A SMART Design for Attendance-based Prize CM

UConn Health

Status: Completed

Conditions: Substance Abuse

Treatments: Behavioral: contingency management

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00840151

P50DA009241-16 (U.S. NIH Grant/Contract)

09-053-2

Details and patient eligibility

About

The purpose of this study is to compare different forms of treatment for substance abuse. This study will involve a type of treatment called contingency management, in which patients receive incentives (prizes) for attending outpatient treatment. This study will compare contingency management to standard treatment that does not involve incentives. This study will also compare contingency management treatment that lasts 6 weeks to contingency management that lasts 12 weeks. Finally, this study will compare contingency management treatment delivered at the beginning of outpatient treatment to contingency management treatment delivered later during outpatient treatment. The investigators hypothesize that (1) a 12-week attendance-based contingency management intervention will improve retention and enhance drug abstinence versus standard treatment, (2) initial short-term exposure to attendance-based contingency management (in weeks 1-6 only) will improve substance abuse treatment outcomes compared to standard treatment alone, and (3) contingency management in weeks 7-12 will be particularly useful for those with sporadic attendance or continued drug use during initial stages of treatment.

Enrollment: 360 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• age > 18 years
• current DSM-IV diagnosis of cocaine abuse or dependence or recent cocaine use (self-reported use in past 30 days or positive urine toxicology screen)
• willing to sign informed consent and able to pass an informed consent quiz

Exclusion criteria

• serious, uncontrolled psychiatric illness (e.g., acute schizophrenia, bipolar disorder, severe or psychotic major depression, or suicide risk) on the basis of history or medical examination
• in recovery from pathological gambling (meet DSM-IV criteria for lifetime pathological gambling and are actively trying to refrain from gambling)
• do not speak English (all treatment is provided in English at these clinics)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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360 participants in 4 patient groups

Treatment Group A

No Intervention group

Description:

Individuals randomized to Treatment Group A will receive standard treatment for study weeks 1-6.

Treatment Group B

Experimental group

Description:

Individuals randomized to Treatment Group B will receive contingency management plus standard treatment for study weeks 1-6.

Treatment:

Behavioral: contingency management

Aftercare Group A

No Intervention group

Description:

All participants will be re-randomized after study week 6. Those participants assigned to Aftercare Group A will receive standard treatment for study weeks 7-12.

Aftercare Group B

Experimental group

Description:

All participants will be re-randomized after study week 6. Those participants assigned to Aftercare Group B will receive contingency management treatment plus standard treatment for weeks 7-12.

Treatment:

Behavioral: contingency management