P03-253 - Attitudes And Response Of Opioid-Dependent Clients To Receiving Certificates As Contingency Management- A Qualitative Survey

Abstract

Introduction

The UK NICE Guidelines recommends Contingency Manangement as “the only psychosocial intervention wIth clear evidence for effectiveness as an adjunct to drug detoxification”.

Most resarch has been done with money,vouchers as incentives,raising ethical issues.

Aims

The aim of this study is to analyze the subjective attitudes of clients and changes in their recovery process,when awarded certificates as incentives for giving clean drug screens and complying with care-plan.

Methods

Clients were awarded 3 tiered certificates on providing a specific number of random consecutive negative drug screens to Heroin and Cocaine. Screens were deemed positive, if the client did not attend their appointments.

Level 1- three negative drug screens.

Level 2- six negative drug screens

Level 3- ten negative drug screens.

Study questionnares were filled by key-workers and clients.

Results

15 clients received certificates.

12 clients knew about certificates before their treatment began.

100% clients reported higher motivation to achieve subsequent certificates.

100% clients reported ‘encouragement’ to produce negative drug screens.

73% clients reported ‘encouragement’ to attend appointments with key-workers.

100% clients reported improved self-esteem.

100%clients reported positive responses from family, friends and clinicians.

100% reported a positive shift in their attitudes & behaviours towards drugs.

A few clients agreed that certificates enhanced their determination to give negative drug screens but would have done either ways.

Conclusions

Contingency management is a positive and effective adjunct to opiod detoxification. It should be incorporated into detox regimes more robustly and consistently.

Certificates as Contingency management raise no ethical issues,requires no staff training and requires low budget.