Clinical Trials Logo

Clinical Trial Summary

Reinforcement interventions have pronounced effects on reducing cocaine use. This study will evaluate a novel approach in which reinforcement frequency varies by patient performance. To test efficacy, 280 patients with cocaine use disorder will be randomly assigned to: standard care, standard care plus traditional twice weekly reinforcement, or standard care plus adaptive variable interval reinforcement.


Clinical Trial Description

Reinforcement interventions have pronounced effects on reducing cocaine use. We developed and evaluated a low-cost reinforcement intervention, systematically moving it through the Stages of development to dissemination and broad clinical implementation. In an ongoing project, reinforcement interventions are yielding benefits when reinforcers are provided at treatment initiation and for longer durations. However, less than half of patients remain engaged for 12 weeks with traditional reinforcement interventions, which require frequent attendance for monitoring and reinforcing abstinence. Interventions that extend into aftercare and that are acceptable to and efficacious in preventing long-term relapse are critically needed. Reinforcement interventions are efficacious during periods they are in effect, and pilot data show that variable interval (VI) reinforcement schedules, once behavior change occurs, hold potential for maintaining gains when administered infrequently. Assessing methods to extend benefits of these interventions is of paramount scientific and clinical concern. This study will evaluate a novel approach in which reinforcement frequency varies by patient performance. In this intervention, reinforcement will be available for 24 weeks, on a progressive VI schedule, that adapts according to patient status. Patients who maintain abstinence earn maximum reinforcers as infrequently as every three weeks on average, while frequency of monitoring and reinforcing abstinence will increase in those who relapse until abstinence is re-instated. To test efficacy, 280 patients with cocaine use disorder will be randomly assigned to: standard care (SC), SC+traditional twice weekly reinforcement, or SC+adaptive VI reinforcement. Evaluations will be completed at baseline and throughout 18 months to assess objective and self-reported indices of drug use, psychosocial problems, and HIV risk behaviors. Primary hypotheses are (1) the adaptive VI reinforcement intervention will improve outcomes relative to standard care during the treatment period and throughout follow-up, and (2) the adaptive VI reinforcement intervention will improve outcomes relative to the traditional reinforcement system. This study will also evaluate the roles of cognitive control and treatment outcome. Patients with better cognitive control are expected to maintain longer durations of abstinence across conditions. If these measures differentially relate to outcomes across treatments, such results suggest the potential of pairing reinforcement interventions to individuals most likely to benefit from them; they may also indicate possible markers of response in a treatment-specific manner. If cognitive indices mediate treatment response, future studies can refine interventions to improve cognitive processes and long-term outcomes. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT02143063
Study type Interventional
Source UConn Health
Contact
Status Completed
Phase N/A
Start date August 2014
Completion date October 2020

See also
  Status Clinical Trial Phase
Completed NCT03538548 - Treatment Outcome in CBT for Cocaine Use N/A
Recruiting NCT04994821 - tDCS to Reduce Craving in Cocaine Addiction- Phase 2 Study Phase 2
Not yet recruiting NCT06050304 - CRACK-TARGET 1: ÉTUDE DESCRIPTIVE DE LA SENSIBILISATION COMPORTEMENTALE OBSERVÉE et ATTENTES
Completed NCT02233647 - Phendimetrazine and Cocaine Early Phase 1
Completed NCT02239913 - Topiramate-Phentermine Combinations for Cocaine Dependence Phase 1
Not yet recruiting NCT05974202 - rTMS and Cognitive-behavioral Therapy for Cocaine Use Disorder Phase 2
Recruiting NCT04927143 - Encouraging Abstinence Behavior in a Drug Epidemic Phase 2
Completed NCT03224546 - Cocaine Use Reduction and Health N/A
Recruiting NCT03656653 - Imagery-based Coping for Cocaine Use Disorder N/A
Completed NCT03348384 - [11C]NOP-1A and Cocaine Use Disorders Early Phase 1
Recruiting NCT05019430 - Cocaine and Zolmitriptan Early Phase 1
Recruiting NCT03344419 - Glutamatergic Modulation to Facilitate the Behavioral Treatment of Cocaine Use Disorders Phase 3
Recruiting NCT05507814 - Temporal Window and Episodic Future Thinking in CUD N/A
Active, not recruiting NCT03799341 - Neurocognitive Factors in Substance Use Treatment Response: The Ways of Rewarding Abstinence Project N/A
Completed NCT02798627 - Trial Of NS2359 For The Treatment of Cocaine Dependence Phase 2
Completed NCT02785406 - Role of the Orexin Receptor System in Stress, Sleep and Cocaine Use Phase 2
Completed NCT02444208 - A Feasibility Trial for Inhibitory-Control Training to Reduce Cocaine Use N/A
Recruiting NCT05902819 - Reconsolidation Blockade of Intrusive Trauma- and Cocaine-related Memories N/A
Recruiting NCT05833529 - Innovative Cognitive and Behavioral Psychotherapy for Cocaine Use Disorder N/A
Recruiting NCT05521854 - Contingency Management for Drug Use: Does Age Matter? N/A