Effectiveness of Contingency Management in the Treatment of Crack Addiction in Brazil

Federal University of São Paulo

Status: Completed

Conditions: Contingency Management; Addiction, Cocaine; Substance Use Disorders

Treatments: Behavioral: Standard treatment; Behavioral: Contingency Management

Study type: Interventional

Funder types: Other

Identifiers

NCT03345394

FAPESP 2017/05371-8

Details and patient eligibility

About

Crack addiction has become a severe public health problem in Brazil. Crack users present elevated prevalence rates of psychiatric comorbidities, sexual transmitted infections and unemployment with high probability of living or have lived in the streets, history of incarceration and engagement in illegal activities. For the last 20 years a treatment called Contingency Management (CM) have achieved the best results regarding reduction of substance use, promotion of abstinence, treatment attendance and retention in treatment. The first CM study conducted in Brazil advocates for the efficacy of CM on all of these outcomes, suggesting that CM can be effective in a Brazilian population of crack users.

Full description

The objective of this study is to evaluate the effectiveness of Contingency Management (CM) for crack users living in the "Crackland" region. To achieve this goal, regular treatment staff from Unidade Recomeço Helvétia treatment service will be capacitated in CM to latter-on apply the CM intervention in their respective services. The design will be a single-blind randomized clinical trial composed of a sample of 100 subjects with current diagnose for crack/cocaine dependence. Participants allocated to the control condition will receive 12 weeks of the usual care treatment provided by these two treatment facilities. Participants allocated to the experimental condition will receive the exact same treatment as control participants associated with CM. CM procedure will occur 2 timer per week (every Monday and Thursday or Tuesday and Friday). Primary outcomes are: (1)retention in treatment; (2) reduction of crack use; (3) promotion of continuous crack cocaine abstinence. Secondary findings are reduction on psychiatric symptomatology. The investigator hypothesis is that participants in the CM condition will have a better treatment response in all studied outcomes.

Enrollment: 98 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• DSM-V diagnose for crack cocaine use disorder

Exclusion criteria

• being under 18 years old

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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98 participants in 2 patient groups

Standard Treatment

Active Comparator group

Description:

12 weeks of standard treatment offered by Unidade Recomeço Helvétia treatment program

Treatment:

Behavioral: Standard treatment

Contingency Management

Experimental group

Description:

12 weeks of standard treatment offered at Unidade Recomeço Helvétia treatment program associated with Contingency Management

Treatment:

Behavioral: Contingency Management