Contingency Management for Drug Use: Does Age Matter?

NCT05521854 | Active Not Recruiting

• 3 other identifiers: IRB0010656822.187E10568
• Study Type: interventional
• Target: 175
• Locations: 1 country
• Sites: 2

Brief Summary

The OVERALL AIM is to assess whether app-based incentives are effective for older adults and to quantify the associations between age and both the efficacy and take-up of app-based incentives. This will allow us to determine if older adults with substance use disorders (SUDs) are willing to engage with app-based incentives and whether they perform similarly to their younger counterparts. Because the study will leverage data from an existing study on app-based incentives, a small add-on study is sufficient to address these three aims. This aim will be achieved while simultaneously gathering data that will shed light on the two aims of the first phase of the study: whether app-based incentives are effective overall, and how to optimize the size of incentives over time to maximize their effectiveness.

Conditions

Opioid Use Disorder; Methamphetamine Abuse; Cocaine Use Disorder

Keywords

contingency management; reward; abstinence; drugs; substance use disorder

Outcome Measures

Primary Outcomes (2)

• Drug-negative saliva tests

  Percent of three (3) scheduled video-verified saliva test results classified as drug-negative

  3 months

• App uptake

  Percent of eligible population which uptakes app

  Through study completion, an average of 1 year

Secondary Outcomes (1)

• Longest period of continuous abstinence

  3 months

Study Arms (7)

Control

SHAM COMPARATOR

Participants in this group will have access to the DynamiCare app; however, no behavioral incentives will be provided to this group.

Behavioral: Sham control

Escalating Low

EXPERIMENTAL

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every negative drug test up to a ceiling and "reset" to the lowest amount when a test is positive or missed. The "Low" group will receive lower incentive amounts than the "High" group.

Behavioral: DynamiCare app (app-based contingency management)

Escalating High

EXPERIMENTAL

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every negative drug test up to a ceiling and "reset" to the lowest amount when a test is positive or missed. The "High" group will receive higher incentive amounts than the "Low" group.

Behavioral: DynamiCare app (app-based contingency management)

De-Escalating Low

EXPERIMENTAL

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every positive drug tests (up to a ceiling), and decrease by the same increment with every negative drug test (down to a floor). The "Low" group will receive lower incentive amounts than the "High" group.

Behavioral: DynamiCare app (app-based contingency management)

De-Escalating High

EXPERIMENTAL

Participants will have access to the DynamiCare app. Through the app, participants will receive incentive amounts for drug negative saliva tests. Incentive amounts increase with every positive drug tests (up to a ceiling), and decrease by the same increment with every negative drug test (down to a floor). The "High" group will receive higher incentive amounts than the "Low" group.

Behavioral: DynamiCare app (app-based contingency management)

Constant High

EXPERIMENTAL

In the Constant groups, incentive amounts will remain unchanged across time. The "High" group will receive higher incentive amounts than the "Low" group.

Behavioral: DynamiCare app (app-based contingency management)

Constant Low

EXPERIMENTAL

In the Constant groups, incentive amounts will remain unchanged across time. The "Low" group will receive lower incentive amounts than the "High" group.

Behavioral: DynamiCare app (app-based contingency management)

Interventions

DynamiCare app (app-based contingency management) BEHAVIORAL

Participants will receive financial incentives for submitting randomly generated drug-negative saliva tests across the intervention period.

Constant High; Constant Low; De-Escalating High; De-Escalating Low; Escalating High; Escalating Low

Sham control BEHAVIORAL

Participants get access to the DynamiCare app but will not be provided with financial incentives.

Control

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age at least 18 years old;
• Meet DSM-5 OUD, CoUD, or MUD criteria as evidenced by an OUD CPT code F11\* (opioid related disorders), a CoUD CPT code F14\* (cocaine related disorders), a MUD CPT code F15.1/F15.2 or other clinical notes indicating illicit opioid/cocaine/methamphetamine use for treatment;
• Have access to a smartphone (iOS or Android) with data plan and willing to download DynamiCare app;
• Have an email and can access it from their smartphone;
• Are in residential, day (PHP), partial day (IOP), or outpatient (OP) AODA treatment;
• Are likely to be helped by contingency management because at least ONE of the following conditions is true:
• Were first enrolled in residential, PHP, or IOP substance use treatment no longer than 2 treatment weeks (14 days/encounters of treatment) prior to providing informed consent.
• Used non-medical opioids, cocaine, and/or methamphetamine within the last 21 days.
• Understands English.

