Contingency Management for the Treatment of Methamphetamine Use Disorders

• Published in: The American journal of psychiatry 2006-11, Vol.163 (11), p.1993-1999
• Main Authors: Roll, John M., Petry, Nancy M., Stitzer, Maxine L., Brecht, Mary L., Peirce, Jessica M., McCann, Michael J., Blaine, Jack, MacDonald, Marilyn, DiMaria, Joan, Lucero, Leroy, Kellogg, Scott
• Format: Article
• Language: English
• Subjects: Adult; Amphetamine-Related Disorders - psychology; Amphetamine-Related Disorders - therapy; Amphetamine-Related Disorders - urine; Behavior Therapy - methods; Behavior, Addictive - psychology; Behavior, Addictive - therapy; Behavior, Addictive - urine; Biological and medical sciences; Clinical outcomes; Cocaine; Drug abuse; Drug therapy; Drug use; Female; Humans; Immunotherapy; Intervention; Male; Medical sciences; Methamphetamine; Neuropharmacology; Pharmacology. Drug treatments; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Reinforcement Schedule; Substance Abuse Detection; Substance abuse treatment; Substance Abuse Treatment Centers; Token Economy; Treatment Outcome
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/ajp.2006.163.11.1993

Objective: Theory and some preliminary evidence suggest that contingency management may be an effective treatment strategy or adjunct to psychosocial treatment for methamphetamine use disorders. An experimentally rigorous investigation on the topic was provided by a large multisite trial conducted under the auspices of the Clinical Trials Network of the National Institute on Drug Abuse. Method: The authors report data on 113 participants who were diagnosed with methamphetamine abuse or dependence. They were randomly assigned to receive 12 weeks of either treatment as usual or treatment as usual plus contingency management. Urine samples were tested for illicit drugs, and breath samples were tested for alcohol. The reinforcers for drug-negative samples were plastic chips, some of which could be exchanged for prizes. The number of plastic chips drawn increased with each week of negative samples but was reset to one after a missed or positive sample. Results: The participants in both groups remained in treatment for equivalent times, but those receiving contingency management in addition to usual treatment submitted significantly more negative samples, and they were abstinent for a longer period of time (5 versus 3 weeks). Conclusions: These results suggest that contingency management has promise as a component in treatment strategies for methamphetamine use disorder.