Therapy Improves Outlook for Meth Abusers

New research suggests that offering methamphetamine abusers a behavioral therapy program called contingency management (CM — also known as Motivational Incentives) along with their usual care is more effective than the usual care alone.

Previous studies have shown the effectiveness of CM as a treatment for stimulant abuse (primarily cocaine). A team led by Dr. John Roll of Washington State University set out to see whether CM could help methamphetamine abusers. Their study was supported by NIH’s National Institute on Drug Abuse (NIDA) and conducted through NIDA’s National Drug Abuse Clinical Trials Network, an infrastructure that tests the effectiveness of interventions in community-based treatment settings.

CM applies rules and consequences to help people change their behavior. In this case, the rules required production of drug-free urine samples. The rewards were plastic chips that could be exchanged for prizes. The more the patients followed the rules, the more chips they earned. If they didn’t follow the rules, they lost chips. All 113 participants underwent usual care and were randomized to receive either additional CM treatment or no additional treatment.

In the November 2006 issue of the American Journal of Psychiatry, the researchers report that participants who received CM in addition to treatment as usual submitted significantly more substance-free urine samples than participants who received only usual treatment during the 12-week study. Participants who were part of the CM program reported being continuously abstinent for an average of almost five weeks, while those who received the usual treatment were continuously abstinent an average of less than three.

Usual treatment was not the same at all the clinics, but at the one with the largest proportion of participants, usual care consisted of the Matrix Model of psychosocial treatment. The Matrix Model is a comprehensive treatment approach including individual counseling, cognitive behavioral therapy, family education, self-help programs and monitoring for drug use by urine testing. It’s currently thought to be the most effective therapy for methamphetamine addiction.

While this study was fairly small, it suggests that combining CM with the Matrix Model would give doctors an even more powerful weapon against methamphetamine abuse.