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An abbreviated breath test for detecting the disulfiram metabolite carbon disulfide (CS2) was evaluated in an analogue investigation of the sensitivity of the test in identifying disulfiram and non-disulfiram intake in a group of 14 alcoholic inpatients. Disulfiram (250 mg) was administered within an ABAB repeated measures design over a 12-day period with corresponding breath tests administered during morning and afternoon time periods. Dependent measures included spectrophotometric analysis of reacted test samples and visual ratings of sample color. Results indicated that the test was highly sensitive in discriminating disulfiram administration for the group as a whole, as well as for individual subjects. Moreover, visual ratings were more accurate than spectrophotometric cut-off scores in identifying disulfiram administration. The test shows considerable promise as a rapid means of assessing disulfiram compliance.

The utility of disulfiram in the treatment of alcohol abuse has been limited by the high frequency with which clients refuse the regimen. The present study identified variables influencing disulfiram acceptance/rejection within the framework of the theory of reasoned action. Eighty male inpatients on an alcohol treatment unit completed a questionnaire operationalizing the components of the model. The theoretical components were then used to predict requests for the drug. Multiple regression analyses revealed significant correlations among components of the model consistent with the assumptions of the theory. In addition, significant differences were found between disulfiram requestors and rejectors in terms of behavioral and normative beliefs about the consequences of being placed on the drug. Implications of these results for the design of effective interventions are discussed.

Developed and evaluated a home-based contracting program to determine its effect on the compliance rates of discharged alcohol patients to a disulfiram (antabuse) regimen. The three comparison groups included (a) no contract/no recording; (b) contract/recording; and (c) contract/recording plus instructions for positive reinforcement. Twenty-five patients who had been treated in a behaviorally oriented inpatient alcohol dependence treatment program and who lived with a significant other (i.e., spouse, sibling, parent) participated in the study. At the end of the 3-month period for which the disulfiram was prescribed, those Ss who were involved in contracting and recording reached criterion more frequently than those who were in the minimal treatment group. Furthermore, 84% of this S sample were abstinent at the 3-month follow-up according to collateral reports. The discussion centers on the use of home-based contracting as an inexpensive alternative to other, more costly disulfiram programs. Additional methods for obtaining measures of reliability on self-report of disulfiram usage also are discussed.