Contingency Management for Meth in South Africa Methamphetamine Abuse in South Africa

Overview

This study will link findings from neuroscience with clinical outcomes using contingency management (CM) to identify changes in brain structure and function that emerge during purely behavioral therapy for methamphetamine (MA) use.

Full Title of Study: “Combating Craving With Contingency Management: Neuroplasticity and Methamphetamine Abuse in South Africa”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: February 15, 2018

Detailed Description

This study will correlate MA-abstinence outcomes from an 8-week program of voucher-based incentives using an escalating schedule for 30 treatment-seeking, MA-dependent individuals with scores on tasks of working memory and assessments of neuropsychological and demographic status. At the beginning and end of the CM program, participants will participate in MRI scans while performing a working memory task and will complete a battery of select neurocognitive and psychological assays to address two specific aims: (1) to determine whether changes in neural function within frontostriatal circuitry from baseline to end of the 8-week CM program are associated with parallel changes in measures of cognitive control and impulsivity and with MA abstinence outcomes and (2) to determine whether structural changes in frontostriatal circuitry over the 8-week CM intervention correspond with neurocognitive, psychological and MA abstinence measures.

Interventions

  • Behavioral: Contingency Management
    • as described above

Arms, Groups and Cohorts

  • Experimental: Contingency Management
    • In exchange for consecutive urine samples documenting methamphetamine abstinence, participants receive increasingly valuable reinforcers.

Clinical Trial Outcome Measures

Primary Measures

  • Responses to Contingency Management
    • Time Frame: 8 weeks
    • urine samples documenting methamphetamine abstinence
  • fMRI Measures
    • Time Frame: Change b/w baseline and 8 Weeks
    • measures of resting state connectivity

Secondary Measures

  • Stop Signal Task
    • Time Frame: Change b/w baseline and 8 Weeks
    • measure of inhibitory control
  • Continuous Performance Task
    • Time Frame: Change b/w baseline and 8 Weeks
    • test of sustained attention
  • Stroop
    • Time Frame: Change b/w baseline and 8 Weeks
    • test of inhibitory control
  • Balloon Analog Risk Task
    • Time Frame: Change b/w baseline and 8 Weeks
    • measure of risk taking and decision making

Participating in This Clinical Trial

Inclusion Criteria

  • provide voluntary informed consent – meet DSM-5 criteria for MA or amphetamine use disorder – provide at least one urine sample positive for MA/amphetamine metabolites during screening (i.e. prior to the commencement of the study). – aged 18-45 – right-handed – English-speaking Exclusion Criteria:

  • currently receiving treatment for stimulant addiction or needing more intensive treatment than outpatient care – meet DSM-5 criteria for substance use disorder other than nicotine – unable to attend 4+ visits during the 2-week screening period or to complete measures – Physical or mental illness that would require intervention that would alter imaging or that would interfere with safe study participation – pregnant, claustrophobic, or have metal prostheses, cardiac pacemakers, or metal clips that are incompatible with the scanner – HIV positive status – unable to comprehend written or spoken English – currently taking psychiatric medication

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 45 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of California, Los Angeles
  • Collaborator
    • University of Cape Town
  • Provider of Information About this Clinical Study
    • Principal Investigator: Steve Shoptaw, Professor – University of California, Los Angeles

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