Cocaine Dependence Clinical Trial
Official title:
Enhanced and Attendance-based Prize CM in Community Settings
The purpose of this study is to address the conditions under which prize contingency
management (CM) for abstinence and attendance may improve outcomes of cocaine-dependent
patients.
For patients who initiate treatment with a cocaine-positive urine specimen, we will evaluate
the efficacy of two CM procedures relative to standard, non-CM treatment. The two CM
procedures will be provided as additions to standard care and will reinforce drug abstinence
but will differ in expected magnitudes of prizes patients can earn, especially during early
stages of abstinence. They will provide expected magnitudes of winning about $250 and $560,
respectively. We expect that both CM conditions will improve retention and abstinence
relative to the standard treatment, non-CM condition. If the enhanced CM condition engenders
better outcomes than the $250 CM condition, this finding would suggest that patients
initiating treatment while actively using cocaine may best be treated with relatively high
reinforcement prize CM as an adjunct to standard care.
For patients who initiate treatment with a cocaine-negative urine specimen, we will evaluate
the efficacy of a CM procedure that reinforces treatment attendance. The expected magnitude
of winnings will be about $250, and again CM treatment will be in addition to standard care.
This CM condition will be compared to standard treatment without CM as well as to a CM
treatment that provides a similar magnitude of reinforcement, but contingent upon abstinence.
Results from this study will inform an important clinical question of whether simply
reinforcing attendance can improve clinical outcomes. Increased retention may result in
greater exposure to therapeutic processes that may reduce drug use, especially among patients
who begin treatment having already achieved some abstinence. We will also evaluate the
cost-effectiveness of CM by examining the effects of the interventions on hospitalizations,
medical and psychiatric care, criminal justice costs, and productivity.
n/a
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