Voucher Program Provides Positive Drug Treatment Outcome

Cocaine addiction is a global problem, and some European countries have higher rates of cocaine use than the United States. “Cocaine accounted for 46.9% of all treatment admissions for drug dependence in Spain, and 62.5% of the total if we consider only those cases treated for the first time in the person’s life,” said researchers from Spain. In an attempt to determine how the Community Reinforcement Approach (CRA) to treatment worked compared to the CRA plus a voucher system, the researchers conducted a study on 64 individuals who met the criteria for cocaine addiction. The team enrolled half of the participants into a standard care treatment program, in which they received group therapy twice a week for six months, and then once a week for the next six months. The therapy focused on addiction awareness, strategies for managing emotions and the development of coping skills. The participants were taught problem solving techniques and were educated on addiction prevention and given skills to resolve interpersonal problems. The second group of participants was enrolled in a similar program, but they also received vouchers based on positive drug tests. The vouchers could be redeemed throughout the year for products and services that supported a drug free lifestyle.

Based on specimens gathered from both groups throughout the study, the researchers found that the participants, who were offered incentive via the vouchers, achieved much higher rates of abstinence. “Among patients assigned to the CRA plus vouchers condition, 65.5% completed 12 months of treatment versus 28.6% of those assigned to the standard care condition,” said the team. “At the 12-month assessment, 58.6% of patients assigned to the CRA plus vouchers condition were abstinent, compared with 25.7% in the standard care condition; furthermore, 34.5% of patients assigned to the CRA plus vouchers condition achieved twelve months of continuous cocaine abstinence, versus 17.1% in the standard care condition. Those treated in the CRA plus vouchers condition also achieved greater improvements in psychosocial functioning than those treated in the standard care condition.”

Secades-Villa, Roberto, Olaya García-Rodríguez, Gloria García-Rodríguez, Emilio Sánchez-Hervás, Jose R. Fernandez-Hermida, and Stephen T. Higgins. “Community Reinforcement Approach plus Vouchers among Cocaine-dependent Outpatients: Twelve-month Outcomes.” Psychology of Addictive Behaviors 25.1 (2011): 174-79. Print.

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Layna


    September 24th, 2011 at 12:26 PM

    Wow! This is a great idea! How would this program need to be implemented worldwide because I see this having a HUGE potential for success!

  • Ross Taylor

    Ross Taylor

    September 24th, 2011 at 11:50 PM

    @Layna: Yeah, it is a great way to go about with de-addiction. And yes, it should preferably be implemented all over. But that’s just not going to happen with most countries, including the US. And you know why? Because we have no money for these things, all our drug-prevention related money is being pumped to fight against the BIG EVIL, Marijuana! A substance that isn’t even addictive, and something that cannot even be compared to deadly drugs like cocaine!

  • Danielle


    September 25th, 2011 at 5:18 AM

    I would think that one of the hardest parts about getting a program like this up and running would be to find the right donors. Donors who are willing to give and give freely in the hopes of helping to make the difference in someone’s life that could turn them around for the better. I still think that it is too soon to hinge too many hopes all on this, but it is something interesting and different and definitely worth continuing.

  • May Harrison

    May Harrison

    September 25th, 2011 at 3:58 PM

    What a creative yet logical idea to solve this drug importing epidemic. Cocaine costs a profuse amount of money, so for most users money is tight. Offering these rewards would be great as an incentive to become abstinent.

    Danielle raised an astute observation, saying “Donors who are willing to give and give freely in the hopes of helping to make the difference in someone’s life that could turn them around for the better.”. Organizations responsible for carrying out this treatment could find a way to reward donors, links to donors websites, website donor badges and acknowledgement could get plenty of donors on board.

    The biggest hurtle in this whole thing is getting more people to commit to the treatment process. While 58% is great, it is minuscule compared to the entire european cocaine addict population.

  • gary


    September 25th, 2011 at 10:17 PM

    but won’t this turn them into parasites?they will come to expect things for free and will not have the motivation to work to earn a living.they will change from drug-addicts to yet another section of the society that leeches off tax dollars.

  • Tyler


    September 26th, 2011 at 4:24 AM

    but don’t you kind of feel like it smacks a little of bribery? and then what happens when the vouchers are all gone? do you think that they will then fall off the abstinence wagon? i would hope not but i think that prolonged studies should be continued before we think that this is the real answer. for some people i think that this could work but not everyone is going to respond to simply getting free stuff.

  • Hans


    September 26th, 2011 at 8:44 AM

    Sounds like it could work but not everywhere. It would depend on the local conditions. They could try implementing this in a few regions and then see how it goes.

  • Carson


    September 26th, 2011 at 4:40 PM

    I would love to see something like a gym membership.



    September 27th, 2011 at 3:56 PM

    I would do a progran like this if I were an addict. It kind of gives you goals and rewards to think about, something even more than just a chip for being so many days sober. These are going to be vouchers for things that are tangible, and although you are having to do the hard work you might be getting some pretty good stuff in return.

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