A Randomized Controlled Trial of Ethyl Glucuronide-Based Contingency Management for Outpatients With Co-Occurring Alcohol Use Disorders and Serious Mental Illness

• DOI: 10.1176/appi.ajp.2016.16050627
• Publication Date: 2017-01-31T08:01:33Z
• Authors: Michael G. McDonell; Emily Leickly; Sterling McPherson; Jordan Skalisky; Debra Srebnik; Frank Angelo; Roger Vilardaga; Jenny R. Nepom; John M. Roll; Richard K. Ries
• Keywords: Ethyl glucuronide; Contingency management; Alcohol use disorder

Objective: The authors examined whether a contingency management intervention using the ethyl glucuronide (EtG) alcohol biomarker resulted in increased abstinence outpatients with co-occurring serious mental illnesses. Secondary objectives were to determine was associated changes heavy drinking, treatment attendance, drug use, cigarette smoking, psychiatric symptoms, and HIV-risk behavior. Method: Seventy-nine (37% female, 44% nonwhite) illness dependence receiving as usual completed 4-week observation period randomly assigned 12 weeks of for EtG-negative urine samples addiction or reinforcement only study participation. Contingency included variable magnitude "prize draw" procedure contingent on (<150 ng/mL) three times week weekly gift cards outpatient attendance. Urine EtG, test, self-report outcomes assessed during 12-week 3-month follow-up periods. Results: participants 3.1 (95% CI=2.2–4.5) more likely submit an test period, attaining nearly 1.5 additional compared controls. had significantly lower mean EtG levels, reported less drinking fewer episodes, stimulant-negative smoking-negative breath samples, Differences self-reported use maintained at follow-up. Conclusions: This is first randomized trial utilizing accurate validated demonstrate efficacy illness.