Clinical Trial: The Effect of a Contingency Management Intervention on Substance Use

This study is not yet open for patient recruitment.
Verified by Department of Veterans Affairs November 2005

Sponsored by: Department of Veterans Affairs
Information provided by: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00252512

Purpose

Contingency management interventions involve providing a tangible reward for progress toward treatment goals. The purpose of this study is to determine whether a contingency management intervention added to usual care leads to improved attendance and decreased substance use in patients attending outpatient substance use disorders treatment.
Condition Intervention
Substance Use Disorders
Alcohol-Related Disorders
 Behavior: Contingency Management

MedlinePlus related topics:  Drug Abuse;   Prescription Drug Abuse

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study

Official Title: Effectiveness of Contingency Management in VA Addictions Treatment

Further study details as provided by Department of Veterans Affairs:
Primary Outcomes: Urine drug and breath alcohol screens during the 8 week intervention period; attendance at treatment appointments during the 8 week intervention period; days abstinent during the prior 30 days at follow-up interviews.
Secondary Outcomes: Employment, housing, legal, and psychiatric status at two, six, and 12 month follow-up interviews; administrative data on VA service utilization at six and 12 month follow-ups.
Expected Total Enrollment:  360

Study start: July 2006;  Expected completion: December 2008
Last follow-up: July 2008;  Data entry closure: July 2008

Objectives: To compare differences between usual care alone and usual care plus contingency management on: 1) negative urine drug and breath alcohol screens over the 8-week intervention period, 2) rates of attendance at scheduled substance use disorders treatment appointments during the 8-week intervention period, and 3) self-reported percent days abstinent at six and 12 month follow-up interviews.

Design: This will be a randomized, controlled trial. 360 veterans presenting for specialty substance use disorders treatment at the Minneapolis VAMC and the VA Puget Sound Health Care System will be randomly assigned to 8 weeks of Usual Care or Usual Care plus Contingency Management. Minimal exclusion criteria include primary cannabis dependence, primary opioid dependence, screening positive for pathological gambling, serious psychiatric symptoms or suicide risk. Randomization will be stratified by site and primary substance use disorder (alcohol or stimulant). All participants will meet with a research assistant twice per week to submit urine drug and breath alcohol samples. Participants randomized to the contingency management interventions will have the opportunity to draw tokens (with replacement) from a bowl each time they submit negative urine drug and breath alcohol screens. The number of drawings allowed escalates with continuous weeks of negative screens or returns to baseline if screens are positive or missed. Half of the 500 tokens will result in social reinforcement (“Good Job!”). The remainder will earn a VA canteen voucher worth $1 (209 of 500), $20 (40 of 500) or $80 (1 of 500). Follow-up assessments occur 2, 6, and 12 months after enrollment into the study. Primary outcomes measures include number of days with negative urine drug and breath alcohol screens during the intervention phase, days of treatment attendance during the intervention phase, and percent days abstinent on the Timeline Follow-Back interview at follow-up assessments. Secondary outcomes include a brief assessment of employment, housing, legal, and psychiatric status, and administrative data on VA service utilization. A process evaluation and an economic analysis are included.

Significance: This trial will determine the impact on treatment attendance and during and post-treatment abstinence rates of adding a contingency management intervention to standard substance use disorders treatment within the VA. An economic analysis will assess the cost of the contingency management intervention as well any potential savings generated by improved outcomes. In addition to data on extended outcome effects, this trial will provide the research team and participating clinic staff with valuable experience in the process and barriers of establishing contingency management interventions in VA substance use disorders treatment clinics and will inform future implementation and dissemination efforts.

Eligibility

Ages Eligible for Study:  18 Years and above,  Genders Eligible for Study:  Both
Criteria

Inclusion Criteria:

Veterans presenting for outpatient substance use disorders treatment with a diagnosis of alcohol, cocaine, amphetamine, or methamphetamine dependence.

Exclusion Criteria:

Primary cannabis dependence; primary opioid dependence; severe psychiatric symptoms; suicide risk; positive history or screen for pathological gambling; lacking transportation or living to far away to attend twice per week research appointments.

Location and Contact Information

Please refer to this study by ClinicalTrials.gov identifier  NCT00252512

Hildi J Hagedorn, PhD      (612) 467-3875    hildi.hagedorn@med.va.gov

Minnesota
      Minneapolis VA Medical Center, Minneapolis,  Minnesota,  55417,  United States
Jill A Johnson, BA  612-467-3887    jill.johnson4@va.gov 
Hildi J Hagedorn, PhD  (612) 467-3875    hildi.hagedorn@med.va.gov 
Hildi J. Hagedorn, PhD,  Principal Investigator

Study chairs or principal investigators

Hildi J. Hagedorn, PhD,  Principal Investigator,  Minneapolis VA Medical Center   

More Information

Study ID Numbers:  IIR 03-120
Last Updated:  December 8, 2005
Record first received:  November 9, 2005
ClinicalTrials.gov Identifier:  NCT00252512
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2006-01-10



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