Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluating the Efficacy of Including Contingency Management to Standard Ambulatory Treatment for Crack Addiction - A Randomized Controlled Trial
Brief Summary: Crack addiction has become a severe health problem in Brazil. Today, crack addiction is the primary cause for inpatient treatment for all illicit substances. When compared to cocaine, crack users develop much faster diagnoses for crack dependence, shows a more compulsive pattern of use, has higher probability of living or have lived in the streets, and of engaging in illegal activities. Consequently to this, mortality of crack addicts is 7 times higher than for the rest of the population.

Despite all efforts being made for the development of effective pharmacological treatments for stimulant addiction (crack included), up to today, there is no robust evidence of efficacy of any pharmacological treatment. For that reason, the use of evidence based psychosocial interventions is so important for treating this population.

Although today open treatment facilities in Brazil are more and more starting to use evidence-based interventions such as motivational interviewing, cognitive behavior therapy, relapse prevention and coping skills, such treatments present very modest results when treating crack addiction. The biggest difficulties encountered when treating this population are maintaining patients in treatment, reducing crack use and achieving continued abstinence.

A psychosocial treatment based in behavioral principals' named Contingency Management (CM) is widely applied in the USA. Recent meta-analyses and review studies present robust evidence that, when applied alone or in adjunction with other psychosocial and pharmacological treatment, CM is the most effective treatment for what regards, treatment retention, reducing drug use and promoting continued abstinence.

The purpose of this study is to evaluate if Contingence Management (CM) can be affective in the treatment of crack addiction in Brazil. To accomplish this, 60 individuals (male and female from 18 to 65 years of age) seeking open treatment for crack addiction will be randomized to 2 treatment conditions (Standard treatment (ST) or ST+CM. Both treatments will last 12 weeks with 3 and 6-month follow-up. In both groups patients will be encourage to leave urine samples 3 times week.

Hypotheses: Patients receiving ST+CM will stay longer in treatment, have more negative tests for cocaine/crack, and achieve longer periods of cocaine/crack abstinence when compared to patients receiving ST alone.


Options:
A: Inclusion Criteria:

1. diagnosed MA dependence in accordance with the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (Association, 2000);
2. more than 9 years of education;
3. aged of 18-60 years old;
4. normal vision, audition and no color blindness;
5. receive no detoxification medications during treatment and
6. right handedness.

Exclusion Criteria:

1. current medical diseases that required hospitalization or regular monitoring;
2. serious physical or neurological illness that required pharmacological treatment affecting cognitive function;
3. history of major psychiatric disorder such as bipolar disorder, schizophrenia, depression and disorders of high comorbidity with substance abuse/dependence;
4. neurological diseases such as stroke, seizure, migraine, head trauma
5. substance dependence other than nicotine, within the past 5 years;
6. intelligence quotient (IQ) \<70.
B: Inclusion Criteria:

* Current diagnose of crack addiction (DSM IV)
* having used crack in the last month

Exclusion Criteria:

* Current psychotic disorder
* Diagnose of schizophrenia
C: Inclusion Criteria:

* Over age 18
* Reported sexual activity in the prior 4 months
* Recent cocaine, heroin or amphetamine use
* Reported living in the St. Louis metropolitan area

Exclusion Criteria:

* Under age 18
* No sexual activity in the prior 4 months
* No recent use of cocaine, heroin or amphetamines
* Resides outside the St. Louis metropolitan area
D: Inclusion Criteria:

* report heroin use

Exclusion Criteria:

* report current suicidal or homicidal ideation;
* have a severe psychiatric disorder

Answer: B