Contingency management (CM) is highly efficacious for reducing substance use, and recent data suggest that reinforcing attendance at treatment can significantly improve treatment outcomes. Importantly, CM interventions that reinforce attendance are more likely to be adopted clinically than those that reinforce abstinence. Having objective indicators of drinking outcomes, nevertheless, is critical for quantifying the benefits of attendance-based CM treatment in alcohol abusing populations. New technology is now available to gauge alcohol use in patients'natural environments. The Secure Continuous Remote Alcohol Monitor (SCRAMx?) continuously monitors alcohol consumption 24 hours a day. As such, it may be ideal for objective evaluation of alcohol consumption during treatment intervention studies, including those that involve CM. In this study, 114 patients participating in community based outpatient treatment programs for alcohol use disorders will wear SCRAMx for a 12-week period. They will be randomized to standard care or standard care plus CM, with reinforcement contingent upon attendance at treatment. We will assess treatment attendance and alcohol use via SCRAMx and self reports. We expect that patients randomized to the CM intervention will remain in treatment longer and show reductions in both SCRAMx assessed and self reported drinking days relative to those randomized to standard care. Long-term follow-up evaluations will examine drinking outcomes for 12 months. We will also estimate net benefits of CM from both the clinic's and society's perspectives, as well as its cost-effectiveness. In addition, we will assess predictors of relapse, focusing on the associations of GABRA2 and nearby GABRG1 genotypes with differential treatment response. Secondary analyses will evaluate the effects of CM on reducing other drug use, psychosocial problems, and HIV risk behaviors, which have been closely linked with alcohol consumption. Results from this study will be important for guiding future research and clinical use of SCRAMx, and paving the way toward integrating CM into clinical practice for the treatment of alcohol use disorders.

Public Health Relevance

Contingency management (CM) is highly efficacious in reducing illicit drug use, but technological limitations have hindered its application to alcohol use. This study will evaluate if reinforcing treatment attendance is efficacious in reducing drinking using a new technology. Findings will be instrumental for determining ultimate dissemination of attendance-based CM, and will guide future use of this technology

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Comprehensive Center (P60)
Project #
5P60AA003510-37
Application #
8601000
Study Section
Special Emphasis Panel (ZAA1-GG)
Project Start
Project End
Budget Start
2013-12-01
Budget End
2014-11-30
Support Year
37
Fiscal Year
2014
Total Cost
$195,723
Indirect Cost
$40,388
Name
University of Connecticut
Department
Type
DUNS #
022254226
City
Farmington
State
CT
Country
United States
Zip Code
06030
Weiss, Nicole H; Bold, Krysten W; Contractor, Ateka A et al. (2018) Trauma exposure and heavy drinking and drug use among college students: Identifying the roles of negative and positive affect lability in a daily diary study. Addict Behav 79:131-137
Armeli, Stephen; Covault, Jonathan; Tennen, Howard (2018) Long-term changes in the effects of episode-specific drinking to cope motivation on daily well-being. Psychol Addict Behav 32:715-726
Higgins-Biddle, John C; Babor, Thomas F (2018) A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions. Am J Drug Alcohol Abuse 44:578-586
Petry, Nancy M; Zajac, Kristyn; Ginley, Meredith K (2018) Behavioral Addictions as Mental Disorders: To Be or Not To Be? Annu Rev Clin Psychol 14:399-423
Lieberman, Richard; Kranzler, Henry R; Levine, Eric S et al. (2018) Examining the effects of alcohol on GABAA receptor mRNA expression and function in neural cultures generated from control and alcohol dependent donor induced pluripotent stem cells. Alcohol 66:45-53
Bauer, Lance O (2018) Inter-trial variability in brain activity as an indicator of synergistic effects of HIV-1 and drug abuse. Drug Alcohol Depend 191:300-308
Rash, Carla J; Petry, Nancy M; Alessi, Sheila M (2018) A randomized trial of contingency management for smoking cessation in the homeless. Psychol Addict Behav 32:141-148
Bauer, Lance O (2018) HIV/AIDS and an overweight body mass are associated with excessive intra-individual variability in response preparation. J Neurovirol 24:577-586
Petry, Nancy M; Alessi, Sheila M; Rash, Carla J et al. (2018) A randomized trial of contingency management reinforcing attendance at treatment: Do duration and timing of reinforcement matter? J Consult Clin Psychol 86:799-809
Rash, Carla J; Stitzer, Maxine; Weinstock, Jeremiah (2017) Contingency Management: New Directions and Remaining Challenges for An Evidence-Based Intervention. J Subst Abuse Treat 72:10-18

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