Peer Support for Methamphetamine Abuse

Not currently recruiting at 1 trial location

Overseen By Sara McCrimmon, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon Health and Science University

Disqualifiers: Violence, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new approach to help people reduce methamphetamine use through peer support and rewards. The study compares two methods: Peer Contingency Management, where peers help set personal goals with rewards, and regular peer visits offering support. The goal is to determine which method more effectively supports individuals aiming to reduce methamphetamine use. This trial suits those who have used stimulants like methamphetamine or cocaine in the past month and are open to peer support. As an unphased trial, it offers a unique opportunity to explore innovative methods for reducing methamphetamine use with peer support.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that contingency management (CM) is a safe and well-accepted treatment. Studies have found that CM helps treat substance use disorders by rewarding positive behavior changes. Many healthcare settings have successfully used this method without major safety issues.

No evidence indicates serious side effects from CM itself. By focusing on encouraging and rewarding personal goals, it offers a supportive and non-invasive approach. In summary, CM is considered safe for individuals aiming to reduce harm from methamphetamine use. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Peer Contingency Management (PEER-CM) for methamphetamine abuse because it introduces a peer-facilitated approach to recovery, which is different from traditional methods. Unlike standard contingency management, which is typically clinician-driven, PEER-CM leverages the support and accountability of peers who have firsthand experience with recovery. This unique feature could enhance motivation and engagement, potentially leading to better outcomes for individuals struggling with methamphetamine abuse.

What evidence suggests that this trial's treatments could be effective for methamphetamine abuse?

Research has shown that contingency management (CM) offers a promising approach to treating methamphetamine addiction. In CM, patients earn rewards for achieving personal goals to reduce drug use. Studies indicate that CM can decrease methamphetamine use and lower health risks. This trial will assign participants to one of two groups: one receiving Peer-facilitated Contingency Management (PEER-CM) and the other receiving Standard of Care Contingency Management. When peers—individuals with similar experiences—lead CM, it may enhance participation and effectiveness. These findings suggest that peer-led CM could be a valuable tool in reducing harm for methamphetamine users. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for community-based organizations that use peer support to help individuals with methamphetamine abuse. These organizations should be open to training in two strategies for peer-facilitated harm reduction and contingency management.

Inclusion Criteria

Community-based organization sites that use peer support specialists to provide direct outreach and harm reduction services to people who use drugs

De-identified administrative data is used to identify an analytic sample of clients who reported past 30-day methamphetamine use at community-based organization intake.

My organization is open to training in peer-facilitated strategies.

Exclusion Criteria

Community-based organization sites that do not use peer support specialists to provide direct outreach and harm reduction services to people who use drugs

My organization is not open to training in peer-facilitated contingency management strategies.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive contingency management incentives for achieving self-identified harm reduction goals

6 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Peer Contingency Management
• Standard of Care Contingency Management

Trial Overview

The study compares two methods: one where clients are incentivized to achieve personal harm reduction goals (Contingency Management), and the standard of care which includes incentives for visiting peers who provide harm reduction services.

How Is the Trial Designed?

Group I: PEER-CM Experimental Treatment 1 Intervention

Peer-facilitated contingency management (PEER-CM).

Group II: Standard of Care Active Control 1 Intervention

Standard of care contingency management.

Peer Contingency Management is already approved in United States for the following indications:

Approved in United States as Contingency Management for:

• Methamphetamine use disorder
• Stimulant use disorder

Who Is Running the Clinical Trial?

Oregon Health and Science University

Lead Sponsor

Trials

1,024

Recruited

7,420,000+

Comagine Health

Collaborator

Trials

3

Recruited

2,500+

Oregon Health Authority

Collaborator

Trials

4

Recruited

24,100+

Comagine Health

Collaborator

Trials

3

Recruited

2,500+

Oregon Health Authority

Collaborator

Trials

4

Recruited

24,100+

Published Research Related to This Trial

Contingency management (CM) is highly effective in reducing methamphetamine use, as shown in a systematic review of 27 studies, with 20 out of 21 studies reporting positive outcomes for drug abstinence.

CM not only increases drug abstinence but also enhances the use of other treatments and medical services, while significantly reducing risky sexual behaviors among methamphetamine users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contingency management for the treatment of methamphetamine use disorder: A systematic review. Brown, HD., DeFulio, A.[2021]

Contingency management has been identified as a potentially effective approach for treating methamphetamine use disorders, as it can enhance treatment outcomes.

