This study also aims to develop and apply a standard repetitive transcranial magnetic stimulation (rTMS) protocol on drug users. The investigators want to focus on the effects of rTMS on amphetamine and cocaine as they are the most commonly used types of illicit drugs in Hong Kong. The primary research question is: • To examine if rTMS can reduce craving and consumption of the most commonly used illicit drugs (amphetamine, cocaine) among people with drug use disorders in Hong Kong? The secondary research questions are: * What is the association between rTMS protocol (frequency, intensity) and drug craving and consumption? * Would there be gains in executing functioning among participants who have received rTMS treatment? * Would there be a reduction in depressive and anxiety symptoms among participants who have received rTMS treatment? The investigators would use a cross-over design (figure 1) to investigate the effects of rTMS. The investigators would recruit participants through community drug rehabilitation and youth outreach services. Participants who meet the selection and exclusion criteria will be invited to join. Upon obtaining their written consent, the investigators would randomize participants to a treatment (rTMS) group and a sham stimulation (placebo) group. Upon completing the first phase (2 weeks), there would be a washout period of 2 weeks. The two groups will swap (treatment becomes sham, and vice-versa) and the second phase will proceed. A double-blinded procedure will be implemented. Outcome measures will be conducted at baseline, after Phase I, at the start of Phase II, and at the end of Phase II.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
48
Transcranial Magnetic Stimulation (TMS) uses magnetic fields to stimulate nerve cells in the brain. TMS uses a small electromagnetic coil controlled by a computer program to deliver short, powerful pulses of magnetic energy focused precisely on parts of the brain's pre-frontal cortex. High-frequency repetitive TMS can enhance the excitability of the stimulated region.
The Hong Kong Polytechnic University
Hong Kong, Hong Kong
Craving
An 11-item Craving Experience Questionnaire (CEQ), a theory-based and concise assessment tool for measuring substance cravings, is utilized. Each item is rated on a scale of 0 to 10, resulting in a total score range of 0 to 110. A higher score indicates a higher level of craving.
Time frame: Baseline (before the phase I intervention)
Craving
An 11-item Craving Experience Questionnaire (CEQ), a theory-based and concise assessment tool for measuring substance cravings, is utilized. Each item is rated on a scale of 0 to 10, resulting in a total score range of 0 to 110. A higher score indicates a higher level of craving.
Time frame: 3-week post intervention (after 6-session of the phase I intervention)
Craving
An 11-item Craving Experience Questionnaire (CEQ), a theory-based and concise assessment tool for measuring substance cravings, is utilized. Each item is rated on a scale of 0 to 10, resulting in a total score range of 0 to 110. A higher score indicates a higher level of craving.
Time frame: Baseline (before the phase II intervention)
Craving
An 11-item Craving Experience Questionnaire (CEQ), a theory-based and concise assessment tool for measuring substance cravings, is utilized. Each item is rated on a scale of 0 to 10, resulting in a total score range of 0 to 110. A higher score indicates a higher level of craving.
Time frame: 3-week post intervention (after 6-session of the phase II intervention)
Readiness for change
The Contemplation Ladder which measures the motivation for change, is used. The motivation for change is rated on a scale of 0 (No thought about quitting. I cannot live without drugs) to 10 (I have changed my drug use and will never go back to the way I used drugs before), with a total score of 10. A higher score means a higher motivation for change.
Time frame: Baseline (before the phase I intervention)
Readiness for change
The Contemplation Ladder which measures the motivation for change, is used. The motivation for change is rated on a scale of 0 (No thought about quitting. I cannot live without drugs) to 10 (I have changed my drug use and will never go back to the way I used drugs before), with a total score of 10. A higher score means a higher motivation for change.
Time frame: 3-week post intervention (after 6-session of the phase I intervention)
Readiness for change
The Contemplation Ladder which measures the motivation for change, is used. The motivation for change is rated on a scale of 0 (No thought about quitting. I cannot live without drugs) to 10 (I have changed my drug use and will never go back to the way I used drugs before), with a total score of 10. A higher score means a higher motivation for change.
Time frame: Baseline (before the phase II intervention)
Readiness for change
The Contemplation Ladder which measures the motivation for change, is used. The motivation for change is rated on a scale of 0 (No thought about quitting. I cannot live without drugs) to 10 (I have changed my drug use and will never go back to the way I used drugs before), with a total score of 10. A higher score means a higher motivation for change.
