However, patients can regain the higher voucher values by providing five consecutive cocaine-negative specimens. Points already in the patients' accounts can never be lost. Money is not provided directly to patients. Instead, vouchers are used to purchase retail items in the community by a staff member. Items obtained using the vouchers are quite diverse and have included ski-lift passes, fishing licenses, gift certificates to local restaurants, camera equipment, bicycle equipment, and continuing education materials.
Therapists retain veto power over all purchases.
Purchases are only approved if, in the therapists' opinion, they are in concert with individual treatment goals related to increasing drug-free prosocial activities. Objective monitoring is necessary for fair and effective implementation of the incentive program and other behavioral contracts used in this treatment. Such contracts are only effective if they are administered consistently and precisely. Reliance on self-reports would not be adequate for those purposes. By the time illicit drug abusers enroll in treatment, family, friends, employers, and others have often lost confidence in their veracity.