Clinical trial NCT00368524: Cost Effective Treatment for Dually Diagnosed Homeless
Official title: Cost Effective Treatment for Dually Diagnosed Homeless
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cocaine Dependence
Mental Disorder
Homelessness
Unemployment
Keywords: cocaine dependence
mental disorder
dual diagnoses
homelessness
Lead sponsor: University of Alabama at Birmingham
Sponsor class: OTHER
First posted: 2006-08-24
Enrollment: 160
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This randomized controlled trial examined whether an abbreviated treatment using abstinence contingency management for housing and work/training (CM, n=103) with cocaine dependent, non-psychotic, dually diagnosed homeless persons, would show non-inferior outcomes compared to the full treatment (CM+, n=103). It was hypothesized that CM+ would show superior abstinence and retention outcomes, but that CM, with components derived from previously effective behavioral day treatment, would obtain non-inferior outcomes, defined as 75% or more of those observed for the full treatment (CM+) during active treatment months 1-6. The CM+ included all CM components but added behavioral day treatment that included voucher reinforcement of $7.50-15.00, for objective weekly therapeutic goal attainment in five domains of functioning: drug dependence, homelessness, unemployment, non-drug related recreational activities, and behavioral, health, or mental health problems. Abstinence was assessed by observed urine specimen collection and weekly testing weeks 1-52, and randomly, bi-monthly for months 13-18. Abstinence, homelessness, employment and other outcomes were also assessed at baseline, 2, 6, 12, and 18 months.


Eligibility criteria: Inclusion Criteria: McKinney Act criteria for homelessness; DSM IV diagnosis for Cocaine Dependence; self-reported use within the last 2 weeks; psychological distress indicated by score of 70 on 1 or more Brief Symptom Inventory scales; willingness to participate; no plans to move from Birmingham area for 18 months;

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Exclusion Criteria: cognitive impariment precluding informed consent; requiring immediate inpatient medical treatment

Primary outcomes:
measure: abused drug abstinence measured by observed urine specimen testing weeks 1-52, and bimonthly months 13-18
Secondary outcomes:
measure: abstinence, housing, employment and other outcomes at 0, 2, 6, 12 and 18 months.
Other outcomes:
Locations:
Study officials:
affiliation: University of Alabama at Birmingham
name: Jesse B. Milby, Ph.D. ABPP
role: PRINCIPAL_INVESTIGATOR
References:
citation: Milby JB, Schumacher JE, Wallace D, Freedman MJ, Vuchinich RE. To house or not to house: the effects of providing housing to homeless substance abusers in treatment. Am J Public Health. 2005 Jul;95(7):1259-65. doi: 10.2105/AJPH.2004.039743.
citation: Milby JB, Schumacher JE, Vuchinich RE, Freedman MJ, Kertesz S, Wallace D. Toward cost-effective initial care for substance-abusing homeless. J Subst Abuse Treat. 2008 Mar;34(2):180-91. doi: 10.1016/j.jsat.2007.03.003. Epub 2007 May 23.