OBJECTIVE: The primary objective of this study was to determine whether contingency management was associated with increased abstinence from stimulant drug use in stimulant-dependent patients with serious mental illness treated in a community mental health center. Secondary objectives were to determine whether contingency management was associated with reductions in use of other substances, psychiatric symptoms, HIV risk behavior, and inpatient service utilization. METHOD: A randomized controlled design was used to compare outcomes of 176 outpatients with serious mental illness and stimulant dependence. Participants were randomly assigned to receive 3 months of contingency management for stimulant abstinence plus treatment as usual or treatment as usual with reinforcement for study participation only. Urine drug tests and self report, clinician-report, and service utilization outcomes were assessed during the 3-month treatment period and the 3-month follow-up period. RESULTS: Although participants in the contingency management condition were significantly less likely to complete the treatment period than those assigned to the control condition (42% compared with 65%), they were 2.4 times (95% CI=1.9–3.0)more likely to submit a stimulant-negative urine test during treatment. Compared with participants in the control condition,they had significantly lower levels of alcohol use, injection drug use, and psychiatric symptoms and were one-fifth as likely as those assigned to the control condition to be admitted for psychiatric hospitalization during treatment. They also reported significantly fewer days of stimulant drug use during the 3-month follow-up. CONCLUSIONS: When added to treatment as usual, contingency management is associated with large reductions in stimulant,injection drug, and alcohol use.Reductions in psychiatric symptoms and hospitalizations are important secondary benefits.
RCT Entities:
OBJECTIVE: The primary objective of this study was to determine whether contingency management was associated with increased abstinence from stimulant drug use in stimulant-dependent patients with serious mental illness treated in a community mental health center. Secondary objectives were to determine whether contingency management was associated with reductions in use of other substances, psychiatric symptoms, HIV risk behavior, and inpatient service utilization. METHOD: A randomized controlled design was used to compare outcomes of 176 outpatients with serious mental illness and stimulant dependence. Participants were randomly assigned to receive 3 months of contingency management for stimulant abstinence plus treatment as usual or treatment as usual with reinforcement for study participation only. Urine drug tests and self report, clinician-report, and service utilization outcomes were assessed during the 3-month treatment period and the 3-month follow-up period. RESULTS: Although participants in the contingency management condition were significantly less likely to complete the treatment period than those assigned to the control condition (42% compared with 65%), they were 2.4 times (95% CI=1.9–3.0)more likely to submit a stimulant-negative urine test during treatment. Compared with participants in the control condition,they had significantly lower levels of alcohol use, injection drug use, and psychiatric symptoms and were one-fifth as likely as those assigned to the control condition to be admitted for psychiatric hospitalization during treatment. They also reported significantly fewer days of stimulant drug use during the 3-month follow-up. CONCLUSIONS: When added to treatment as usual, contingency management is associated with large reductions in stimulant,injection drug, and alcohol use.Reductions in psychiatric symptoms and hospitalizations are important secondary benefits.
Authors: Richard K Ries; Dennis G Dyck; Robert Short; Debra Srebnik; Anastasia Fisher; Katherine A Comtois Journal: Psychiatr Serv Date: 2004-04 Impact factor: 3.084
Authors: Mary F Brunette; Dianne Asher; Rob Whitley; Wilma J Lutz; Barbara L Wieder; Amanda M Jones; Gregory J McHugo Journal: Psychiatr Serv Date: 2008-09 Impact factor: 3.084
Authors: Lauren M Hill; Carol E Golin; Nisha C Gottfredson; Brian W Pence; Bethany DiPrete; Jessica Carda-Auten; Jennifer S Groves; Sonia Napravnik; David Wohl; Kevin Knight; Patrick M Flynn Journal: AIDS Behav Date: 2019-08
Authors: Lois A Benishek; Karen L Dugosh; Kim C Kirby; Jason Matejkowski; Nicolle T Clements; Brittany L Seymour; David S Festinger Journal: Addiction Date: 2014-05-23 Impact factor: 6.526
Authors: Matthew J Mimiaga; David W Pantalone; Katie B Biello; Jackie M White Hughto; John Frank; Conall O'Cleirigh; Sari L Reisner; Arjee Restar; Kenneth H Mayer; Steven A Safren Journal: AIDS Care Date: 2019-03-19
Authors: Frank N Angelo; Michael G McDonell; Michael R Lewin; Debra Srebnik; Jessica Lowe; John Roll; Richard Ries Journal: Drug Alcohol Depend Date: 2012-12-27 Impact factor: 4.492
Authors: André Q C Miguel; Clarice S Madruga; Hugo Cogo-Moreira; Rodolfo Yamauchi; Viviane Simões; Claudio J da Silva; Sterling McPherson; John M Roll; Ronaldo R Laranjeira Journal: Psychol Addict Behav Date: 2016-07-21
Authors: Michael McDonell; Sterling McPherson; Roger Vilardaga; Debra Srebnik; Frank N Angelo; Emily Leickly; Andrew J Saxon; John Roll; Richard Ries Journal: Am J Addict Date: 2013-09-13