Clinical trial NCT01841892: The Therapeutic Workplace Intervention in Community Settings
Official title: The Therapeutic Workplace Intervention in Community Settings
Study type: INTERVENTIONAL
Overall status: WITHDRAWN
Phase: NA
Conditions: Drug Abuse
Alcohol Abuse
Lead sponsor: University of Maryland, Baltimore County
Sponsor class: OTHER
Collaborators: name: Johns Hopkins University
First posted: 2013-04-29
Enrollment: 0
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Methadone is effective for heroin addiction, but many methadone patients continue to use cocaine. High magnitude and long-duration voucher-based abstinence reinforcement, in which participants receive vouchers exchangeable for goods and services contingent on providing drug-free biological samples, is one of the most effective treatments for drug addiction and can maintain cocaine abstinence over extended periods of time. Our research on a model Therapeutic Workplace has shown that employment-based abstinence reinforcement, in which participants must provide drug-free urine samples to access the workplace and maintain maximum pay, can maintain cocaine abstinence and reduce drug-related HIV risk behaviors over extended time periods. Our next challenge is to disseminate employment-based reinforcement for the treatment of drug addiction. The investigators propose to develop, manualize, and pilot test a community-friendly Therapeutic Workplace intervention that can be implemented widely throughout the US and elsewhere. Methadone patients who use injection or crack cocaine during methadone treatment will be invited to participate (N = 58) and randomly assigned to one of two groups: Usual Care (control) group or Community Therapeutic Workplace group. As in our prior implementations of the Therapeutic Workplace intervention, Community Therapeutic Workplace participants will enroll in Phase 1 to initiate drug abstinence and acquire job skills. Participants who initiate abstinence and acquire job skills in Phase 1 will be hired into community workplaces with collaborating employers in Phase 2. During Phase 2, employment-based abstinence reinforcement contingencies will be implemented using procedures for workplace drug and alcohol testing overseen by the US Department of Transportation. Using this system, a national provider of Drug-Free Workplace Services will arrange random drug testing and employment-based abstinence reinforcement contingencies in which employees will be required to remain drug-free to maintain employment. The investigators hypothesize that participants in the Community Therapeutic Workplace group will provide more drug-free samples, and engage in fewer HIV-risk behaviors than participants in the Usual Care group. The study will provide vital information on the acceptability of the intervention to participants and employers, and provide preliminary data on the effectiveness of the investigators procedures to maintain abstinence and promote employment.


Eligibility criteria: Inclusion Criteria:

* ≥18 years old
* enrolled in methadone treatment in Baltimore
* unemployed
* provide a cocaine-positive urine sample at intake
* meet DSM IV criteria for cocaine dependence
* report using injection or crack cocaine

Exclusion Criteria:

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

Primary outcomes:
measure: Abstinence from alcohol, cocaine, opiates, marijuana, PCP, and amphetamine
timeFrame: Once per month for first 10 study months
Secondary outcomes:
measure: HIV Risk Behavior
timeFrame: Once per month for first 10 study months, and once at 6 months follow-up after discharge
measure: Rates of community employment
timeFrame: Once per month for study months 5-10, and once at 6 months follow-up after discharge
Other outcomes:
measure: Adherence of community employers with Phase 2 procedures
timeFrame: Weekly throughout study months 5-10
measure: Acceptability of intervention to participants and employers
timeFrame: Weekly throughout study months 5-10
Locations:
city: Baltimore
country: United States
facility: Center for Learning and Health, Johns Hopkins University School of Medicince, Department of Psychiatry and Behavioral Sciences
state: Maryland
Study officials:
affiliation: University of Maryland, Baltimore County
name: Sigurdur O Sigurdsson, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: