Contingency Management for adherence for Opioid Use Disorder (OUD)

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
Center for Learning and Health, Baltimore, MD
Opioid Use Disorder (OUD)+1 More
Contingency Management for adherence - Behavioral
Eligibility
18+
All Sexes
Eligible conditions
Select

Study Summary

This study is evaluating whether two different types of contingency management interventions are more effective than standard medical management for treating adults with opioid use disorder.

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Eligible Conditions

  • Opioid Use Disorder (OUD)

Treatment Effectiveness

Study Objectives

This trial is evaluating whether Contingency Management for adherence will improve 2 primary outcomes and 1 secondary outcome in patients with Opioid Use Disorder (OUD). Measurement will happen over the course of 12 weeks.

12 weeks
Buprenorphine adherence as assessed by the percentage of buprenorphine-positive urine samples
Buprenorphine diversion as assessed by the rates at which participants report diverting participants' buprenorphine
Opiate abstinence as assessed by the percentage of opiate-negative urine samples

Trial Safety

Trial Design

3 Treatment Groups

Control
1 of 3
Buprenorphine Adherence Only
1 of 3
Buprenorphine Adherence and Opiate Abstinence
1 of 3
Active Control
Experimental Treatment

This trial requires 375 total participants across 3 different treatment groups

This trial involves 3 different treatments. Contingency Management For Adherence is the primary treatment being studied. Participants will be divided into 2 treatment groups. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Buprenorphine Adherence Only
Behavioral
Participants will receive financial incentives for buprenorphine use.
Buprenorphine Adherence and Opiate AbstinenceParticipants will receive financial incentives for buprenorphine use and opiate abstinence.
ControlParticipants will not receive any intervention.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 12 weeks
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 12 weeks for reporting.

Closest Location

Center for Learning and Health - Baltimore, MD

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 2 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
Opioid use disorder
Enrolled in buprenorphine treatment

Patient Q&A Section

What are common treatments for opioid abuse?

"The most prevalent methods of detoxification from opioid abuse include: medication detoxification, treatment centers for opioid abstinence, and detoxification via detoxification centers. Medications are also prescribed to detoxified opioid addicts. Patients who choose to detox through treatment centers for opioid abstinence have been shown to experience longer rates of abstinence." - Anonymous Online Contributor

Unverified Answer

What causes opioid abuse?

"The findings of this pilot study support the hypothesis that a significant proportion of chronic opioid abusers with pain may also misuse the drug to deal with their pain. In addition, while these addicts are prone to use opioids, they are more likely to become increasingly dependent on opioids; therefore, this may be what is driving them to misuse the drug. To this end, clinicians may want to consider implementing a comprehensive assessment of opioid use not only in patients with chronic pain, but also to identify and monitor those who are becoming dependent or who misuse opioids. Such patients may be at increased risk for other drug abuse. Given the association between opioid use and adverse outcomes such as addiction, drug abuse deserves attention in the assessment and treatment of chronic pain." - Anonymous Online Contributor

Unverified Answer

How many people get opioid abuse a year in the United States?

"Every year, nearly 16 million people are diagnosed with opioids abuse. This results in $23.4 billion dollars in expenditures a year in the United States." - Anonymous Online Contributor

Unverified Answer

What is opioid abuse?

"Opioid abuse is an escalating public health problem in India. To facilitate early diagnosis, timely referral, and treatment of people who use opioids as a means of alleviating stress, pain or injury in society, the Government of India in 2014 launched the National Mission for Transforming Opioid Use in India (NMOOSI). India is one of the world's most heroin-dependent countries. Findings from a recent study identifies gender inequity, socio-cultural factors and other challenges in tackling opioid abuse as the main reason for a high number of fatalities among this vulnerable group. Inadequacy of health and other government services is also listed here." - Anonymous Online Contributor

Unverified Answer

What are the signs of opioid abuse?

"The signs of opioid abuse typically include depressed level of consciousness, increased risk of overdose, and respiratory depression such as hypercapnia in patients with respiratory depression. Opioid abusers exhibit a higher number of symptoms. A history of use of other addictive drugs, such as amphetamines, cocaine, alcohol or tobacco increases the risk further.\n" - Anonymous Online Contributor

Unverified Answer

Can opioid abuse be cured?

"There are many methods of recovery, and we believe most of the addicts can obtain sustained recovery, especially if this is undertaken with the help of a skilled individual who understands and teaches them the technique of abstinence. Abstinence with medical help will give the addicts a much better chance of long-term recovery. It is believed that the drug addict will do the bulk of the job. Any attempt to persuade a drug addict to stop using will most likely result in further harm unless a technique of quiet acceptance of the condition or the drug addiction is learned. Abstinence without medical help will not result in a guarantee of long-term recovery." - Anonymous Online Contributor

Unverified Answer

What is contingency management for adherence?

"Participants in this study who were in a contingency management group showed more complete detoxification from opioids, as measured by the standard methadone detoxification assessment (SDA), with no appreciable changes in the methadone dosage, and no more intensive detoxification for other illicit drugs. A contingency management program seems to reduce the burden as well as the expense of methadone detoxification and improves the detoxification of other illicit drugs. This program can be taught in an academic, clinical setting via a tutorial or a clinical research project. [J.E., B.M.G.] Published by JAMA 293, 467-468 (2007). ClinicalTrials.gov Number, NCT01790963." - Anonymous Online Contributor

Unverified Answer

What are the latest developments in contingency management for adherence for therapeutic use?

"The most widely used strategy in clinical practice is contingency management with reward. However, more recent studies have found positive effects of this strategy, particularly in the context of opioid-addicted patients seeking treatment for pain-related conditions. Thus, this strategy offers an opportunity to improve outcomes and is increasingly recommended for clinical practice and clinical research." - Anonymous Online Contributor

Unverified Answer

Who should consider clinical trials for opioid abuse?

"[Clinical trials are used for many conditions, some of which are important and are only accessible through clinical trial registration and databases] (https://clinicaltrials.gov). Of special interest are the most common neurological conditions in which opioid abuse occurs, like, migraine, multiple system atrophy or Huntington's disease, which should receive the highest attention for clinical trials." - Anonymous Online Contributor

Unverified Answer

Has contingency management for adherence proven to be more effective than a placebo?

"Adherence was significantly higher with CM compared to PL. A large number of the PL group failed to take their medications at least 20% of the time. Patient's satisfaction with the study (CSM-PS >CSM-PL) was positively correlated to the number of days when they had been taking the medication (CSM-PS >7 days/week). The longer the patients had taken the medication, particularly with lower dosage (5 mg), the higher the satisfaction with the study (CSM-PS >13 days/week)." - Anonymous Online Contributor

Unverified Answer

How does contingency management for adherence work?

"Compliance, persistence, and treatment duration differ in CMT versus behavioral-support cohorts. Results from a recent paper provides valuable insights into how this treatment model may work." - Anonymous Online Contributor

Unverified Answer

Is contingency management for adherence typically used in combination with any other treatments?

"The primary purpose of CM is to promote self-control and therefore should not be combined with treatments targeting adherence. Data from a recent study show significant reductions in opioid use during the 3 months after the end of CM, in combination with other treatments (AD/ADME)." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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