Contingency Management for Meth in South Africa Methamphetamine Abuse in South Africa

Study Overview
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Brief Summary
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This study will link findings from neuroscience with clinical outcomes using contingency management (CM) to identify changes in brain structure and function that emerge during purely behavioral therapy for methamphetamine (MA) use.

Detailed Description
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This study will correlate MA-abstinence outcomes from an 8-week program of voucher-based incentives using an escalating schedule for 30 treatment-seeking, MA-dependent individuals with scores on tasks of working memory and assessments of neuropsychological and demographic status. At the beginning and end of the CM program, participants will participate in MRI scans while performing a working memory task and will complete a battery of select neurocognitive and psychological assays to address two specific aims: (1) to determine whether changes in neural function within frontostriatal circuitry from baseline to end of the 8-week CM program are associated with parallel changes in measures of cognitive control and impulsivity and with MA abstinence outcomes and (2) to determine whether structural changes in frontostriatal circuitry over the 8-week CM intervention correspond with neurocognitive, psychological and MA abstinence measures.

Official Title
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Combating Craving With Contingency Management: Neuroplasticity and Methamphetamine Abuse in South Africa

Conditions
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Methamphetamine Abuse

Intervention / Treatment
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* Behavioral: Contingency Management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: provide voluntary informed consent meet DSM-5 criteria for MA or amphetamine use disorder provide at least one urine sample positive for MA/amphetamine metabolites during screening (i.e. prior to the commencement of the study). aged 18-45 right-handed English-speaking Exclusion Criteria: currently receiving treatment for stimulant addiction or needing more intensive treatment than outpatient care meet DSM-5 criteria for substance use disorder other than nicotine unable to attend 4+ visits during the 2-week screening period or to complete measures Physical or mental illness that would require intervention that would alter imaging or that would interfere with safe study participation pregnant, claustrophobic, or have metal prostheses, cardiac pacemakers, or metal clips that are incompatible with the scanner HIV positive status unable to comprehend written or spoken English currently taking psychiatric medication

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Contingency Management<br>In exchange for consecutive urine samples documenting methamphetamine abstinence, participants receive increasingly valuable reinforcers. | Behavioral: Contingency Management<br>* as described above<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Responses to Contingency Management | urine samples documenting methamphetamine abstinence | 8 weeks | 
| fMRI Measures | measures of resting state connectivity | Change b/w baseline and 8 Weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stop Signal Task | measure of inhibitory control | Change b/w baseline and 8 Weeks | 
| Continuous Performance Task | test of sustained attention | Change b/w baseline and 8 Weeks | 
| Stroop | test of inhibitory control | Change b/w baseline and 8 Weeks | 
| Balloon Analog Risk Task | measure of risk taking and decision making | Change b/w baseline and 8 Weeks |