Time frame: 3-week post intervention (after 6-session of the phase II intervention)
Drug Consumption
A self-report questionnaire Set 6 of Beat Drug Fund (BDF)-Hong Kong, which assesses drug use frequency in past two weeks, is used. The patients are required to indicate their usage of each type of drug by selecting one of the following options: Never used, Used occasionally, and Used regularly.
Time frame: Baseline (before the phase I intervention)
Drug Consumption
A self-report questionnaire Set 6 of Beat Drug Fund (BDF)-Hong Kong, which assesses drug use frequency in past two weeks, is used. The patients are required to indicate their usage of each type of drug by selecting one of the following options: Never used, Used occasionally, and Used regularly.
Time frame: 3-week post intervention (after 6-session of the phase I intervention)
Drug Consumption
A self-report questionnaire Set 6 of Beat Drug Fund (BDF)-Hong Kong, which assesses drug use frequency in past two weeks, is used. The patients are required to indicate their usage of each type of drug by selecting one of the following options: Never used, Used occasionally, and Used regularly.
Time frame: Baseline (before the phase II intervention)
Drug Consumption
A self-report questionnaire Set 6 of Beat Drug Fund (BDF)-Hong Kong, which assesses drug use frequency in past two weeks, is used. The patients are required to indicate their usage of each type of drug by selecting one of the following options: Never used, Used occasionally, and Used regularly.
Time frame: 3-week post intervention (after 6-session of the phase II intervention)
Trail Making Test
A test of speed of processing
Time frame: Baseline (before the phase I intervention)
Trail Making Test
A test of speed of processing
Time frame: 3-week post intervention (after 6-session of the phase I intervention)
Trail Making Test
A test of speed of processing
Time frame: Baseline (before the phase II intervention)
Trail Making Test
A test of speed of processing
Time frame: 3-week post intervention (after 6-session of the phase II intervention)
Continuous Performance Test-Identical Pairs (CPT-IP)
A computer-administered measure of sustained attention
Time frame: Baseline (before the phase I intervention)
Continuous Performance Test-Identical Pairs (CPT-IP)
A computer-administered measure of sustained attention
Time frame: 3-week post intervention (after 6-session of the phase I intervention)
Continuous Performance Test-Identical Pairs (CPT-IP)
A computer-administered measure of sustained attention
Time frame: Baseline (before the phase II intervention)
Continuous Performance Test-Identical Pairs (CPT-IP)
A computer-administered measure of sustained attention
Time frame: 3-week post intervention (after 6-session of the phase II intervention)
Mazes test from The Neuropsychological Assessment Battery® (NAB®)
Mazes test is used to measure reasoning and problem-solving.
Time frame: Baseline (before the phase I intervention)
Mazes test from The Neuropsychological Assessment Battery® (NAB®)
Mazes test is used to measure reasoning and problem-solving.
Time frame: 3-week post intervention (after 6-session of the phase I intervention)
Mazes test from The Neuropsychological Assessment Battery® (NAB®)
Mazes test is used to measure reasoning and problem-solving.
Time frame: Baseline (before the phase II intervention)
Mazes test from The Neuropsychological Assessment Battery® (NAB®)
Mazes test is used to measure reasoning and problem-solving.
Time frame: 3-week post intervention (after 6-session of the phase II intervention)
The Depression Anxiety Stress Scale (DASS)-short form
The anxiety and depression subscales (13 items) of DASS is used for monitoring the negative emotional states of the participants. The total score is 39 with a higher scores indicating a higher level of emotional problems.
Time frame: Baseline (before the phase I intervention)
The Depression Anxiety Stress Scale (DASS)-short form
The anxiety and depression subscales (13 items) of DASS is used for monitoring the negative emotional states of the participants. The total score is 39 with a higher scores indicating a higher level of emotional problems.
Time frame: 3-week post intervention (after 6-session of the phase I intervention)
The Depression Anxiety Stress Scale (DASS)-short form
The anxiety and depression subscales (13 items) of DASS is used for monitoring the negative emotional states of the participants. The total score is 39 with a higher scores indicating a higher level of emotional problems.
Time frame: Baseline (before the phase II intervention)
The Depression Anxiety Stress Scale (DASS)-short form
The anxiety and depression subscales (13 items) of DASS is used for monitoring the negative emotional states of the participants. The total score is 39 with a higher scores indicating a higher level of emotional problems.
Time frame: 3-week post intervention (after 6-session of the phase II intervention)
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