What side effects are associated with this type of intervention?

Common treatments for Opioid Use Disorder (OUD) include Contingency Management (CM) and Medication-Assisted Treatment (MAT) with buprenorphine-naloxone. CM, which uses positive reinforcement to promote treatment adherence, does not have direct pharmacological side effects but may cause psychological stress or anxiety. MAT with buprenorphine-naloxone can lead to side effects such as nausea, vomiting, constipation, sweating, headache, insomnia, and potential dependence. Both treatments are effective in reducing opioid use and promoting adherence but require careful management to mitigate these side effects.

What prior FDA approvals exist?

The FDA has approved several medications for the treatment of Opioid Use Disorder (OUD), including methadone, buprenorphine, and naltrexone. Methadone and buprenorphine are often used in medication-assisted treatment (MAT) programs, which combine these medications with counseling and behavioral therapies. Buprenorphine, in particular, is frequently used in combination with naloxone (as in Suboxone) to reduce misuse. Contingency management, which uses positive reinforcement to promote treatment adherence, can be effectively integrated with these pharmacologic treatments to enhance outcomes. For example, studies have shown that combining buprenorphine with contingency management strategies can improve adherence and reduce opioid misuse.

What other types of research exist?

Promising novel alternatives to Contingency Management for OUD patients include: 1) Medication-Assisted Treatment (MAT) with buprenorphine-naloxone combined with cognitive-behavioral therapy (CBT) or other psychosocial support, which has shown efficacy in promoting adherence and reducing substance use. 2) Recovery Management Checkups (RMC), which provide routine monitoring and active outreach to enhance engagement and continuation of care. 3) Integrated multimodal interventions that combine skills training, motivational enhancement therapy, and mutual help groups, tailored to individual patient needs. These approaches leverage a combination of pharmacological and behavioral strategies to support long-term recovery.

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Financial Incentives for Opioid Use Disorder

N/A

Recruiting

Research Sponsored by Rowan University

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Participants at least 18 years of age

Be older than 18 years old

Must not have

Participants who demonstrate contraindication with Suboxone treatment or who are currently or have recently used other medication-assisted therapies for opioid use disorder.

Timeline

Screening 3 weeks

Treatment Varies

Follow Up 3-months

Awards & highlights

No Placebo-Only Group

Summary

This trial aims to help patients with opioid use disorder who visit emergency departments. It uses a method where patients get rewards for sticking to their treatment plan, along with a medication that reduces cravings and withdrawal symptoms. The goal is to see if this combined approach helps more people start and continue their treatment compared to standard care.

Who is the study for?

This trial is for adults over 18 with Opioid Use Disorder who are new to the Bridge program at Cooper University ED and have a clinic appointment within a week. They must be in good health, not pregnant or breastfeeding, and able to give informed consent. Those with severe psychiatric conditions or on other opioid treatments can't join.

What is being tested?

The study tests if financial rewards (Contingency Management) help patients start and stick to treatment with buprenorphine + naloxone for Opioid Use Disorder in an emergency department setting compared to standard care without incentives.

What are the potential side effects?

While the trial focuses on Contingency Management rather than medication side effects, buprenorphine + naloxone may cause withdrawal symptoms, nausea, headache, dizziness, fatigue among others.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

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I am 18 years old or older.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

Select...

I cannot use Suboxone or have used other medications for opioid addiction.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ 3-months

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~3-months

This trial's timeline: 3 weeks for screening, Varies for treatment, and 3-months for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Attendance at first scheduled clinic appointment

Percentage of sessions where buprenorphine positive urine results was recorded

Percentage of sessions where opioid free urine results were recorded

+1 more

Secondary study objectives

Delay discounting as a correlate of opioid-free urine test results and buprenorphine-positive results

Neurological Soft Signs correlate with treatment success

Opioid demand as a correlate of opioid-free urine test results and buprenorphine-positive results

+1 more

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: Contingency ManagementExperimental Treatment1 Intervention

Participants in this arm of the study will receive financial incentives for attending their buprenorphine appointments and for being clean from other opioids. Participants in this group will also have up to two rides per week paid for to attend bup appointments.

Group II: Standard CareActive Control1 Intervention

Participants in this group will be treatment as usual and will not receive any incentives for attending their bup appointments or for being opioid abstinent.

Treatment

First Studied

Drug Approval Stage

How many patients have taken this drug

Contingency management

2006

Completed Phase 4

~1020

0 / 2Eligibility criteria met

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.

Mechanism Of Action

Side Effect Profile

Prior Approvals

Other Research

The most common treatments for Opioid Use Disorder (OUD) include buprenorphine, contingency management (CM), and the community reinforcement approach (CRA). Buprenorphine, a partial opioid agonist, helps reduce cravings and withdrawal symptoms by binding to opioid receptors in the brain without producing a high. Contingency management uses positive reinforcement, such as vouchers or rewards, to encourage adherence to treatment and abstinence. The community reinforcement approach combines CM with other behavioral therapies to enhance life satisfaction and reduce substance use. These treatments are essential for OUD patients as they address both the physiological and psychological aspects of addiction, promoting long-term recovery and reducing the risk of relapse.

Narcotics addiction treatment: behavioral methods concurrent with methadone maintenance.Contingency Management for Patients Receiving Medication for Opioid Use Disorder: A Systematic Review and Meta-analysis.Adding an Internet-delivered treatment to an efficacious treatment package for opioid dependence.