The evidence indicates that this method increases the chances of patients providing methamphetamine-free urine samples during treatment, suggesting improved adherence to recovery efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contingency management: an evidence-based component of methamphetamine use disorder treatments. Roll, JM.[2019]

In a pilot study involving 58 heterosexual methamphetamine users, both contingency management (CM) and CM combined with strengths-based case management (CM/SBCM) were found to be feasible and effective in reducing meth use and HIV risk behaviors.

Participants who attended more CM sessions showed greater reductions in drug use, with significant decreases in needle-sharing and sexual risk behaviors, highlighting the potential of these interventions for improving health outcomes in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users. Corsi, KF., Lehman, WE., Min, SJ., et al.[2021]

Contingency management (CM) is an effective treatment for stimulant use disorders, and this guide provides a structured protocol to enhance its implementation in clinical settings.

The article emphasizes the importance of adhering to evidence-based practices in CM, as poorly designed programs are unlikely to improve patient outcomes, highlighting the need for careful planning and preparation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing an evidence-based prize contingency management protocol for stimulant use. Rash, CJ.[2023]

A secondary analysis of 27 crack cocaine users revealed that 92.6% found the contingency management (CM) protocol easy to understand, and all participants reported a positive experience with the treatment.

Most participants (81.5%) felt that CM significantly helped their recovery, with an average impact score of 9 out of 10, suggesting strong support for integrating CM into addiction treatment services in Brazil.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Crack cocaine users views regarding treatment with contingency management in Brazil. Miguel, AQC., Madruga, CS., Simões, V., et al.[2023]

Participants in a study of 30 Australians who use methamphetamine expressed positive attitudes towards contingency management (CM) as a treatment for methamphetamine use disorder, indicating its potential effectiveness if implemented in routine care.

There is a need for CM to be flexible in treatment goals and to incorporate digital technologies for remote support, as participants highlighted concerns about initial financial incentives and managing withdrawal symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perspectives and sentiments on contingency management from people who use methamphetamine. Clay, S., Wilkinson, Z., Ginley, M., et al.[2023]

In a study involving 240 cocaine-dependent methadone patients over 12 weeks, all contingency management (CM) interventions significantly reduced cocaine use compared to usual care, with effect sizes ranging from 0.38 to 0.59.

Interestingly, the standard prize CM offering $300 was just as effective as higher reward options, suggesting that lower-cost interventions can still effectively promote cocaine abstinence in methadone patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Standard magnitude prize reinforcers can be as efficacious as larger magnitude reinforcers in cocaine-dependent methadone patients. Petry, NM., Alessi, SM., Barry, D., et al.[2021]

Contingency management (CM) effectively uses positive reinforcement to enhance treatment outcomes for substance abusers, particularly in achieving sustained abstinence from drugs.

CM is not only beneficial as a direct therapeutic approach but also serves as a valuable tool in clinical trials for testing new medications and improving patient adherence to treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contingency management: utility in the treatment of drug abuse disorders. Stitzer, ML., Vandrey, R.[2019]

In a study involving 113 participants with methamphetamine use disorders, those who received contingency management alongside standard treatment submitted significantly more negative drug tests and maintained abstinence for longer periods (5 weeks) compared to those receiving only standard treatment (3 weeks).

The use of contingency management, which involved rewards for negative drug tests, shows potential as an effective strategy to enhance treatment outcomes for individuals struggling with methamphetamine addiction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contingency management for the treatment of methamphetamine use disorders. Roll, JM., Petry, NM., Stitzer, ML., et al.[2022]

Citations

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This study will randomize eighteen community-based peer harm reduction sites to provide contingency management incentives for achieving self-identified harm ...

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reporter.nih.gov

reporter.nih.gov/project-details/11096428

PEER-CM Peripartum Supplement

Centering peers in design and training for a peer-delivered contingency management program for self-identified harm reduction and treatment goals. Harm ...

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library.samhsa.gov

library.samhsa.gov/sites/default/files/contingency-management-advisory-pep24-06-001.pdf

contingency-management-advisory-pep24-06-001.pdf

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dhcs.ca.gov

dhcs.ca.gov/Documents/Contingency-Management-Policy-Paper-3-16-22.pdf

Contingency-Management-Policy-Paper- ...

What Is Contingency Management (CM)?. CM is an EBP that recognizes and reinforces individual positive behavior change consistent with meeting treatment goals, ...