Economic and social conditions are recognized as important determinants of drug abuse, leading some observers to suggest that a primary focus of drug abuse treatment should be to alter those basic living conditions that are at the roots of the problem. Unemployment is one of those conditions that has received considerable attention. Indeed, drug use is associated with unemployment in the general population, it is common among drug abusers in treatment, and it is associated with poor treatment outcomes. Supported work programs represent a promising approach in the treatment of severe employment problems among drug abusers since they provide job training, work experience, and income. But these programs have an extraordinary, yet simple potential use in the treatment of drug abuse that thus far has not been tapped, and herein lies the crux of this proposal: The salaries that supported work participants earn for work can also be used to reinforce drug abstinence. We are proposing to develop and evaluate a model therapeutic workplace for drug abusers that utilizes this untapped potential of supported workplaces. The therapeutic workplace is designed to integrate the therapeutic effects of abstinence reinforcement contingencies of proven efficacy into a model supported work environment. The target population will be new mothers who are patients in a model treatment program for pregnant drug-abusing women, a population sorely in need of effective interventions to control their drug use and associated risk of acquiring HIV infection and AIDS, as well as interventions to improve their employment status. A pilot phase and one controlled study are planned over a three-year period. The pilot phase will be conducted to refine the therapeutic workplace procedures including refinement of the teaching curriculum, training of staff, refining the scheduling and payment parameters, and integrating of research and training activities. The main study will examine the effects of voucher reinforcement on abstinence and workplace attendance using a balanced factorial design in which incentives are targeted on attendance, abstinence, both or neither for different subject groups. The hypothesis is that best overall outcomes (on productivity and drug use) will be obtained when both desired behaviors (abstinence and attendance) are targeted. This study will directly test the therapeutic benefits of the novel idea being proposed here using appropriate control and comparison conditions. Overall, these studies will allow for the development and rigorous evaluation of a novel approach to the treatment of drug abuse, the therapeutic workplace, in a population of drug abusing new mothers who desperately need effective interventions to control their drug use and to improve their employment status.
| Aklin, Will M; Wong, Conrad J; Hampton, Jacqueline et al. (2014) A therapeutic workplace for the long-term treatment of drug addiction and unemployment: eight-year outcomes of a social business intervention. J Subst Abuse Treat 47:329-38 |
| Wong, Conrad J; Sheppard, Jeannie-Marie; Dallery, Jesse et al. (2003) Effects of reinforcer magnitude on data-entry productivity in chronically unemployed drug abusers participating in a Therapeutic Workplace. Exp Clin Psychopharmacol 11:46-55 |
| Silverman, Kenneth; Svikis, Dace; Wong, Conrad J et al. (2002) A reinforcement-based therapeutic workplace for the treatment of drug abuse: three-year abstinence outcomes. Exp Clin Psychopharmacol 10:228-40 |
| Silverman, K; Svikis, D; Robles, E et al. (2001) A reinforcement-based therapeutic workplace for the treatment of drug abuse: six-month abstinence outcomes. Exp Clin Psychopharmacol 9:14-23 |
