Clean Urines Win the Prize in Patients with Dual Diagnosis

Up to 50% of patients with serious mental illnesses have co-occurring substance abuse, and these patients suffer from greater rates of overall psychiatric impairment, nonadherence, HIV infection, and homelessness than individuals with serious mental illness alone. Applying strategies similar to the contingency rewards proven effective for substance-abusing patients, investigators conducted a randomized, controlled, 3-month study of 176 outpatients with serious mental illness and co-occurring stimulant use.

In the experimental arm, patients underwent urine and alcohol breath testing three times weekly and were rewarded for producing urines clean of methamphetamine, amphetamine, or cocaine, and for continuous stimulant abstinence. With more ne…