Effects of Time-Based Administration of Abstinence Reinforcement Targeting Opiate and Cocaine Use

Toegel et al. (2020) tested a new twist on the Therapeutic Workplace. Adults who used both opiates and cocaine got paid only when their urine tested clean. Instead of waiting for one drug to clear before targeting the other, the team switched targets every two weeks no matter what.

The study used a single-case design. Each participant served as their own control. The goal was to see if this time-based switch could cut use of both drugs.

The schedule worked. Clean urines rose for both opiates and cocaine during the program. Participants stayed abstinent from the drug that was currently being checked, even when the other drug was not yet under control.

Andrade et al. (2014) ran a similar workplace program, but they waited for opiate abstinence before adding cocaine contingencies. That study also boosted clean urines, yet some clients never reached the second drug target. Toegel et al. (2020) show you can skip the wait and still win.

Silverman et al. (2005) first showed that paying for drug-free urines inside a work setting helps adults learn job skills and cut cocaine or heroin use. The 2020 paper keeps the pay-for-abstinence core but adds the fixed two-week switch.

Davidson et al. (2025) reviewed single-drug contingency management and found bigger gains than the dollar value predicts. Toegel’s polydrug test fits this pattern: small incentives still lifted abstinence above baseline.

If you run a day-treatment or vocational program, you can now target two drugs without long waits. Set a calendar reminder: week 1–2 test for cocaine, week 3–4 test for opiates, repeat. Clients earn pay for the current target drug, keeping motivation high while both substances fall. This simple rotation may move more people toward total abstinence faster than the old sequential rules.