关键词:
Contingency Management
Harm Reduction
Excessive Alcohol Use
Transdermal Monitors
Self-Report
摘要:
BackgroundTreatments for alcohol use disorders typically have been abstinence based, but harm reduction approaches that encourage drinkers to alter their drinking behavior to reduce the probability of alcohol-related consequences, have gained in popularity. This study used a contingency management procedure to determine its effectiveness in reducing alcohol consumption among heavy drinkers. MethodsEighty-two nontreatment-seeking heavy drinkers (ages 21 to 54, M=30.20) who did not meet diagnostic criteria for alcohol dependence participated in the study. The study had 3 phases: (i) an Observation phase (4weeks) where participants drank normally;(ii) a Contingency Management phase (12weeks) where participants were paid $50 weekly for not exceeding low levels of alcohol consumption as measured by transdermal alcohol concentrations, <0.03g/dl;and (iii) a Follow-up phase (12weeks) where participants (n=66) returned monthly for 3months to self-report drinking after the contingencies were removed. Transdermal alcohol monitors were used to verify meeting contingency requirements;all other analyses were conducted on self-reported alcohol use. ResultsOn average 42.3% of participants met the contingency criteria and were paid an average of $222 during the Contingency Management phase, with an average $1,998 in total compensation throughout the study. Compared to the Observation phase, the percent of any self-reported drinking days significantly decreased from 59.9 to 40.0% in the Contingency Management and 32.0% in the Follow-up phases. The percent of self-reported heavy drinking days reported also significantly decreased from 42.4% in the Observation phase to 19.7% in the Contingency Management phase, which was accompanied by a significant increase in percent days of self-reported no (from 40.1 to 60.0%) and low-level drinking (from 9.9 to 15.4%). Self-reported reductions in drinking either persisted, or became more pronounced, during the Follow-up phase. ConclusionsContingen