Contingency management/adolescents with marijuana use disorders

应急管理/患有大麻使用障碍的青少年

• 批准号: 7243993
• 负责人: THERESE K KILLEEN
• 金额: $ 17.72万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7243993
• 关键词: Abstinence; Adolescence; Adolescent; Adult; Age; Award; Cannabinoids; Clinical Trials Network; Communities; Consensus; Data; Dependence; Disease; Drug usage; Enrollment; Heel; Illicit Drugs; Impulsivity; Incentives; Intervention; Marijuana; Marijuana Abuse; Methods; Modification; Numbers; Outcome Measure; Outpatients; Participant; Pharmaceutical Preparations; Population; Positive Reinforcements; Preclinical Drug Evaluation; Prize; Procedures; Randomized; Rewards; Role; Sampling; Screening Result; Substance abuse problem; Testing; Treatment outcome; Urine; Visit; Week; base; contingency management; cost; drug of abuse; follow-up; programs; psychosocial; stimulant abuse; success; treatment program

DESCRIPTION (provided by applicant): Marijuana is one of the most widely abused drugs during adolescence and may be a gateway to other illicit drug use, yet there is no consensus about the best approach to the treatment of adolescents with marijuana use disorders. Contingency management (CM) procedures have been shown to be efficacious with many difficult to treat substance dependent populations. The immediate and tangible positive reinforcement provided by CM may be particularly appealing to adolescents. The proposed study will assess the feasibility of implementation of CM procedures in a community treatment program and provide preliminary data concerning the efficacy of contingency management for adolescents with marijuana abuse and dependence. Using the "abstinence bowl" incentive procedure (described in methods) will reduce the cost of implementation. Since this particular procedure has not been explored in the adolescent population, modifications (such as age appropriate prizes) will be made to fit this population. The specific aims of this R-21 exploratory application are: 1. To implement a contingency management intervention in an adolescent treatment program at a community-based substance abuse treatment program; 2. To assess the impact of a contingency management intervention on marijuana use as determined by UDS in adolescents with marijuana abuse or dependence; and 3. To assess the impact of a contingency management intervention on retention in treatment for adolescents with marijuana abuse or dependence. The primary outcome measures in this randomized study will be abstinence from marijuana and retention in treatment. Those randomized to the incentive group will be awarded chances to draw for prizes when urine drug screens are negative for drugs. The number of draws will increase with consecutive negative screens. The noncontingent group will receive a fixed number of draws per visit regardless of urine drug screen results. Both groups will be enrolled in outpatient substance abuse treatment and submit twice weekly urine drug samples for 12 weeks. The proposed CM intervention holds much promise for success. This program has demonstrated efficacy with drug dependent adults and the immediate and tangible rewards are likely to be particularly appealing to adolescents. If findings are positive, a larger efficacy study will be proposed.

描述（由申请人提供）： 大麻是青春期滥用最广泛的药物之一，可能是使用其他非法药物的门户，但对于治疗患有大麻使用障碍的青少年的最佳方法尚未达成共识。事实证明，应急管理（CM）程序对于许多难以治疗的物质依赖人群是有效的。 CM 提供的直接且切实的积极强化可能对青少年特别有吸引力。拟议的研究将评估在社区治疗计划中实施 CM 程序的可行性，并提供有关大麻滥用和依赖青少年应急管理有效性的初步数据。使用“禁欲碗”激励程序（方法中描述）将降低实施成本。由于这一特殊程序尚未在青少年人群中进行探索，因此将进行修改（例如适合年龄的奖品）以适应这一人群。 R-21 探索性应用的具体目标是： 1. 在基于社区的药物滥用治疗计划中的青少年治疗计划中实施应急管理干预； 2. 评估 UDS 确定的应急管理干预措施对滥用或依赖大麻的青少年大麻使用的影响； 3. 评估应急管理干预措施对吸食或依赖大麻的青少年继续接受治疗的影响。 这项随机研究的主要结果指标是戒除大麻和坚持治疗。当尿液药物筛查结果呈阴性时，那些随机分配到奖励组的人将获得抽奖机会。平局次数会随着连续的负掩护而增加。无论尿液药物筛查结果如何，非偶然组每次就诊都将接受固定次数的抽检。两组患者都将参加门诊药物滥用治疗，并每周提交两次尿液药物样本，持续 12 周。拟议的 CM 干预有望取得成功。该计划已证明对吸毒成瘾的成年人有效，而直接和切实的回报可能对青少年特别有吸引力。如果结果是积极的，将提议进行更大规模的疗效研究。