A Therapeutic Workplace for Alcohol Dependence

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00183144
Recruitment Status : Completed
First Posted : September 16, 2005
Last Update Posted : May 19, 2010
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Information provided by:
Johns Hopkins University

Brief Summary:
The purpose of this study is to determine whether the Therapeutic Workplace is effective in increasing and maintaining long-term drug abstinence in homeless, alcohol dependent adults.

Condition or disease Intervention/treatment Phase
Alcohol Dependence Behavioral: Contingency management Phase 2

Detailed Description:

Few populations are beset with the constellation of economic, social and health problems that afflict homeless individuals. At the heart of much of this misfortune are staggering rates of alcoholism and drug addiction. While it is not clear whether substance abuse is a cause, consequence, or simply a correlate of homelessness, there is no question that substance abuse is among the most common and most serious problems facing the homeless. Given their unique set of serious and chronic problems, the Institute of Medicine has identified the homeless as a group of people in need of specialized substance abuse interventions. Prior research has shown that the Therapeutic Workplace intervention is effective in the treatment of chronically unemployed heroin and cocaine dependent individuals. The intervention integrates abstinence reinforcement contingencies of proven efficacy into a model supported work program. Under this intervention, patients are paid to perform data entry jobs in the Therapeutic Workplace. Those lacking needed skills are given intensive training in basic academic and job skills. To reinforce abstinence from alcohol and drugs, patients are required to provide an alcohol-free breath sample and drug-free urine sample to gain entrance to the workplace each day. In this way, patients can work and earn salary only when they abstain from alcohol and drugs. Patients are paid in vouchers instead of cash to reduce the chance they will use their earnings to purchase alcohol or drugs.

A randomized trial was conducted to evaluate the efficacy of this intervention in homeless, alcohol-dependent adults who completed an inpatient alcohol detoxification. After the detoxification, 124 participants were invited to attend the workplace for 6 months. They were randomly assigned to one of three groups that differed in the requirements for voucher reinforcement. One group received the full therapeutic workplace intervention in which vouchers were contingent on both abstinence and work (Abstinence and Work group). A second group was paid for work, but did not have to provide an alcohol-free breath sample or drug-free urine sample to gain access to the workplace; their vouchers were contingent on work only (Work-Only group). A third group was invited to attend the therapeutic workplace but received no vouchers for work performed or abstinence achieved during treatment (No Voucher group).

Study Type : Interventional  (Clinical Trial)
Enrollment : 156 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Therapeutic Workplace for Alcohol Dependence
Study Start Date : November 2001
Actual Study Completion Date : April 2006

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Primary Outcome Measures :
  1. percentage of 30 day assessments that subjects reported alcohol abstinence
  2. percentage of heavy drinking days
  3. percentage of positive breath-alcohol tests
  4. percent of patients meeting criteria for current alcohol dependence

Secondary Outcome Measures :
  1. percentage of urine samples negative for other drugs
  2. percentage of participants employed each month
  3. days employed per month
  4. employment income per month

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • meet DSM IV criteria for alcohol dependence
  • are homeless in that they lack a fixed nighttime residence
  • are unemployed
  • are at least 18 years old

Exclusion Criteria:

  • are currently physically dependent on opioids
  • are considered in imminent risk of suicide
  • have a psychiatric disorder that is likely to result in behaviors that could disrupt the workplace functioning or limit their ability to provide informed consent
  • are physically unable to perform typing or keypad entry

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00183144

United States, Maryland
Center for Learning and Health, Johns Hopkins Bayview Medical Campus, 5200 Eastern Ave., Suite W142
Baltimore, Maryland, United States, 21224
Sponsors and Collaborators
Johns Hopkins University
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Principal Investigator: Kenneth Silverman, PhD Johns Hopkins/Center for Learning and Health Identifier: NCT00183144     History of Changes
Other Study ID Numbers: NIAAASIL12154
R01AA012154 ( U.S. NIH Grant/Contract )
NIH RO1 - AA12154
First Posted: September 16, 2005    Key Record Dates
Last Update Posted: May 19, 2010
Last Verified: October 2007

Keywords provided by Johns Hopkins University:
contingency management
Therapeutic Workplace

Additional relevant MeSH terms:
Alcohol-Related Disorders
Substance-Related Disorders
Chemically-Induced Disorders
Mental Disorders