Peer Support for Methamphetamine Abuse

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

1800 Participants Needed

Trial Summary

What is the purpose of this trial?

The main goal of this study is to tests the effect of incentivizing achievement of self-identified, personal harm reduction goals (Contingency management or CM) compared with standard of care (peer harm reduction service with incentives for peer visits) to increase the reach and effectiveness of methamphetamine (MA) harm reduction services.

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.

What data supports the effectiveness of the treatment Peer Contingency Management for methamphetamine abuse?

Research shows that contingency management, which uses rewards to encourage positive behavior, is one of the most effective treatments for reducing methamphetamine use. Studies have found it leads to greater drug abstinence and reduces risky behaviors. ^{1 2 3 4 5}

Is contingency management safe for humans?

Contingency management (CM) has been studied in various settings and appears to be safe for humans, as it is widely used to help reduce drug use and risky behaviors without reported safety concerns. ^{1 2 6 7 8}

How is Peer Contingency Management different from other treatments for methamphetamine use?

Peer Contingency Management is unique because it involves using rewards to encourage positive behavior changes, like staying drug-free, and it is supported by peers rather than just healthcare professionals. This approach has shown broad benefits, including increased drug abstinence and reduced risky behaviors, making it a promising option for methamphetamine use disorder. ^{1 2 6 7 9}

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

References

1. Ireland pubmed.ncbi.nlm.nih.gov

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

2. Australia pubmed.ncbi.nlm.nih.gov

Perspectives and sentiments on contingency management from people who use methamphetamine. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Contingency management: utility in the treatment of drug abuse disorders. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Contingency management for the treatment of methamphetamine use disorders. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Standard magnitude prize reinforcers can be as efficacious as larger magnitude reinforcers in cocaine-dependent methadone patients. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

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

8. England pubmed.ncbi.nlm.nih.gov

Crack cocaine users views regarding treatment with contingency management in Brazil. [2023]

9. England pubmed.ncbi.nlm.nih.gov

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