Trial Summary
What is the purpose of this trial?Phosphatidylethanol (PEth) is a direct biomarker of alcohol that can detect moderate to heavy drinking with high sensitivity and specificity over 3-week periods. Reinforcing negative PEth results alongside attendance may increase the proportion of participants who respond to CM during and post treatment. In the proposed study, the investigators will collect PEth samples every 3 weeks for 12 weeks in 150 participants initiating outpatient treatment for alcohol use disorders. Using a two-group randomized design, participants will be assigned to standard care with PEth monitoring alone or with CM for attending treatment and submitting PEth negative samples. Compared to standard care and monitoring, the investigators expect that the CM intervention will result in greater attendance, more PEth negative samples, and higher proportions of self-reported non-drinking days, along with lower proportions of heavy drinking days, over the short term and the long term, measured throughout a 12-month follow-up. The investigators anticipate that the reinforcement intervention may decrease other drug use and sexual risk behaviors that spread HIV, reduce psychiatric symptoms, and improve quality of life as well.
Do I need to stop my current medications for this trial?
The trial protocol does not specify whether you need to stop taking your current medications.
What data supports the idea that Contingency Management for Alcoholism is an effective treatment?
The available research shows that Contingency Management (CM) is effective in treating alcoholism. In one study, 84% of participants who received CM stayed in treatment for 8 weeks, compared to only 22% of those who received standard treatment. This suggests that CM helps people stick with their treatment plans better than standard care. Another study highlights that CM is one of the most effective treatments for promoting abstinence from alcohol by using tangible rewards to encourage positive behavior.
12345What safety data exists for Contingency Management in treating alcoholism?
The provided research does not directly address safety data for Contingency Management (CM) in treating alcoholism. However, CM is described as an evidence-based intervention that improves treatment outcomes for substance use disorders, including alcohol use. The studies discuss its implementation, resource requirements, and efficacy, but do not specifically mention safety concerns or data. Further research specifically focused on safety would be needed to answer this question comprehensively.
23678Is Contingency Management a promising treatment for alcoholism?
Yes, Contingency Management is a promising treatment for alcoholism. It uses rewards to encourage people to reduce or stop drinking, and has been shown to be effective in helping people stay away from alcohol. It's also a low-cost and adaptable approach that can be used in different communities.
237910Eligibility Criteria
This trial is for individuals with an alcohol use disorder who are starting intensive outpatient treatment. It's not suitable for those with conditions that could interfere with their participation in the study.Inclusion Criteria
You have been diagnosed with a drinking problem by a mental health professional.
I am currently in a rigorous outpatient treatment program.
Exclusion Criteria
You have a medical condition that may make it difficult for you to participate in the study.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive outpatient treatment for alcohol use disorders with PEth monitoring every 3 weeks for 12 weeks. Participants are assigned to either standard care or standard care plus contingency management.
12 weeks
4 visits (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment, with a focus on alcohol abstinence and group attendance.
12 months
Participant Groups
The study tests if adding a reward system (Contingency Management) to standard care improves attendance and reduces alcohol consumption in patients. Participants will either receive standard care or standard care plus rewards for attending treatment and providing alcohol-free blood samples.
2Treatment groups
Experimental Treatment
Active Control
Group I: Experimental GroupExperimental Treatment2 Interventions
Standard care plus contingency management
Group II: Control GroupActive Control1 Intervention
Standard care
Contingency management is already approved in United States, European Union for the following indications:
🇺🇸 Approved in United States as Contingency Management for:
- Alcohol dependence
- Substance use disorders
🇪🇺 Approved in European Union as Contingency Management for:
- Alcohol dependence
- Substance use disorders
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
The VillageHartford, CT
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Who Is Running the Clinical Trial?
UConn HealthLead Sponsor
National Institute on Alcohol Abuse and Alcoholism (NIAAA)Collaborator
References
Contingency management for individuals with chronic health conditions: A systematic review and meta-analysis of randomized controlled trials. [2021]Contingency management (CM) interventions involve providing reinforcement for engaging in a desired behavior, and have been shown to increase treatment adherence and promote abstinence in the treatment of substance use disorders. This review was conducted to systematically review the literature on the effectiveness of CM when applied to a range of medical conditions outside of substance use disorders.
