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

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

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

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

Psychiatry & Behavioral Sciences

Research output: Contribution to journal › Article › peer-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 language	English (US)
Pages (from-to)	371-382
Number of pages	12
Journal	Journal of Substance Abuse Treatment
Volume	10
Issue number	4
State	Published - 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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title = "Compliance with tubercolosis treatment in methadone-maintained patients: Behavioral interventions",

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.",

keywords = "behavioral interventions, compliance, methadone-maintenance, substance abuse, tubercolosis (TB)",

author = "Ronith Elk and John Grabowski and Howard Rhoades and Ralph Spiga and Joy Schmitz and William Jennings",

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.",

year = "1993",

month = jul,

language = "English (US)",

volume = "10",

pages = "371--382",

journal = "Journal of Substance Abuse Treatment",

issn = "0740-5472",

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TY - JOUR

T1 - Compliance with tubercolosis treatment in methadone-maintained patients

T2 - Behavioral interventions

AU - Elk, Ronith

AU - Grabowski, John

AU - Rhoades, Howard

AU - Spiga, Ralph

AU - Schmitz, Joy

AU - Jennings, William

N1 - 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.

PY - 1993/7

Y1 - 1993/7

N2 - 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.

AB - 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.

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