Contingency management is effective in promoting abstinence and retention in treatment among crack cocaine users with a previous history of poor treatment response: a crossover trial

Author(s)

Constantino Miguel, Andre de Queiroz ^{[1, 2]} ; Madruga, Clarice Sandi ^{[1, 2]} ; Simoes, Viviane ^[1] ; Yamauchi, Rodolfo ^[1] ; da Silva, Claudio Jeronimo ^[1] ; McDonell, Michael ^[3] ; McPherson, Sterling ^[3] ; Roll, John ^[3] ; Laranjeira, Ronaldo Ramos ^{[1, 2]} ; Mari, Jair de Jesus ^[2]

Affiliation

^[1] Fed Univ Sao Paulo UNIFESP, Natl Inst Policies Alcohol & Drugs INPAD, Dept Psychiat & Med Psychol, Rua Dr Diogo de Faria 1036, Sao Paulo, SP - Brazil

^[2] Fed Univ Sao Paulo UNIFESP, Dept Psychiat & Med Psychol, Rua Borges Lagoa 570, 1 Andar Vila Clementino, BR-04038030 Sao Paulo, SP - Brazil

^[3] Washington State Univ, Program Excellence Addict Res, POB 1469, Spokane, WA - USA

• Document type: Journal article
• Source: PSICOLOGIA-REFLEXAO E CRITICA; v. 32, JUL 15 2019.
• Web of Science Citations: 0

Abstract

Abstract Background: Crack use has become a severe health problem in Brazil. Contingency management has shown robust evidence of efficacy in the treatment of cocaine use disorder (CUD) in high-income countries; however, it is still unclear how this intervention can impact treatment in low-income countries. Objective: To evaluate the efficacy of contingency management in the treatment of CUD among individuals with a previous history of poor treatment response in Brazil. Methods: Six months after the end of treatment, 32 participants previously allocated to the usual care condition (UCC) were invited to receive an additional 12 weeks of treatment in a contingency management condition (CMC), and 16 accepted the invitation. We compared data obtained from only the 16 participants (14 male) exposed to both treatment conditions. Results: Participants attended more treatment sessions and were retained in treatment for a longer period during the CMC than during the UCC (p < .01 for both). The proportion of negative cocaine samples submitted, the mean longest duration of cocaine abstinence, and the odds of being abstinent from cocaine during the 12 weeks of treatment were significantly higher during treatment in the CMC when compared to the UCC (p < .05). Conclusions: This study provides further evidence that contingency management is effective in promoting abstinence and retention in treatment among individuals with CUD with a history of poor treatment response. Our findings argue for the incorporation of CM among public treatment services for CUD in Brazil. Trial registration: This study was registered at ClinicalTrials.gov as NCT01815645 on March 21, 2013. (AU)

• FAPESP's process: 11/01469-7 - Evaluating the efficacy of contingency management in a standard open treatment facility for individuals with crack dependence disorder
• Grantee: Ronaldo Laranjeira
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/22004-9 - BEPE/FAPESP international training for the project effectiveness of contingency management in the treatment of crack addiction for individuals living in the Crackland region: a crossover randomized clinical trial
• Grantee: André de Queiroz Constantino Miguel
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• FAPESP's process: 17/05371-8 - Effectiveness of Contingency Management in the treatment of crack addiction for crack users living in the "Crackland" region. A Crossover Randomized Clinical Trial.
• Grantee: André de Queiroz Constantino Miguel
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 13/04138-7 - Evaluating the efficacy of Contingency Management in a standard open treatment facility for individuals with crack dependence disorder
• Grantee: André de Queiroz Constantino Miguel
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)