N/A
N=45
Neurocognitive Factors in Substance Use Treatment Response: The Ways of Rewarding Abstinence Project
Cocaine Use Disorder
Bottom Line
View on ClinicalTrials.gov: NCT03799341 ↗Enrolled (actual)
45
Serious AEs
24.4%
Results posted
Sep 2025
Primary outcome: Primary: % Cocaine-Negative Urine Specimens Per Participant — 42.2; 59.1; 51.0 % negative specimens per participant — p=0.177
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Prize-Based Contingency Management (Behavioral); Treatment As Usual Outpatient Substance Use Treatment (Behavioral)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Oct 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY % Cocaine-Negative Urine Specimens Per Participant |
42.2; 59.1; 51.0 | 0.177 |
| PRIMARY Longest Duration of Cocaine Abstinence (LDCA) |
21.36; 34.95; 11.00 | 0.033 sig |
| SECONDARY % Contingency Management (CM) Sessions Attended Per Participant (CM Groups Only) |
51.7; 68.0 | 0.126 |
| SECONDARY Total Non-CM Treatment Encounters Per Participant |
10.7; 12.5; 20.0 | 0.384 |
| SECONDARY % Self-Reported Cocaine-Abstinent Days During Treatment |
86.0; 86.8; 81.7 | 0.308 |
| SECONDARY % Self-Reported Drug- and Alcohol-Abstinent Days During Treatment |
72.6; 65.3; 56.4 | 0.976 |
| SECONDARY % Self-Reported Stimulant-Abstinent Days at Post-Treatment (CM Groups Only) |
86.1; 92.1 | 0.920 |
| SECONDARY % Self-Reported Drug- and Alcohol-Abstinent Days at Post-Treatment (CM Groups Only) |
70.9; 72.7 | 0.873 |
Summary
The proposed work will investigate changes in brain signaling and cognitive functioning that support recovery from addiction, as well as use of pretreatment neurocognitive functioning to inform substance use treatment planning. Substance use disorders are prevalent amongst Veterans. Cocaine addiction, in particular, has been shown to complicate treatment of other high priority behavioral health problems in the Veteran population (e.g., PTSD, opioid addiction). While there are currently no approved medications to support recovery from cocaine addiction, research indicates that Contingency Management (CM) - a behavioral intervention for cocaine users - can be effective. However, individual responses are variable and long-term benefits are limited. This CDA will test a new model of how CM works by examining brain-based predictors and indicators of treatment response. Results will have immediate implications for measurement-based implementation of existing CM variants within the VA, supporting access to the version of CM that is best aligned with each Veteran's needs.
Eligibility Criteria
Inclusion Criteria
- Military Veterans
- DSM-5 Criteria for Cocaine Use Disorder (Mild, Moderate, or Severe)
- Cocaine Use Within Past 60 Days
- Stated Goal of Cocaine Abstinence or Reduced Cocaine Use
- Normal or Corrected-to-Normal Vision
- Average or Corrected Hearing
Exclusion Criteria
- History of Severe Traumatic Brain Injury, Seizure Disorder, or other Neurological Illness
- Severe or Unstable Medical or Psychiatric Condition
- Pregnant or Lactating Women
- Moderate-to-Severe Neurocognitive Impairment per Medical Record, SLUMS < 21, or Mini MoCA < 11
- In Ongoing Residential Treatment or Imminently Expected to Enter Residential Treatment During the Study Interval at Time of Screening
Data sourced from ClinicalTrials.gov (NCT03799341). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.