Compliance with tubercolosis treatment in methadone-maintained patients: Behavioral interventions

Ronith Elk, John Grabowski, Howard Rhoades, Ralph Spiga, Joy Schmitz, William Jennings

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Tubercolosis has increased dramatically in the United States. Noncompliance with treatment is high. The purpose of this investigation was to achieve compliance with prophylactic TB treatment and simultaneously decrease drug use in a high-risk group of intravenous drug users. Two studies were conducted. Study 1: Subjects were 9 chronic opiate users who tested positive for tubercolosis and were placed on isoniazid (INH) and methadone. Methadone was dispensed contingent upon INH ingestion throughout. A within-subject, A-B design with contingency management interventions on drug use was implemented. Results: Compliance with INH was 100% in 8 patients. Cocaine use remained high. Study 2: Two patients, meeting same criteria as Study 1, participated in a within-subject A-B multiple baseline design. Methadone was dispensed contingent upon INH ingestion throughout. Successive decreases in cocaine use were reinforced in the contingent phase. Results: Compliance with INH was high. During contingency, both patients had over 40% cocaine-free urine samples compared with 0% at baseline. This investigation serves as a model for achieving compliance with TB treatment in opiate users.

Original languageEnglish (US)
Pages (from-to)371-382
Number of pages12
JournalJournal of Substance Abuse Treatment
Volume10
Issue number4
StatePublished - Jul 1993

Bibliographical note

Funding Information:
Supported by U.S. Public Health Service/National Institute on Drug Abuse Treatment Demonstration Grant DA-06143 to Dr. Grabowski; Grant FC-32057 from the City of Houston, funded by the Center for Disease Control; and funds from Dr. Robert Guynn, Chair, Department of Psychiatry and Behavioral Sciences, UTHSC. The authors acknowledge the valuable collegial support of the faculty of the SARC and the Department of Psychiatry and Behavioral Sciences. The systematic and outstanding efforts of both the research and clinical staff of the Addictive Behaviors Clinic in sustaining this work are also gratefully acknowledged.

Keywords

  • behavioral interventions
  • compliance
  • methadone-maintenance
  • substance abuse
  • tubercolosis (TB)

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