Comparing Acute and Continuous Drug Abuse Treatment: A Randomized Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Drug addiction is a chronic illness characterized by problematic drug use, followed by periods of abstinence, reductions in use, or return to problematic drug use. Despite this, substance abuse treatment has traditionally been based on an acute care model. The field needs an addiction management model for drug-dependent patients, which, like disease management for other chronic conditions, provides: 1) initial stabilization; 2) ongoing treatment to maintain clinical gains; 3) monitoring of patient symptoms; and 4) adjustments to the treatment based on the patient's response.
In response to these needs we have developed the Long Term Recovery Management (LTRM) model. LTRM is predicated on initiating long-term addiction management at the onset of substance abuse treatment, extending the length of treatment, expediting the transitions between intensive treatment and maintenance of behavioral change, adapting treatment intensity to patient's response to treatment, and actively facilitating the therapeutic alliance. LTRM combines 3 established treatment techniques (Community Reinforcement Approach, Contingency Management, and Facilitated Therapeutic Alliance), each with demonstrated efficacy, into a chronic disease model. In addition, patient cases are kept open, thereby removing potential obstacles to re-engagement with stepped-up care, when indicated. The LTRM model emphasizes: engagement in continuous long-term treatment and recovery support, therapeutic alliance, and early re-intervention as the main mechanisms for maintenance of behavioral change.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Ohio
-
Columbus, Ohio, United States, 43207
- Maryhaven
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
To be eligible for the study, a subject must:
- At least 18 years of age
- Meet current dependence criteria for stimulants (cocaine/other), opioids (heroin/other), and/or alcohol (if also dependent on cocaine or opioids). Persons who are opioid dependent are eligible if they are not in methadone maintenance therapy; they will be eligible if they are in short-term buprenorphine detoxification
- Self-report use of a primary drug of dependence in the past 60 days; 4) be admitted to outpatient care at Maryhaven
- Willing to participate in the protocol (i.e., to be randomized to treatment condition and agree to attend regular treatment sessions).
Exclusion Criteria:
- Potential subjects will be excluded if they: 1) present with current suicide risk
- Have a current, untreated psychotic disorder
- Plan to relocate outside of the area within 12 months
- Have been sentenced to incarceration of more than 30 days over the next 6 months
- Are alcohol dependent without current dependence on cocaine or opioids.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Treatment as Usual (TAU)
|
Outpatient substance abuse treatment
|
|
Experimental: TAU + Long-Term Recovery Management (LTRM)
|
Long-Term Recovery Management (LTRM) combines 3 established treatment techniques (Community Reinforcement Approach, Contingency Management, and Facilitated Therapeutic Alliance), each with demonstrated efficacy, into a chronic disease model.
In addition, patient cases are kept open, thereby removing potential obstacles to re-engagement with stepped-up care, when indicated.
Patients randomly assigned to LTRM will be asked to participate in group sessions each month for 12 months.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The main outcome is weeks of abstinence from the primary drug of dependence.
Time Frame: 12 months
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Secondary outcomes include drug-free days and reduction in HIV risk behaviors.
Time Frame: 12 months
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Robert G Carlson, Ph.D., Wright State University Boonshoft School of Medicine
- Study Director: Russel Falck, MA, Wright State University Boonshoft School of Medicine
- Study Director: Gregory Brigham, Ph.D., Maryhaven
- Study Director: Brenda M Booth, Ph.D., University of Arkansas
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- NIDA/NIH 1RC1DA028467-01
- 1RC1DA028467-01 (U.S. NIH Grant/Contract)
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