Effects of Contingent Payment on Compliance with a Naltrexone Regimen

The effects of several schedules of payment on duration and patterns of compliance with a naltrexone regimen were examined. Patients were paid under contingencies based on either number of doses ingested or on a fixed time schedule. Reinforcement schedules based on number of doses ingested produced more consistent treatment-oriented behavior than a time-based schedule. Covariation between behavior and alternating contingencies (A-B-A) indicated that the schedules contributed to increased duration of treatment compared to previous noncontingent payment. The issue of using extrinsic reinforcers such as monetary payment to enhance compliance is discussed and additional procedures are suggested.