Journal article
Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness
The American journal of psychiatry, Vol.170(1), pp.94-101
01/2013
Handle:
https://hdl.handle.net/2376/108526
PMID: 23138961
Abstract
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.
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.
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.
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.
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Details
- Title
- Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness
- Creators
- Michael G McDonell - Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA. mikemcd@uw.eduDebra SrebnikFrank AngeloSterling McPhersonJessica M LoweAndrea SugarRobert A ShortJohn M RollRichard K Ries
- Publication Details
- The American journal of psychiatry, Vol.170(1), pp.94-101
- Academic Unit
- Elson S. Floyd College of Medicine; Medical Education and Clinical Science, Department of
- Publisher
- United States
- Grant note
- R01 DA022476 / NIDA NIH HHS R01DA022476-01 / NIDA NIH HHS
- Identifiers
- 99900546919801842
- Language
- English
- Resource Type
- Journal article