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

Autor(es)

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]

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: PSICOLOGIA-REFLEXAO E CRITICA; v. 32, JUL 15 2019.
• Citações Web of Science: 0

Resumo

BackgroundCrack 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.ObjectiveTo evaluate the efficacy of contingency management in the treatment of CUD among individuals with a previous history of poor treatment response in Brazil.MethodsSix months after the end of treatment, 32 participants previously allocated to the usual care condition (UCC) were invited to receive an additional 12weeks 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.ResultsParticipants 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 12weeks of treatment were significantly higher during treatment in the CMC when compared to the UCC (p<.05).ConclusionsThis 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 registrationThis study was registered at ClinicalTrials.gov as NCT01815645 on March 21, 2013. (AU)

• Processo FAPESP: 13/04138-7 - Avaliação de eficácia do Manejo de Contingências no tratamento ambulatorial padrão para indivíduos com diagnóstico de dependência por crack
• Beneficiário: André de Queiroz Constantino Miguel
• Linha de fomento: Bolsas no Brasil - Doutorado Direto
• Processo FAPESP: 17/05371-8 - Efetividade do Manejo de Contingências no tratamento da dependência de crack para usuários vivendo na região da Cracolândia. ensaio clínico randomizado controlado com crossover
• Beneficiário: André de Queiroz Constantino Miguel
• Linha de fomento: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 11/01469-7 - Avaliação de eficácia do manejo de contingências no tratamento ambulatorial padrão para indivíduos com diagnóstico de dependência por crack
• Beneficiário: Ronaldo Laranjeira
• Linha de fomento: Auxílio à Pesquisa - Regular
• Processo FAPESP: 17/22004-9 - Capacitação internacional via BEPE/FAPESP no projeto avaliação da efetividade do Manejo de Contingências no tratamento da dependência de crack para usuários vivendo na região da Cracolândia: ensaio clínico randomizado controlado com crossover
• Beneficiário: André de Queiroz Constantino Miguel
• Linha de fomento: Bolsas no Exterior - Estágio de Pesquisa - Pós-Doutorado