Contingency Management for Cocaine Dependence: Cash Versus Vouchers - Full Text View

Purpose

The current study examines both practical and ethical issues related to cash contingency management (CM) procedures. With respect to practical implications, the use of cash incentives may address several concerns that have hindered the transfer of CM interventions into real world practice. First, if cash incentives produce larger effects than cost-equivalent vouchers, treatment providers would be able to use cash incentives to opt for either greater effect sizes at the same cost as vouchers, or for the same effect size at a reduced cost. Second, if cash incentives require less staff time and resources to administer, this could reduce the labor burden associated with implementing a CM intervention. A third goal of the study addresses ethical issues related to whether cash or non-monetary CM procedures impinge on intrinsic motivation or cause other undue harms.

Condition	Intervention
Substance Related Disorders Drug Addiction Substance Abuse	Behavioral: Cash CM Behavioral: Voucher CM Behavioral: Non-CM Control

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject)
Official Title:	Contingency Management for Cocaine Dependence: Cash Versus Vouchers

Resource links provided by NLM:

Drug Information available for: Cocaine hydrochloride

U.S. FDA Resources

Further study details as provided by Treatment Research Institute:

Primary Outcome Measures:

Drug abstinence among cocaine-dependent outpatients in community-based treatment. [ Time Frame: During treatment (12 weeks) ] [ Designated as safety issue: No ]
Determine the differential efficacy of cash CM, voucher CM and standard (non-CM) outpatient treatment in improving during-treatment and post-treatment outcomes (i.e., drug abstinence, treatment attendance, and reduction in psychosocial problems) among cocaine-dependent outpatients in community-based treatment.

Secondary Outcome Measures:

Incremental costs [ Time Frame: During Treatment (12 weeks) ] [ Designated as safety issue: No ]
Determine the incremental costs of implementing cash CM and voucher CM and non-CM outpatient treatment for cocaine-dependent outpatients in community-based treatment.
Cost-effectiveness [ Time Frame: During Treatment (12 weeks) ] [ Designated as safety issue: No ]
Determine the cost-effectiveness of implementing cash CM and voucher CM and non-CM outpatient treatment for cocaine-dependent outpatients in community-based treatment.

Estimated Enrollment:	250
Study Start Date:	April 2008
Estimated Study Completion Date:	March 2012
Estimated Primary Completion Date:	March 2012 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Voucher CM Participants in the voucher condition will earn voucher incentives according to the schedule developed by Higgins (1993, 1994). It involves a 12-week escalating schedule of reinforcement to initiate cocaine abstinence.	Behavioral: Voucher CM Participants in the voucher condition will earn voucher incentives according to the schedule developed by Higgins (1993, 1994). It involves a 12-week escalating schedule of reinforcement to initiate cocaine abstinence.
Experimental: Cash CM Participants in the cash CM condition will be assigned to the identical 12-week escalating schedule of reinforcement, except that the contingencies will be provided in cash rather than vouchers, and no negotiation process will be involved (although counselors may recommend how clients might best spend their money).	Behavioral: Cash CM Participants in the cash CM condition will be assigned to the identical 12-week escalating schedule of reinforcement, except that the contingencies will be provided in cash rather than vouchers, and no negotiation process will be involved (although counselors may recommend how clients might best spend their money).
No Intervention: Non-CM Control Participants in the non-CM control condition will provide urine specimens during the 12-week period as do the two experimental conditions, but will receive no contingent rewards other than praise from the RAs.	Behavioral: Non-CM Control Participants in the non-CM control condition will provide urine specimens during the 12-week period as do the two experimental conditions, but will receive no contingent rewards other than praise from the RAs.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Be a new intake to the Parkside treatment program.
Meet DSM-IV diagnostic criteria for current cocaine dependence as assessed by the Substance Use Disorders section of the Structured Clinical Interview for DSM-IV (SCID-I). (In our past studies at this same facility, 60% of the clients met DSM-IV criteria for current cocaine dependence).
Be capable of providing valid contact information. We have found that a small proportion of participants may provide false contact information, and we consider this to be a passive strategy for refusing research participation. Therefore, the RA will immediately attempt to verify the contact information.
Be capable of providing informed consent.
Be willing and capable of fulfilling the requirements of the research protocol.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01366716

Contacts

Contact: David Festinger, Ph.D.

215-399-0980 ext 126

dfestinger@tresearch.org

Locations

United States, Pennsylvania
Treatment Research Institute	Recruiting
Philadelphia, Pennsylvania, United States, 19106
Contact: David Festinger, Ph.D. 215-399-0980 ext 126 dfestinger@tresearch.org
Principal Investigator: David Festinger, Ph.D.

Sponsors and Collaborators

Treatment Research Institute

National Institute on Drug Abuse (NIDA)

More Information

No publications provided

Responsible Party:	David Festinger, Ph.D. / Principal Investigator, Treatment Research Institute
ClinicalTrials.gov Identifier:	NCT01366716 History of Changes
Other Study ID Numbers:	R01-DA021621, R01DA021621
Study First Received:	June 1, 2011
Last Updated:	July 19, 2011
Health Authority:	United States: Institutional Review Board

Keywords provided by Treatment Research Institute:

Contingency Management
Cash
Substance Abuse
Ethics

Additional relevant MeSH terms:

Substance-Related Disorders
Behavior, Addictive
Cocaine-Related Disorders
Mental Disorders
Compulsive Behavior
Impulsive Behavior
Cocaine
Vasoconstrictor Agents
Cardiovascular Agents
Therapeutic Uses
Pharmacologic Actions
Dopamine Uptake Inhibitors

Dopamine Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Uptake Inhibitors
Physiological Effects of Drugs
Anesthetics, Local
Anesthetics
Central Nervous System Depressants
Sensory System Agents
Peripheral Nervous System Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on May 23, 2013