Cocaine Related Disorders Clinical Trial
Official title:
Evaluating the Efficacy of Including Contingency Management to Standard Ambulatory Treatment for Crack Addiction - A Randomized Controlled Trial
Crack addiction has become a severe health problem in Brazil. Today, crack addiction is the
primary cause for inpatient treatment for all illicit substances. When compared to cocaine,
crack users develop much faster diagnoses for crack dependence, shows a more compulsive
pattern of use, has higher probability of living or have lived in the streets, and of
engaging in illegal activities. Consequently to this, mortality of crack addicts is 7 times
higher than for the rest of the population.
Despite all efforts being made for the development of effective pharmacological treatments
for stimulant addiction (crack included), up to today, there is no robust evidence of
efficacy of any pharmacological treatment. For that reason, the use of evidence based
psychosocial interventions is so important for treating this population.
Although today open treatment facilities in Brazil are more and more starting to use
evidence-based interventions such as motivational interviewing, cognitive behavior therapy,
relapse prevention and coping skills, such treatments present very modest results when
treating crack addiction. The biggest difficulties encountered when treating this population
are maintaining patients in treatment, reducing crack use and achieving continued abstinence.
A psychosocial treatment based in behavioral principals' named Contingency Management (CM) is
widely applied in the USA. Recent meta-analyses and review studies present robust evidence
that, when applied alone or in adjunction with other psychosocial and pharmacological
treatment, CM is the most effective treatment for what regards, treatment retention, reducing
drug use and promoting continued abstinence.
The purpose of this study is to evaluate if Contingence Management (CM) can be affective in
the treatment of crack addiction in Brazil. To accomplish this, 60 individuals (male and
female from 18 to 65 years of age) seeking open treatment for crack addiction will be
randomized to 2 treatment conditions (Standard treatment (ST) or ST+CM. Both treatments will
last 12 weeks with 3 and 6-month follow-up. In both groups patients will be encourage to
leave urine samples 3 times week.
Hypotheses: Patients receiving ST+CM will stay longer in treatment, have more negative tests
for cocaine/crack, and achieve longer periods of cocaine/crack abstinence when compared to
patients receiving ST alone.
This study is a Randomized Clinical Trial deigned to investigate the effects of including Contingency Management to a standard public ambulatory treatment in Brazil on treatment attendance, retention in treatment, reduction of crack cocaine use and promotion of crack cocaine abstinence for crack dependent individuals seeking treatment for there addiction. In total 65 subjects will be randomized to receive Standard Treatment Alone or Standard Treatment plus Contingency Management. Both interventions will last for 12 weeks. ;
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