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Incentives increase enrolment in substance abuse treatment at community needle exchange site

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Question

Question:

Do motivational interventions, with or without monetary incentive, increase uptake of substance abuse treatment compared with standard referral to a needle exchange programme?

Patients:

281 opioid dependent individuals (DSM-IV criteria), newly registered to the Baltimore Needle Exchange Program (BNEP). Exclusions: age >60 years; those currently receiving substance abuse treatment; major mental illness or severe cognitive impairment.

Setting:

Two community locations in Baltimore, USA; time period unclear.

Intervention:

Motivational referral condition (MRC) or MRC plus monetary incentive (MRC+1). MRC involved 1 h individual motivational enhancement therapy (MET) sessions (eight delivered twice weekly during the first 2 months of treatment) and 1 h treatment readiness groups (16 delivered twice weekly). Services are delivered through a mobile medical van. MET aims to facilitate behaviour change through building motivation, strengthening commitment and creating a plan; treatment readiness involved use of a manual guided protocol to promote an informed and positive view of the benefits of substance abuse treatment and encourage treatment enrolment. Participants in the MRC+1 group additionally received cash …

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