Contingency management: utility in the treatment of drug abuse disorders. [2019]Contingency management (CM) is a strategy that uses positive reinforcement to improve the clinical outcomes of substance abusers in treatment, especially sustained abstinence from drugs of abuse. Further, CM has been adopted to improve methodology and interpretation of outcomes in clinical trials testing new pharmacotherapies and to improve adherence to efficacious medications in substance abuse patients. Thus, CM has proven to be widely useful as a direct therapeutic intervention and as a tool in treatment development.
A randomized study of cellphone technology to reinforce alcohol abstinence in the natural environment. [2022]Contingency management (CM) uses tangible incentives to systematically reinforce abstinence and is among the most efficacious psychosocial substance abuse treatments. This study assessed the feasibility and initial efficacy of a portable CM procedure designed to address technical limitations for detecting drinking that have prevented using CM for alcohol problems.
Give them prizes, and they will come: contingency management for treatment of alcohol dependence. [2022]This study evaluated the efficacy of a contingency management (CM) procedure that provided opportunities to win prizes as reinforcers. At intake to outpatient treatment, 42 alcohol-dependent veterans were randomly assigned to receive standard treatment or standard treatment plus CM, in which they earned the chance to win prizes for submitting negative Breathalyzer samples and completing steps toward treatment goals. Eighty-four percent of the CM participants were retained in treatment for an 8-week period compared with 22% of the standard treatment participants (p
Home-Based Contingency Management Delivered by Community Health Workers to Improve Alcohol Abstinence: A Randomized Control Trial. [2020]To evaluate the effectiveness of home-based contingency management (CM) in improving abstinence in an incentive-dependent manner among alcoholic individuals.
Implementation of Contingency Management at a Large VA Addiction Treatment Center. [2018]Contingency management (CM) is an evidence-based intervention that reinforces target behaviors of patients, such as abstinence from substance use. This column discusses the experiences and lessons learned at a large U.S. Department of Veterans Affairs Addiction Treatment Center during implementation of CM as part of the VA's national rollout. Challenges are discussed related to staff reception and limited initial referrals, identifying a drug testing method and staff confidence in that method, training requirements, and financial resources needed. Local innovations and CM expansion since 2012 are also reviewed.
Budget Impact Tool for Implementing Contingency Management for Co-occurring Alcohol Use Disorders and Serious Mental Illness. [2023]Contingency management (CM) is a behavioral intervention in which tangible incentives are provided to patients when they achieve a desired behavior (e.g., reducing or abstaining from alcohol use). The authors sought to describe the resource requirements and associated costs of various CM versions (usual, high magnitude, and shaping) tailored to a high-risk population with co-occurring serious mental illness and severe alcohol use disorder.
Contingency management treatment for substance use disorders: How far has it come, and where does it need to go? [2019]Contingency management (CM) interventions consistently improve substance abuse treatment outcomes, yet CM remains a highly controversial intervention and is rarely implemented in practice settings. This article briefly outlines the evidence base of CM and then describes 4 of the most often-cited concerns about it: philosophical, motivational, durability, and economic. Data supporting and refuting each of these issues are reviewed. The article concludes with suggestions to address these matters and other important areas for CM research and implementation, with the aims of improving uptake of this efficacious intervention in practice settings and outcomes of patients with substance use disorders. (PsycINFO Database Record
Focus groups to increase the cultural acceptability of a contingency management intervention for American Indian and Alaska Native Communities. [2020]Many American Indian and Alaska Native (AI/AN) people seek evidence-based, cost-effective, and culturally acceptable solutions for treating alcohol use disorders. Contingency management (CM) is a feasible, low-cost approach to treating alcohol use disorders that uses "reinforcers" to promote and support alcohol abstinence. CM has not been evaluated among AI/AN communities. This study explored the cultural acceptability of CM and adapted it for use in diverse AI/AN communities.
Group-based randomized trial of contingencies for health and abstinence in HIV patients. [2021]Contingency management (CM) treatments are usually applied individually for drug abstinence, but CM can also be targeted toward health behaviors and implemented in groups. This study evaluated effects of a group-based CM intervention that focused on reinforcing health behaviors.