Using app-based incentives to encourage abstinence from drugs

Encouraging Abstinence Behavior in a Drug Epidemic: Optimizing Dynamic Incentives

This study is testing whether using an app to give money rewards can help people with opioid and cocaine use disorders stay drug-free for longer.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 600 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Wake Forest University Health Sciences (Academic / other)
• Locations: 2 sites (Oconomowoc, Wisconsin and 1 other locations)
• Trial ID: NCT04927143 on ClinicalTrials.gov

What this trial studies

This project aims to combat the opioid epidemic by evaluating two types of dynamically adjusting incentive schedules to encourage abstinence in individuals with opioid and cocaine use disorders. The study will implement 'escalating' and 'de-escalating' incentive models through an app-based contingency management approach. Participants will receive financial incentives based on their success in maintaining abstinence, with the goal of optimizing the effectiveness of these incentives. The study will involve a randomized evaluation to determine which incentive schedule is more effective in promoting long-term abstinence.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older who meet the criteria for opioid or cocaine use disorders and are currently in treatment.

Not a fit: Patients who are not currently engaged in treatment or do not have access to a smartphone may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly improve treatment outcomes for individuals struggling with substance use disorders.

How similar studies have performed: Previous studies have shown promising results for incentive-based approaches in treating substance use disorders, indicating that this method has potential for success.

Eligibility criteria

Inclusion Criteria:

* 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:

  1. 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.
  2. Used non-medical opioids, cocaine, and/or methamphetamine within the last 21 days.
* Understands English.

Exclusion Criteria:

* 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.

Where this trial is running

Oconomowoc, Wisconsin and 1 other locations

• Rogers Behavioral Health — Oconomowoc, Wisconsin, United States (Recruiting)
• Advocate Aurora Behavioral Health Services — Wauwatosa, Wisconsin, United States (Recruiting)

Study contacts

• Principal investigator: Mercedes Robaina, PhD — Advocate Aurora Behavioral Health Services
• Study coordinator: Kevin Petranu

Conditions Opioid-use Disorder; Cocaine Use Disorder; Opioid Use; Cocaine Use; Substance Use; Methamphetamine Abuse; Methamphetamine-dependence; contingency management