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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a method called contingency management (a behavioral therapy) to help reduce methamphetamine use. The goal is to evaluate its effectiveness for individuals hospitalized due to serious injuries who tested positive for methamphetamine. Participants will visit a clinic up to three times a week to check their progress and share experiences after completing the program. Suitable candidates have been hospitalized for trauma, use meth weekly, and have shown signs of methamphetamine addiction for at least six months before their injury. As an unphased trial, this study offers a unique opportunity to contribute to research that could improve treatment options for methamphetamine addiction.

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 prior data suggests that this contingency management program is safe for participants?

Research has shown that contingency management (CM) is generally well-received by individuals dealing with substance use issues, such as methamphetamine addiction. In studies on CM, most participants did not report serious negative side effects. This treatment involves providing rewards for staying drug-free, which many find motivating and helpful.

For those considering joining a clinical trial, it is important to know that past research has used CM successfully without major safety concerns. It is considered a safe and supportive method to help reduce drug use and encourage healthy habits. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about contingency management for methamphetamine addiction because it offers a novel approach that uses positive reinforcement to encourage sobriety. Unlike traditional treatments like cognitive-behavioral therapy or medication, contingency management rewards patients with tangible incentives when they meet specific goals, such as testing negative for drug use. This method not only provides immediate motivation for individuals to stay drug-free but also helps build new, healthier habits over time. By focusing on behavior change through positive rewards, it presents an innovative strategy that could enhance recovery outcomes for those struggling with methamphetamine addiction.

What evidence suggests that contingency management is effective for methamphetamine addiction?

Research has shown that contingency management (CM), the treatment under study in this trial, effectively reduces methamphetamine use. Studies have found that CM can decrease methamphetamine use in various settings, including community clinics. Although not commonly available in regular care, CM is currently regarded as one of the best treatments for methamphetamine use disorder. This approach involves providing rewards or incentives to encourage individuals to remain drug-free and has shown promise in helping them reduce or stop methamphetamine use. ^{6 7 8 9 10}

Who Is on the Research Team?

Todd Seto, MD

Principal Investigator

The Queens Medical Center

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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