Contingency Management for Methamphetamine Addiction

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Queen's Medical Center

Disqualifiers: Active psychosis, Traumatic brain injury, Pregnancy, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to use contingency management (CM) as an intervention tool to address methamphetamine use. The main objectives are to: * Gather effectiveness data on a pilot a CM program for participants in Hawaii who use methamphetamine following hospitalization due to traumatic injury * To assess participant perspectives on engaging with a CM program based at a Level 1 Trauma Center. Researches will assess both patient-reported and biologically-confirmed medium-term program effectiveness and conduct qualitative interviews with participants post-program. Participants will: * Visit a follow-up clinic up to three times per week to complete urinalysis following discharge from the trauma unit * Complete Treatment Effectiveness Assessments at 6 and 12-weeks * Engage in a qualitative interview at the end of the CM program

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Contingency Management for methamphetamine addiction?

Research shows that Contingency Management is one of the most effective treatments for reducing methamphetamine use. It helps people stay off drugs, use other treatments and medical services more, and engage in less risky sexual behavior.

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Is contingency management safe for treating methamphetamine addiction?

The research does not specifically mention safety concerns related to contingency management for methamphetamine addiction, suggesting it is generally considered safe for use in humans.

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How is the treatment Contingency Management different from other treatments for methamphetamine addiction?

Contingency Management is unique because it uses a reward system to encourage positive behavior changes, such as staying drug-free, which is different from other treatments that may not focus on immediate incentives. It has shown broad benefits, including increased drug abstinence and reduced risky behaviors, making it one of the most effective treatments for methamphetamine addiction.

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Eligibility Criteria

This trial is for adults in Hawaii who've been hospitalized for trauma, use methamphetamine at least weekly, and have moderate Amphetamine-Type Substance Use Disorder. They must be able to understand the study and communicate in English. Those with severe head injuries or unable to participate are excluded.

Inclusion Criteria

I have been admitted to the hospital due to a trauma.

I experience at least 4 symptoms of moderate amphetamine addiction.

I am over 18 years old.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a Contingency Management program addressing methamphetamine use, with urinalysis up to three times per week and Treatment Effectiveness Assessments at 6 and 12 weeks

12 weeks

Up to 3 visits per week (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including qualitative interviews

4 weeks

Participant Groups

The trial tests a Contingency Management program aimed at reducing methamphetamine use among patients post-hospitalization. It involves regular urine tests, effectiveness assessments at weeks 6 and 12, and an interview after completing the program.

Group I: Contingency Managment Experimental Treatment 1 Intervention

Participants are allowed to complete CM three times per week for the maximum of 12-weeks. At the six- and 12-week time points, participants will complete the Treatment Effectiveness Assessment (TEA) with study personnel.

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

The Queen's Medical Center Honolulu, HI

Who Is Running the Clinical Trial?

Queen's Medical Center Lead Sponsor

National Institute of General Medical Sciences (NIGMS) Collaborator

References

1. Ireland pubmed.ncbi.nlm.nih.gov

Contingency management for the treatment of methamphetamine use disorder: A systematic review. [2021] Methamphetamine use continues to be an important public health problem. Contingency management is among the most effective interventions for reducing methamphetamine use. It has been more than ten years since the last systematic review of contingency management for methamphetamine use disorder. Since then, an additional ten randomized controlled trials and a variety of other studies have been completed. The present systematic review includes 27 studies. Several factors, most notably problem severity, appear to predict treatment outcome. However, the effectiveness of CM has been demonstrated in studies restricted to MSM, studies restricted to implementation in community programs, and in studies of the general population of methamphetamine users conducted in research treatment programs. There appear to be broad benefits of contingency management intervention, including greater drug abstinence, higher utilization of other treatments and medical services, and reductions in risky sexual behavior. Twenty of the twenty-one studies that reported abstinence outcomes showed an effect of contingency management on abstinence, and seven of the nine studies that reported sexual risk behavior outcomes showed an effect of contingency management in reducing risky sexual behavior. Taken together, recent evidence suggests strongly that outpatient programs that offer treatment for methamphetamine use disorder should prioritize adoption and implementation of contingency management intervention.

2. United States pubmed.ncbi.nlm.nih.gov

Contingency management for the treatment of methamphetamine use disorders. [2022] Theory and some preliminary evidence suggest that contingency management may be an effective treatment strategy or adjunct to psychosocial treatment for methamphetamine use disorders. An experimentally rigorous investigation on the topic was provided by a large multisite trial conducted under the auspices of the Clinical Trials Network of the National Institute on Drug Abuse.

3. Australia pubmed.ncbi.nlm.nih.gov

Perspectives and sentiments on contingency management from people who use methamphetamine. [2023] Contingency management (CM) is currently the most efficacious treatment for methamphetamine use, yet it is rarely available in routine care. We examined the viewpoints of people who use methamphetamine on CM as a potential treatment for methamphetamine use disorder.

4. Ireland pubmed.ncbi.nlm.nih.gov

Contingency management: schedule effects. [2013] Contingency management interventions provide reinforcement for abstaining from drugs and withhold reinforcement when drug use is detected. Previous work demonstrates that the reinforcement schedule with which reinforcement is delivered modulates the efficacy of the intervention. This pilot study explores the effects of reinforcement in methamphetamine-dependent individuals. Results suggest that schedules incorporating an increasing magnitude of reinforcement for consecutive abstinences with a reset in reinforcer magnitude for a positive drug test produce superior results.

5. England pubmed.ncbi.nlm.nih.gov

Contingency management: an evidence-based component of methamphetamine use disorder treatments. [2019] To review briefly some of the available evidence regarding the utility of contingency management in treating methamphetamine use disorders.

6. Netherlands pubmed.ncbi.nlm.nih.gov

An Acute Care Contingency Management Program for the Treatment of Stimulant Use Disorder: A Case Report. [2022] Illicit stimulants such as crystal methamphetamine and cocaine are a rising cause of morbidity and mortality in North America. Unfortunately, there are few evidence-based approaches for the management of stimulant use disorder. Contingency management programs are currently the best evidenced treatment strategy, designed to reward behavior change and offer competing reinforcers toward the goal of reducing substance use, but these programs are often difficult to access. Given that it is well understood that hospitalization presents a valuable opportunity for the initiation of treatment for a variety of substance use disorders, the adaptation of contingency management programs to an acute medicine inpatient setting is a potentially viable option to improve care, and to increase access to effective treatment for stimulant use disorders.