Grants and Contracts Details
Description
Promoting reductions in problem behaviors is common in medical practice wherein at-risk individuals are
counseled to make moderate, sustainable changes in lifestyle. Reducing the percentage of heavy drinking
days in individuals with alcohol use disorder is an accepted intervention target in alcohol addiction treatment,
yet for other drug use disorders, complete abstinence remains the standard for demonstrating treatment
efficacy. Interventions that promote reductions in drug use should improve biopsychosocial outcomes. Little
research has been conducted to demonstrate benefits of reduced drug use, however. Demonstrating the
benefits of reduced cocaine (COC) use would significantly advance treatment development by challenging
expectations for outcomes from possible interventions. COC use produces a number of biopsychosocial
detriments (e.g., cardiovascular toxicity, disrupted immune function, increased psychiatric comorbidities) that
could be ameliorated by COC use reduction. No studies have prospectively or comprehensively evaluated this
possibility to date. To fill this critical knowledge gap, we propose a randomized, controlled 12-week trial in
which financial incentives will be used to reduce COC use. Subjects will be randomly assigned to one of three
groups (n=50 completers/ group): 1) high value financial incentives for COC abstinence in which frequency of
COC use is expected to be substantially reduced if not completely eliminated, 2) low value financial incentives
for COC abstinence in which frequency of COC use is expected to be reduced or 3) a non-contingent control
group, in which frequency of COC use is expected to remain stable. This study aims to demonstrate that
reduced COC use improves physiological and biochemical indicators of cardiovascular and immune fitness, as
well as psychosocial function. The overarching hypothesis is that individuals assigned to the active treatment
conditions will display improvements in biopsychosocial domains compared to individuals assigned to the noncontingent
control group. A “dose-response” is also expected whereby individuals assigned to the high value
condition will display greater reductions in COC use, and consequently greater improvements, relative to the
low value condition. Innovations of this research will advance the field by: 1) using multifaceted health
outcomes to provide prospective evidence supporting reduced drug use as a viable endpoint for COC
treatment development, 2) identifying biochemical indicators of health improvements associated with reduced
COC use and 3) laying the foundation for a paradigm-shifting definition of COC treatment success, thereby
challenging expectations for outcomes in behavioral and pharmacological intervention development. These
innovations will accelerate identification of promising treatments for cocaine use disorder, resulting in a
sustained and powerful impact on scientific and clinical practice.
Status | Finished |
---|---|
Effective start/end date | 9/1/17 → 11/30/24 |
Funding
- National Institute on Drug Abuse: $2,922,854.00
Fingerprint
Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint.