\/jats:italic>\n \u00a0=\u00a00.06] and on analyses that controlled for cocaine use (thrice\u2010weekly samples, OR\u00a0=\u00a03.9, 95% CI\u00a0=\u00a03.3\u20134.5,\n P<\/jats:italic>\n \u00a0<\u00a00.01; monthly samples, OR\u00a0=\u00a03.4, 95% CI\u00a0=\u00a01.1\u201311.1,\n P<\/jats:italic>\n \u00a0=\u00a00.04), which was high and associated with opiate use. The difference in opiate abstinence rates between contingency and prescription participants was reduced when controlling for naltrexone adherence (monthly samples, OR\u00a0=\u00a01.1, 95% CI\u00a0=\u00a00.7\u20131.7,\n P<\/jats:italic>\n \u00a0=\u00a00.84).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Incentives for naltrexone adherence increase opiate abstinence in heroin\u2010dependent adults, an effect that appears to be due to increased naltrexone adherence produced by the incentives.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/add.13724","type":"journal-article","created":{"date-parts":[[2016,12,9]],"date-time":"2016-12-09T17:26:22Z","timestamp":1481304382000},"page":"830-837","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Effects of incentives for naltrexone adherence on opiate abstinence in heroin\u2010dependent adults"],"prefix":"10.1111","volume":"112","author":[{"given":"Brantley P.","family":"Jarvis","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"August F.","family":"Holtyn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"DeFulio","sequence":"additional","affiliation":[{"name":"Department of Psychology Western Michigan University Kalamazoo MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly E.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Everly","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Pittsburgh at Greensburg Greensburg PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie\u2010Marie S.","family":"Leoutsakos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Umbricht","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fingerhood","sequence":"additional","affiliation":[{"name":"Department of Medicine Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George E.","family":"Bigelow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Silverman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2011.10.018"},{"key":"e_1_2_7_3_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Federal Guidelines for Opioid Treatment Programs.HHS Publication; PEP15\u2010FEDGUIDETOTP. 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