This proposal is a randomized clinical trial of a 12-week contingency management (CM) paradigm focused on the treatment of methamphetamine, amphetamine, and/or cocaine abuse in severely mentally ill (SMI) patients attending an urban community mental health center (CMHC), with a 26 week follow-up. Despite a great deal of interest in the treatment of co-occurring disorders, as well as in the growing problems of both methamphetamine (and its movement from more rural to urban settings) and cocaine abuse, there have been no published randomized trials of CM as the primary intervention for psycho-stimulant use disorders in the SMI population. The CM paradigm to be used is one which has been shown effective in several recent large clinical trials, using the variable magnitude of reinforcement procedure. The reinforcers will be vouchers or actual items useful for day to day living in this population. 200 SMI participants with co-occurring methamphetamine or cocaine abuse will be recruited from an urban CMHC and randomized to receive either the active CM paradigm plus treatment as usual (TAD), or TAU which will include the delivery of reinforcement for study involvement. The primary outcome is change in psycho-stimulant use (methamphetamine, amphetamine, and/or cocaine). Secondary outcomes include: changes in use of other illegal drugs or alcohol;changes in CMHC treatment adherence;changes in psychiatric symptoms,quality of life, and community outcomes (homelessness, incarcerations, etc.), nicotine use, and HIV risk status. Further, potential mediators and moderators of the CM paradigm in this population will be studiedand include demographics, psychiatric diagnosis and symptomatology, motivation, stage of change and cognitive function. This proposalis responsive to the NIDA Behavioral and Integrative Treatment Development Program announcement, PA-06-486, for Stage 3 evaluation.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
Project #
Application #
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Grossman, Debra
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Washington
Schools of Medicine
United States
Zip Code
Oluwoye, Oladunni; Hirchak, Katherine; Leickly, Emily et al. (2018) Interaction between pre-treatment drug use and heterogeneity of psychiatric diagnosis predicts outcomes in outpatients with co-occurring disorders. Psychiatry Res 260:233-235
Murphy, Sean M; McDonell, Michael G; McPherson, Sterling et al. (2015) An economic evaluation of a contingency-management intervention for stimulant use among community mental health patients with serious mental illness. Drug Alcohol Depend 153:293-9
McDonell, Michael; McPherson, Sterling; Vilardaga, Roger et al. (2014) Preliminary findings: Contingency management targeting psycho-stimulant use results in secondary decreases in smoking for severely mentally ill adults. Am J Addict 23:407-10
Srebnik, Debra S; McDonell, Michael G; Ries, Richard K et al. (2014) Conflicts among CMHC clinicians over the role of urine drug testing. Psychiatr Serv 65:700-1
McDonell, Michael G; Srebnik, Debra; Angelo, Frank et al. (2013) Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness. Am J Psychiatry 170:94-101
Srebnik, Debra; Sugar, Andrea; Coblentz, Patrick et al. (2013) Acceptability of contingency management among clinicians and clients within a co-occurring mental health and substance use treatment program. Am J Addict 22:432-6
Angelo, Frank N; McDonell, Michael G; Lewin, Michael R et al. (2013) Predictors of stimulant abuse treatment outcomes in severely mentally ill outpatients. Drug Alcohol Depend 131:162-5
McDonell, Michael G; Howell, Donelle N; McPherson, Sterling et al. (2012) Voucher-based reinforcement for alcohol abstinence using the ethyl-glucuronide alcohol biomarker. J Appl Behav Anal 45:161-5
McDonell, Michael G; Srebnik, Debra; Angelo, Frank et al. (2011) Evaluation of ethyl glucuronide immunoassay urinalysis in five alcohol-dependent outpatients. Am J Addict 20:482-4
McDonell, Michael G; Angelo, Frank; Sugar, Andrea et al. (2011) A pilot study of the accuracy of onsite immunoassay urinalysis of illicit drug use in seriously mentally ill outpatients. Am J Drug Alcohol Abuse 37:137-40

Showing the most recent 10 out of 12 publications