Contingency Management for Methamphetamine Addiction

Overseen By Karen Ng, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Queen's Medical Center

Disqualifiers: Active psychosis, Traumatic brain injury, Pregnancy, others

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

Compensation: Varies

Number of Visits: 3

Duration: 12 weeks

20 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to use contingency management (CM) as an intervention tool to address methamphetamine use. The main objectives are to: * Gather effectiveness data on a pilot a CM program for participants in Hawaii who use methamphetamine following hospitalization due to traumatic injury * To assess participant perspectives on engaging with a CM program based at a Level 1 Trauma Center. Researches will assess both patient-reported and biologically-confirmed medium-term program effectiveness and conduct qualitative interviews with participants post-program. Participants will: * Visit a follow-up clinic up to three times per week to complete urinalysis following discharge from the trauma unit * Complete Treatment Effectiveness Assessments at 6 and 12-weeks * Engage in a qualitative interview at the end of the CM program

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

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

Research shows that Contingency Management is one of the most effective treatments for reducing methamphetamine use. It helps people stay off drugs, use other treatments and medical services more, and engage in less risky sexual behavior. ^{1 2 3 4 5}

Is contingency management safe for treating methamphetamine addiction?

The research does not specifically mention safety concerns related to contingency management for methamphetamine addiction, suggesting it is generally considered safe for use in humans. ^{1 2 3 5 6}

How is the treatment Contingency Management different from other treatments for methamphetamine addiction?

Contingency Management is unique because it uses a reward system to encourage positive behavior changes, such as staying drug-free, which is different from other treatments that may not focus on immediate incentives. It has shown broad benefits, including increased drug abstinence and reduced risky behaviors, making it one of the most effective treatments for methamphetamine addiction. ^{1 2 3 5 6}

Research Team

Todd Seto, MD

Principal Investigator

The Queens Medical Center

Eligibility Criteria

This trial is for adults in Hawaii who've been hospitalized for trauma, use methamphetamine at least weekly, and have moderate Amphetamine-Type Substance Use Disorder. They must be able to understand the study and communicate in English. Those with severe head injuries or unable to participate are excluded.

Inclusion Criteria

I have been admitted to the hospital due to a trauma.

I experience at least 4 symptoms of moderate amphetamine addiction.

I am over 18 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a Contingency Management program addressing methamphetamine use, with urinalysis up to three times per week and Treatment Effectiveness Assessments at 6 and 12 weeks

12 weeks

Up to 3 visits per week (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including qualitative interviews

4 weeks

Treatment Details

Interventions

• Contingency Management

Trial Overview The trial tests a Contingency Management program aimed at reducing methamphetamine use among patients post-hospitalization. It involves regular urine tests, effectiveness assessments at weeks 6 and 12, and an interview after completing the program.

Participant Groups

Group I: Contingency Managment Experimental Treatment 1 Intervention

Participants are allowed to complete CM three times per week for the maximum of 12-weeks. At the six- and 12-week time points, participants will complete the Treatment Effectiveness Assessment (TEA) with study personnel.

Who Is Running the Clinical Trial?

Queen's Medical Center

Lead Sponsor

Trials

24

Recruited

4,900+

National Institute of General Medical Sciences (NIGMS)

Collaborator

Trials

315

Recruited

251,000+

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]

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]

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]

A pilot study on methamphetamine-dependent individuals indicates that using a reinforcement schedule that increases rewards for consecutive days of abstinence leads to better outcomes.

The study found that resetting the reward magnitude after a positive drug test enhances the effectiveness of contingency management interventions, suggesting a strategic approach to reinforcing abstinence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contingency management: schedule effects. Roll, JM., Shoptaw, S.[2013]

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]

Contingency management programs, which reward behavior change to reduce stimulant use, are currently the most effective treatment for stimulant use disorder, but they are often hard to access.

A case study of a patient with osteomyelitis showed that adapting these programs to an inpatient hospital setting can significantly improve treatment outcomes for individuals with stimulant use disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Acute Care Contingency Management Program for the Treatment of Stimulant Use Disorder: A Case Report. Bach, P., Garrod, E., Robinson, K., et al.[2022]

References

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

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

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

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

3. Australia pubmed.ncbi.nlm.nih.gov

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

4. Ireland pubmed.ncbi.nlm.nih.gov

Contingency management: schedule effects. [2013]

5. England pubmed.ncbi.nlm.nih.gov

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

6. Netherlands pubmed.ncbi.nlm.nih.gov

An Acute Care Contingency Management Program for the Treatment of Stimulant Use Disorder: A Case Report. [2022]