You may not qualify if:

• Have evidence of active (non-substance related) psychosis that might impair participation as determined by the PI.
• Has significant cognitive impairment that might confound participation as determined by the PI or are so significantly cognitively impaired that they have a legal guardian.

Sponsors & Collaborators

• Wake Forest University Health Sciences: lead
• Massachusetts Institute of Technology: collaborator
• University of California Santa Cruz: collaborator

Study Sites (2)

Advocate Health Care

Chicago, Illinois, 60007, United States

Location

Aurora Behavioral Health Services

Milwaukee, Wisconsin, 53213, United States

Location

Related Publications (9)

• Benishek LA, Dugosh KL, Kirby KC, Matejkowski J, Clements NT, Seymour BL, Festinger DS. Prize-based contingency management for the treatment of substance abusers: a meta-analysis. Addiction. 2014 Sep;109(9):1426-36. doi: 10.1111/add.12589. Epub 2014 May 23.

  PMID: 24750232 BACKGROUND

• Dickert N, Grady C. What's the price of a research subject? Approaches to payment for research participation. N Engl J Med. 1999 Jul 15;341(3):198-203. doi: 10.1056/NEJM199907153410312. No abstract available.

  PMID: 10403861 BACKGROUND

• Festinger DS, Marlowe DB, Dugosh KL, Croft JR, Arabia PL. Higher magnitude cash payments improve research follow-up rates without increasing drug use or perceived coercion. Drug Alcohol Depend. 2008 Jul 1;96(1-2):128-35. doi: 10.1016/j.drugalcdep.2008.02.007. Epub 2008 Apr 18.

  PMID: 18395365 BACKGROUND

• Halpern SD, Chowdhury M, Bayes B, Cooney E, Hitsman BL, Schnoll RA, Lubitz SF, Reyes C, Patel MS, Greysen SR, Mercede A, Reale C, Barg FK, Volpp KG, Karlawish J, Stephens-Shields AJ. Effectiveness and Ethics of Incentives for Research Participation: 2 Randomized Clinical Trials. JAMA Intern Med. 2021 Nov 1;181(11):1479-1488. doi: 10.1001/jamainternmed.2021.5450.

  PMID: 34542553 BACKGROUND

• Kurti AN, Davis DR, Redner R, Jarvis BP, Zvorsky I, Keith DR, Bolivar HA, White TJ, Rippberger P, Markesich C, Atwood G, Higgins ST. A Review of the Literature on Remote Monitoring Technology in Incentive-Based Interventions for Health-Related Behavior Change. Transl Issues Psychol Sci. 2016 Jun;2(2):128-152. doi: 10.1037/tps0000067.

  PMID: 27777964 BACKGROUND

• Lussier JP, Heil SH, Mongeon JA, Badger GJ, Higgins ST. A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction. 2006 Feb;101(2):192-203. doi: 10.1111/j.1360-0443.2006.01311.x.

  PMID: 16445548 BACKGROUND

• Petry NM, Alessi SM, Carroll KM, Hanson T, MacKinnon S, Rounsaville B, Sierra S. Contingency management treatments: Reinforcing abstinence versus adherence with goal-related activities. J Consult Clin Psychol. 2006 Jun;74(3):592-601. doi: 10.1037/0022-006X.74.3.592.

  PMID: 16822115 BACKGROUND

• Grant RW, Sugarman J. Ethics in human subjects research: do incentives matter? J Med Philos. 2004 Dec;29(6):717-38. doi: 10.1080/03605310490883046.

  PMID: 15590518 BACKGROUND

• Schottenfeld RS, Chawarski MC, Pakes JR, Pantalon MV, Carroll KM, Kosten TR. Methadone versus buprenorphine with contingency management or performance feedback for cocaine and opioid dependence. Am J Psychiatry. 2005 Feb;162(2):340-9. doi: 10.1176/appi.ajp.162.2.340.

  PMID: 15677600 BACKGROUND

MeSH Terms

Conditions

Opioid-Related Disorders; Substance-Related Disorders

Condition Hierarchy (Ancestors)

Narcotic-Related Disorders; Chemically-Induced Disorders; Mental Disorders

Study Officials

• Mercedes Robaina

  Wake Forest University Health Sciences

  PRINCIPAL INVESTIGATOR

• Ariel Zucher, PhD

  University of California Santa Cruz

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 15, 2022
• First Posted: August 30, 2022
• Study Start: May 1, 2023
• Primary Completion (Estimated): May 31, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: March 17, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)