Please select the eligibility criteria that correspond to the clinical trial below.
Title: Therapeutic Workplace Maintenance Study
Brief Summary: This application is a competing continuation of a grant in which we developed and pilot tested a computerized Therapeutic Workplace designed to train and employ adults as data entry operators. A randomized trial is planned over 5 years to investigate the Therapeutic Workplace business as a maintenance intervention to sustain long-term abstinence and employment. Welfare recipients in methadone treatment, actively using cocaine, and at risk for contracting or spreading HIV infection will participate in an initial Therapeutic Workplace training phase. Participants who become abstinent and skilled will be randomly assigned to an Abstinence \& Employment, or an Employment Only group. Participants in the Abstinence \& Employment group will be employed for one year in a Therapeutic Workplace business and will have to provide drug-free urine samples to work and earn salary. Employment Only participants will be offered employment for one year, but these participants will not have to provide drug-free urine samples to work. This study will provide a rigorous evaluation of the efficacy of the Therapeutic Workplace business as a long-term treatment of cocaine addiction and unemployment; determine the benefits of requiring daily evidence of abstinence to work; and provide information on the extent to which a Therapeutic Workplace business can become self-sustaining. This research could provide firm scientific foundation for the dissemination of Therapeutic Workplace businesses in the long-term treatment of cocaine addiction and unemployment. The main hypothesis being tested is that cocaine abstinence will be reliably maintained during the yearlong intervention evaluation period only in the group exposed to the explicit abstinence maintenance intervention. We expect that cocaine abstinence in the Abstinence and Employment group will be significantly greater than cocaine abstinence in the Employment Only group.


Options:
A: Inclusion Criteria:

* Applicants in methadone treatment may be eligible to participate in Phase 1 of the study.
* Applicants will be blind to the full details of the eligibility criteria.
* Unemployed
* Provided a urine sample at intake with a detectable concentration of cocaine metabolite or provided a cocaine positive sample during regular urinalysis testing at a methadone maintenance program
* Met DSM-IV criteria for cocaine dependence
* Were receiving welfare benefits in Baltimore, MD
* Received a score of less than or equal to 80% correct on a reading assessment

Exclusion Criteria

* Being at imminent risk for suicide
* Reported hallucinations
* Being incarcerated or otherwise under constant monitoring
* Earned less than or equal to $200 in unreported taxable income from legal activity in the previous month
* Having physical limitations that prevented typing
B: 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
C: Inclusion Criteria:

* Enrolled patient at Community Psychiatric Clinic (CPC), a large mental health center in urban Seattle, Washington;
* Between 18 and 65 years of age;
* Diagnosis of of methamphetamine, amphetamine(illegal), or cocaine dependence or abuse;
* CPC medical record diagnosis of schizophrenia, schizoaffective disorder, bipolar I or II, or recurrent major depressive disorder
* Stimulant drug use one month before enrollment;
* Ability to understand written and spoken English;
* CPC clinical case manager must affirm the potential participant's ability to provide informed consent and clinical appropriateness (i.e., safety/severity of mental/substance/ physical health) to participate in the study.

Exclusion Criteria:

* Any medical/psychiatric condition, or severity of that condition, that, in the opinion of Dr. Ries, the PI, would compromise safe study participation
* Chart defined organic brain disorder or dementia;
* Current participation in a methadone maintenance program;
* Any other circumstances that in the PI's opinion precludes safe study participation.
D: Inclusion Criteria:

* age 18 years or older
* meet DSM-IV criteria for cocaine abuse or dependence
* English speaking
* pass a brief quiz regarding study procedures to ensure understanding of the informed consent process.

Exclusion Criteria:

* dementia
* in recovery from pathological gambling

Answer: A