Crack cocaine users views regarding treatment with contingency management in Brazil

Miguel, André; Madruga, Clarice S.; Simões, Viviane; Yamauchi, Rodolfo; Silva, Claudio J. da; Abdalla, Renata Rigacci; McDonell, Michael G.; McPherson, Sterling; Mari, Jair J.; Laranjeira, Ronaldo

doi:10.1186/s13011-018-0144-7

Cited by 15 publications

(10 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another alternative to promote awareness of CM is to present patients’ perspectives of their experience with this intervention. To this point, our results replicate our previous findings (Miguel, Madruga, Simoes et al, 2018) and suggest that CM is easily understood and well accepted by treatment-seeking crack cocaine users. As such, the dissemination of these findings may be useful to reduce resistance among treatment providers and treatment programs that have not been previously exposed to the effects of CM.…”

Section: Discussionsupporting

confidence: 91%

Acceptability and feasibility of incorporating contingency management into a public treatment program for homeless crack cocaine users in Brazil: A pilot study.

Miguel¹,

Simões²,

Yamauchi³

et al. 2022

Experimental and Clinical Psychopharmacology

Self Cite

View full text Add to dashboard Cite

Homeless substance users are particularly hard to treat. In this pilot study, we evaluated the acceptability and feasibility of incorporating Contingency Management (CM) into a public Abstinent-Contingent Housing (ACH) treatment program developed to treat currently homeless crack cocaine users. A total of 21 homeless crack cocaine users were randomized to receive 12 weeks of ACH alone (n = 9) or ACH plus CM (ACH + CM) (n = 12). Twelve treatment providers in the ACH treatment program were trained to deliver the CM intervention. CM was rated as relatively (41.7%) or very (58.3%) easy to understand and relatively (50%) or very (50%) easy to conduct by the ACH treatment providers. On a 10-point Likert scale, providers rated the importance of incorporating CM into public treatment programs for crack cocaine at M = 8.3 (SD = 2). Participants exposed to CM rated as relatively (33.3%) or very (66.7%) easy to understand. One hundred percent liked receiving the intervention "a lot," and 78.9% believed it helped them achieve and maintain crack cocaine abstinence. Finally, compared to the ACH condition, the ACH + CM condition was consistently associated with better treatment retention and cocaine use outcome measures, yelling small to large effect sizes. However, possibly due to the small sample size, most of these differences did not achieve statistical significance. CM was well integrated into the ACH treatment program and was well accepted by both the providers and participants, suggesting the feasibility of incorporating CM into a public treatment program for homeless crack cocaine users from low-and middle-income countries. Public Significance StatementCrack cocaine use is a major health problem in Brazil. This study offers substantial support for the acceptability and feasibility of incorporating CM into public treatment programs for homeless crack cocaine users in Brazil.

show abstract

Section: Discussionsupporting

confidence: 91%

Acceptability and feasibility of incorporating contingency management into a public treatment program for homeless crack cocaine users in Brazil: A pilot study.

Miguel¹,

Simões²,

Yamauchi³

et al. 2022

Experimental and Clinical Psychopharmacology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Recently, our group published the first Brazilian CM treatment trial for CUD using the classic vouchers-based, escalating reinforcement type of approach for the application of CM (Miguel et al, 2016(Miguel et al, , 2017(Miguel et al, , 2018(Miguel et al, , 2019. Despite our positive results, we observed specific components of the CM approach that could be generating unnecessary costs and limiting the efficacy and treatment engagement potential of CM.…”

Section: Introductionmentioning

confidence: 77%

Contingency Management Banking

Miguel¹,

Simões²,

Yamauchi³

et al. 2020

Rev. Bras. Ter. Comp. Cogn.

Self Cite

View full text Add to dashboard Cite

Contingency Management (CM) is among the most effective behavioral interventions for cocaine use disorders (CUD), yet the dissemination of CM to community treatment settings has been limited and slow due partially to costs. Recently, our group completed the first Brazilian CM trial for CUD. Despite our positive results, we observed specific components of the CM procedure that could be contributing to unnecessary costs. Prompted by this experience and leveraging evidence-based behavioral science principles, we recently developed a modified version of CM designed to reduce costs and increase long-term engagement in treatment. In this technical article we present the scientific, clinical and practical rationale behind a novel CM procedure. We provide a detailed description and rationale for this procedure in an effort to stimulate discussion amongst other scientists about its utility across a diverse array of low-resource treatment settings and discuss why CM banking may reduce costs and enhance treatment engagement.

show abstract

“…CM is among the most effective interventions for substance use disorders, however it has not been widely applied in AUD treatment, in-part because of previous difficulties in detecting alcohol abstinence using standard breath alcohol test procedures [ 24 , 25 ]. Provider participants in this study believed that ARMS could be useful in the treatment of AUD.…”

Section: Discussionmentioning

confidence: 99%

Automated Reinforcement Management System (ARMS): focused phase I provider feedback

Smith

Rodin

Hwang

et al. 2022

Addict Sci Clin Pract

Self Cite

View full text Add to dashboard Cite

Background Alcohol use increases risk for morbidity and mortality and is associated with over 3 million annual deaths worldwide. Contingency Management (CM) is one of the most effective interventions for substance use disorders, and has recently been coupled with technologies to promote novel treatments for alcohol use disorders (AUD). Leveraging these technological advances, we are developing the Automated Reinforcement Management System (ARMS), an integrated CM system designed to enable CM treatment as a component of a digital therapeutic or adjunct therapy remotely to anyone with a smartphone. Objective To collect detailed provider feedback on ARMS and determine the need for modifications to make the system most feasible, acceptable, and useful to providers. Methods Seven providers completed one-hour structured interviews/focus groups wherein we described the ARMS system and its application to clinical care. Providers viewed screen shots of the ARMS provider facing and patient facing systems. Providers gave feedback on their current AUD treatment practices, preferences for the functionality and appearance of the system, preferences for receipt of information on their patients, why they and their patients would or would not use the system, suggestions for improvement, and the proposed intervention overall. To analyze the qualitative data gathered, we used a qualitative descriptive approach with content analysis methods. Results The overarching theme of Individualized Treatment emerged throughout the interviews. This sentiment supports use of ARMS, as it is intended to supplement provider communication and intervention as an adjunctive and customizable tool with the ability to reach rural patients, not a stand-alone option. Themes of Accountability and Objective Assessment arose during discussions of why people would use the system. Themes within provider obstacles included, Information Overload and Clinical Relevance, and in patient obstacles, Sustained Engagement and Security Concerns. Two themes emerged regarding suggestions for improvement: Increasing Accessibility and Bi-directional Communication. Discussion Themes from provider input are being used to modify ARMS to make it more user friendly, time saving, and relevant to treatment of AUD. If successful, ARMS will provide effective, individualized-digital therapeutic for those needing adjunctive treatment or those living in rural remote areas needing better connected care.

show abstract

Crack cocaine users views regarding treatment with contingency management in Brazil

Cited by 15 publications

References 36 publications

Acceptability and feasibility of incorporating contingency management into a public treatment program for homeless crack cocaine users in Brazil: A pilot study.

Acceptability and feasibility of incorporating contingency management into a public treatment program for homeless crack cocaine users in Brazil: A pilot study.

Contingency Management Banking

Automated Reinforcement Management System (ARMS): focused phase I provider feedback

Contact Info

Product

Resources

About