Contingency Management for Alcohol Abuse Using Transdermal Alcohol Detection
Principal Investigator
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Associate Professor (Research) |
Funding Source
NIAAA
Description
Co-investigators: Drs. Jennifer Tidey, Robert Swift, Suzanne Colby. This study investigates the initial efficacy of contingency management for reducing drinking among heavy-drinking adults using a novel device that measures alcohol use transdermally. Prevention and treatment of alcohol abuse is a significant research and public health priority. One of the most promising approaches for substance use reduction is contingency management (CM) which provides substance users with cash, vouchers, or some other reinforcer that is contingent upon a desired treatment goal. CM has not has not been widely studied as a treatment for alcohol abuse or dependence, primarily because there has not been a reliable and feasible way to verify abstinence or drinking reductions. However, devices are now available that provide an indication of alcohol use based on the concentration of alcohol in perspiration. A transdermal sensor is worn close to the skin and can be monitored remotely, which makes it possible to immediately reinforce abstinence or reduction. The objective of this proposal is to study the initial efficacy of CM for reducing drinking among heavy drinkers who are interested in reducing or stopping drinking. Following necessary adaptations to established procedural, data collection, and intervention components with a group of 15 (Aim 1), we will conduct a small (N = 30) clinical trial in which we will compare a 3-week CM condition to yoked noncontingent reinforcement (NR) (Aim 2). Participants in CM will receive reinforcement that is contingent upon maintaining abstinence as measured by a transdermal alcohol monitor; participants in NR will receive yoked reinforcement that is not contingent on their transdermal alcohol levels. A project website will be used to collect daily records of drinking, provide feedback about the detection of alcohol to participants, and provide reinforcers. Transdermal alcohol concentrations and self-report data will provide information about changes in drinking during the active phase of treatment, and a 1-month follow-up assessment will measure short-term post-intervention outcomes. Establishing these components and an initial effect size for CM are essential first steps in a program of research with CM and alcohol monitoring to treat alcohol abuse and dependence. Our eventual goal is to conduct larger clinical trials to more rigorously evaluate the short and long-term outcomes of CM with this and other high-risk drinking populations.