Emergent Effects One Year Later?
This project assessed methods for decreasing HIV-risk behaviors in substance abusers, and assessed the safety and efficacy of pharmacological and behavioral treatments for opioid dependence in those already infected with HIV. Contingency management (CM) rapidly reduces cocaine use, but its effects subside after treatment. Cognitive-behavioral therapy (CBT) produces reductions that emerge 6-12 months after treatment ends. Combined, the 2 treatments might be complementary. In a 2×2 design, 193 cocaine-using methadone-maintained outpatients were randomly assigned to 12 weeks of group therapy (CBT or a control condition) and voucher availability (CM contingent on cocaine-negative urines, or noncontingent vouchers). As part of the CBT treatment, patients were taught 1) to identify and seek out sources of reinforcement that do not carry risks of HIV; and 2) to develop adaptive problem-focused and emotion-focused coping responses to general and drug-specific stressors that might otherwise tri
