Doctors' drug abuse reduced during contingency-contracting treatment.

Fifteen drug-abusing doctors each directed their psychiatrist to mail to their licensing boards a pre-prepared license-surrendering letter if any of a series of urine samples contained drugs. The doctors also received other, individualized treatments. Profound reductions in drug use occurred. Seven patients did not relapse at all during the 2-year (average) follow-up, and 4 others experienced only very brief relapses. Four licenses were suspended temporarily by contract, but 6 were suspended or revoked for other reasons. Other reports on such patients reveal some adverse outcomes, and two of these patients had adverse outcomes after relapsing and discontinuing treatment.