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Summary

Abstinence-Contingent Wage Supplements to Promote Drug Abstinence and Employment was designed to promote drug abstinence and vocational entry among unemployed adults in treatment for opioid use disorder by providing financial incentives dependent on verified abstinence.

During the 12-month program period, unemployed participants could earn up to 20 hours per week of wages for engaging in job-seeking activities with an employment specialist, at $10 per hour. Employed participants could receive wage supplements for verified hours worked, capped at $8 per hour for up to 40 hours per week. These payments were contingent upon maintaining drug abstinence, which was verified through a routine and random drug testing schedule.  

Positive results on the drug test resulted in a temporary reset of the base supplement rate to $1 per hour and restarting of routine mandatory testing. The rate increased by $1 per day for each day the participant provided a drug negative result and worked for at least five minutes until the maximum amount of $8 per hour was achieved.   

The program was implemented in Baltimore, MD. 

 

Populations and employment barriers: Justice involvement, Substance use disorder

Effectiveness rating and effect by outcome domain

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Outcome domain Term Effectiveness rating Effect in 2024 dollars and percentages Effect in standard deviations Sample size
Increase earnings Short-term Cannot assess support
Long-term Cannot assess support
Very long-term Cannot assess support
Increase employment Short-term Cannot assess support
Long-term Little evidence to assess support Effect size could not be calculated -- 91
Very long-term Cannot assess support
Decrease benefit receipt Short-term Cannot assess support
Long-term Cannot assess support
Very long-term Cannot assess support
Increase education and training All measurement periods Cannot assess support

Effectiveness ratings

  • Well- supported
  • Supported
  • Mixed support
  • Not supported
  • Insufficient evidence
  • Cannot assess support

Studies of this program

Study quality rating Study counts per rating
High High 1

Implementation details

Organizations implementing program

Johns Hopkins Center for Learning and Health

Local context

The providers and study site were located in Baltimore, MD.

Characteristics of research participants
Black or African American
56%
White
40%
Another race
4%

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