Contingency Management for Methamphetamine Addiction

Overseen By Nicholas Schumann R Clinical Psychologist

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Queen's Medical Center

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

Will I have to stop taking my current medications?

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 3 4 5 6}

How does the treatment Contingency Management differ 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 involve direct incentives. It has shown broad benefits, including increased drug abstinence and reduced risky behaviors, making it one of the most effective treatments for methamphetamine use disorder. ^{1 3 4 5 6}

What is the purpose of this trial?

This clinical trial is to implement contingency management (CM) as an intervention tool to address methamphetamine use and will be initiated during inpatient acute hospitalization in trauma injured patients. The goals are: * Gather effectiveness data on a CM program for participants in Hawaii who use methamphetamine during hospitalization and following discharge due to trauma 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. * To assess the rate of leaving against medical advice (AMA) and treatment completion in acute hospital setting in participants. * To assess the optimal timing of CM initiation for traumatically injured hospitalized patients by comparing patient outcomes (i.e. duration of CM participation and rates of CM program completion and providing negative urine samples) to NCT06532370 where CM was initiated after discharge from the hospital. For total of 12 weeks, participants will: * Be visited on Mondays, Wednesdays and Fridays by the research team to complete urine analysis during the hospitalization * Visit a follow up clinic up to 3 times per week on Mondays, Wednesdays and Fridays to complete urinalysis following discharge from the hospital * Complete Treatment Effectiveness Assessments at 6 and 12 weeks * Engage in qualitative interview at the end of the CM program

Eligibility Criteria

This trial is for trauma patients in Hawaii who are hospitalized and use methamphetamine. Participants must be willing to undergo urine tests and interviews during their hospital stay and after discharge, up to three times a week for 12 weeks. The study aims to see if starting contingency management (a reward-based treatment) during hospitalization helps with recovery.

Inclusion Criteria

Report at least 4 Diagnostic and Statistical Manual of Mental Disorders 5th Edition, Amphetamine-Type Substance Use Disorder symptoms (at least moderate disease)

Admitted trauma patients

Urine drug screen positive for methamphetamines during the current hospitalization

Exclusion Criteria

Active psychosis (reporting auditory or visual hallucinations)

Patients who are known to be pregnant

Prisoners

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive contingency management intervention during hospitalization and following discharge, with urine analysis conducted on Mondays, Wednesdays, and Fridays

12 weeks

3 visits per week (in-person)

Follow-up

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

4 weeks

Treatment Details

Interventions

• Contingency Management

Trial Overview The trial is testing the effectiveness of initiating contingency management (CM), which rewards positive behavior, during acute hospitalization for trauma patients with methamphetamine addiction. It compares outcomes like program completion and negative urine samples against another study where CM started post-discharge.

Participant Groups

Group I: Contingency management intervention Experimental Treatment 1 Intervention

Intervention is total of 12 weeks. During the hospitalization, participants will be visited by study personnel and will be asked to complete a urine drug screen that will screen for presence of methamphetamine on Mondays, Wednesdays and Fridays (M,W,F). Once discharged, participants will be asked to come into the out patient clinic three times per week (M,W,F) to complete a urine drug screen that will screen for presence of methamphetamine. If the specimen is negative for methamphetamine, the participants will be rewarded. Participants will also be asked to 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+

Findings from Research

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 (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]

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. Australia pubmed.ncbi.nlm.nih.gov

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

2. Ireland pubmed.ncbi.nlm.nih.gov

Contingency management: schedule effects. [2013]

3. England pubmed.ncbi.nlm.nih.gov

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

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

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

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

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

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

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