Enhanced and Attendance-based Prize CM in Community Settings
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Purpose
The purpose of this study is to address the conditions under which prize contingency management (CM) for abstinence and attendance may improve outcomes of cocaine-dependent patients.
For patients who initiate treatment with a cocaine-positive urine specimen, we will evaluate the efficacy of two CM procedures relative to standard, non-CM treatment. The two CM procedures will be provided as additions to standard care and will reinforce drug abstinence but will differ in expected magnitudes of prizes patients can earn, especially during early stages of abstinence. They will provide expected magnitudes of winning about $250 and $560, respectively. We expect that both CM conditions will improve retention and abstinence relative to the standard treatment, non-CM condition. If the enhanced CM condition engenders better outcomes than the $250 CM condition, this finding would suggest that patients initiating treatment while actively using cocaine may best be treated with relatively high reinforcement prize CM as an adjunct to standard care.
For patients who initiate treatment with a cocaine-negative urine specimen, we will evaluate the efficacy of a CM procedure that reinforces treatment attendance. The expected magnitude of winnings will be about $250, and again CM treatment will be in addition to standard care. This CM condition will be compared to standard treatment without CM as well as to a CM treatment that provides a similar magnitude of reinforcement, but contingent upon abstinence. Results from this study will inform an important clinical question of whether simply reinforcing attendance can improve clinical outcomes. Increased retention may result in greater exposure to therapeutic processes that may reduce drug use, especially among patients who begin treatment having already achieved some abstinence. We will also evaluate the cost-effectiveness of CM by examining the effects of the interventions on hospitalizations, medical and psychiatric care, criminal justice costs, and productivity.
| Condition | Intervention | Phase |
|---|---|---|
|
Cocaine Dependence |
Behavioral: Contingency Management |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Factorial Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Enhanced and Attendance-based Prize CM in Community Settings |
- longest continuous period of cocaine abstinence [ Time Frame: baseline and at each follow-up ] [ Designated as safety issue: No ]
| Enrollment: | 443 |
| Study Start Date: | October 2003 |
| Study Completion Date: | April 2009 |
| Primary Completion Date: | April 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Standard Treatment plus prize contingency management for abstinence with an expected probability of winning about $250 in prizes and twice-weekly breath and urine samples.
|
Behavioral: Contingency Management
Rewards valued $1-$100 for abstinence or treatment attendance
|
|
Experimental: 2
Standard Treatment plus prize contingency management for abstinence with an expected probability of winning about $560 in prizes and twice-weekly breath and urine samples.
|
Behavioral: Contingency Management
Rewards valued $1-$100 for abstinence or treatment attendance
|
|
Experimental: 3
Standard Treatment plus prize contingency management for attendance with an expected probability of winning about $250 in prizes and twice-weekly breath and urine samples.
|
Behavioral: Contingency Management
Rewards valued $1-$100 for abstinence or treatment attendance
|
|
No Intervention: 4
Standard Treatment
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age > 18 years
- Current DSM-IV diagnosis of cocaine dependence
- A cocaine-positive urine sample submitted during the first two scheduled treatment days at the center
- Willing to provide names, addresses and phone numbers of individuals to assist in locating the patient for follow-up evaluations
- English speaking
- Willing to sign informed consent.
Exclusion Criteria:
- Serious, uncontrolled psychiatric illness (e.g., acute schizophrenia, bipolar disorder, severe or psychotic major depression, or suicide risk)
- Dementia (<23 on the Mini Mental State Exam; Folstein et al. 1975)
- In recovery from pathological gambling
Contacts and Locations| United States, Connecticut | |
| UConn Health Center | |
| Farmington, Connecticut, United States, 06030 | |
| Principal Investigator: | Nancy M Petry, Ph.D. | UConn Health Center |
More Information
No publications provided
| Responsible Party: | University of Connecticut Health Center |
| ClinicalTrials.gov Identifier: | NCT00606853 History of Changes |
| Other Study ID Numbers: | 04-008, P50DA009241, P50-DA09241 |
| Study First Received: | January 22, 2008 |
| Last Updated: | November 17, 2011 |
| Health Authority: | United States: Federal Government United States: Institutional Review Board |
Keywords provided by University of Connecticut Health Center:
|
Substance abuse Contingency Management |
Additional relevant MeSH terms:
|
Cocaine-Related Disorders Substance-Related Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 19, 2013