Implementing a Contingency Management Program Addressing Methamphetamine Use For and With the People of Hawaii

Queen's Medical Center40 enrolled

Overview

The goal of this clinical trial is to use contingency management (CM) as an intervention tool to address methamphetamine use. The main objectives are to: * Gather effectiveness data on a pilot a CM program for participants in Hawaii who use methamphetamine following hospitalization due to traumatic injury * To assess participant perspectives on engaging with a CM program based at a Level 1 Trauma Center. Researches will assess both patient-reported and biologically-confirmed medium-term program effectiveness and conduct qualitative interviews with participants post-program. Participants will: * Visit a follow-up clinic up to three times per week to complete urinalysis following discharge from the trauma unit * Complete Treatment Effectiveness Assessments at 6 and 12-weeks * Engage in a qualitative interview at the end of the CM program

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Contingency Managment Methamphetamine Use Disorder

Interventions

If the sample be methamphetamine negative, participant will be positively reinforced and offered incentives. Participants immediately draw the reinforcement slip of paper to receive a prize from a selection kept on-site. Approximately, half of the slips offer written praise (e.g. "great job!"). The other half of slips are then divided between low value (e.g. food gift cards, bus passes), medium value (e.g. prepaid cell phone, clothing gift cards), and a few large value rewards (e.g. iPad, jewelry). Should the sample be positive for methamphetamine, no reinforcement and/or incentive to be provided. Participant will be encouraged to continue to participate in CM program and follow-up on the next CM date.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Admitted trauma patients * Age greater than 18 years old * Urine drug screen positive for methamphetamines during the current hospitalization * Report at least weekly methamphetamine use * First methamphetamine use greater than 6 months prior to injury * Report at least 4 DSM-V Amphetamine-Type Substance Use Disorder symptoms (at least moderate disease) * Glasgow Coma Scale ≥13 upon arrival to the emergency department * Ability to understand and participate in study procedures * Ability to communicate in English Exclusion Criteria: * Active psychosis (reporting auditory or visual hallucinations) * Under ongoing cardiorespiratory monitoring * Evidence of moderate or severe traumatic brain injury * Patients who are known to be pregnant * Prisoner * Individuals incarcerated at the time of their hospitalization * Individuals lacking capacity to provide, or are otherwise unable or unwilling to provide written informed consent

Outcomes

Primary Outcomes

TEA Outcomes at 6 and 12-weeks

Treatment Effectiveness Assessment (TEA): This assessment asks individuals to respond to changes in four domains following a drug treatment program: substance use, health, lifestyle, and community. The score for each domain can range from 1 (no change or not much) to 10 (much better), for a total score of 4-40. This score allows for the prioritization of each participants values, and therefore does not require strict abstinence to demonstrate benefit from drug treatment.

Time frame: From enrollment to 6 and 12-weeks

Secondary Outcomes

Qualitative Outcomes

Interviews will be conducted as semi-structured interviews using a priori interview guides. Interviews will be transcribed and analyzed using a Template Analysis approach. Two coders will conduct coding of the interview data to ultimately identify themes that will be used as the basis for interpretation. The final analysis of the qualitative data will include contrasts and comparisons made across interviews to examine overlaps and divergences across any relevant sub-samples (e.g., sex, age). Results will present thematic patterns, how frequently each code occurs, and any contradictory evidence.

Time frame: At the end of treatment at 12-weeks

Central Contacts

Nicholas R Schumann, Clinical Psychologist

CONTACT

(808) 691-7024 nschumann@queens.org

Karen Ng, RN