Contingency management for alcohol use disorder reduces cannabis use among American Indian and Alaska Native adults

Katherine A Hirchak; Abram J Lyons; Jalene L Herron; Gordon Kordas; Jennifer L Shaw; Kelley Jansen; Jaedon P Avey; Sterling M McPherson; Dennis Donovan; John Roll; Dedra Buchwald; Richard Ries; Michael G McDonell; HONOR Study Team

doi:10.1016/j.jsat.2021.108693

Contingency management for alcohol use disorder reduces cannabis use among American Indian and Alaska Native adults

J Subst Abuse Treat. 2022 Jun:137:108693. doi: 10.1016/j.jsat.2021.108693. Epub 2021 Dec 11.

Authors

Affiliations

¹ Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Program of Excellence in Addictions Research, Washington State University, Spokane, WA, USA.
² Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Program of Excellence in Addictions Research, Washington State University, Spokane, WA, USA; School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA.
³ Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, NM, USA; Department of Psychology, University of New Mexico, Albuquerque, NM, USA.
⁴ Southcentral Foundation, Anchorage, AK, USA.
⁵ Southcentral Foundation, Anchorage, AK, USA; Department of Psychology, University of Montana, Missoula, MT, USA.
⁶ Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Program of Excellence in Addictions Research, Washington State University, Spokane, WA, USA; Institute for Research and Education to Advance Community Health, Washington State University, Spokane, WA, USA.
⁷ Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
⁸ Program of Excellence in Addictions Research, Washington State University, Spokane, WA, USA.
⁹ Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Institute for Research and Education to Advance Community Health, Washington State University, Spokane, WA, USA.
¹⁰ Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
¹¹ Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Program of Excellence in Addictions Research, Washington State University, Spokane, WA, USA; Institute for Research and Education to Advance Community Health, Washington State University, Spokane, WA, USA. Electronic address: mmcdonell@wsu.edu.

Abstract

Objective: Determine whether a culturally tailored contingency management (CM) intervention targeting alcohol abstinence resulted in secondary effects on cannabis use among American Indian and Alaska Native (AI/AN) adults.

Methods: The research team conducted this secondary data analysis to examine cannabis abstinence using data from a randomized control trial of CM for alcohol use among three AI/AN-serving organizations. One hundred and fifty-eight adults met the randomization criteria (i.e., submission of 50% or more urine samples and one alcohol-positive urine test during a 4-week, pre-randomization, observation period). For 12 weeks after randomization, participants received incentives for submitting a urine test negative for ethyl glucuronide (EtG < 150 ng/mL, CM group) or incentives for submitting a urine sample regardless of abstinence (Non-contingent [NC] Control group). Generalized linear mixed effects models assessed group differences in cannabis abstinence during the intervention, verified by urine tetrahydrocannabinol negative tests (11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid <50 ng/mL).

Results: At baseline, 42.2% (n = 35) of participants in the NC group and 40.0% (n = 30) of those in the CM group had a cannabis positive urine test. An overall intervention by time interaction was detected for a cannabis negative urine test (χ² = 13.40, p = 0.001). Compared to the NC group, the CM group had 3.92 (95% CI:1.23-12.46) times higher odds of having a cannabis negative urine test during the intervention period and 5.13 (95% CI:1.57-16.76) times higher odds of having a negative cannabis test at the end of intervention period.

Conclusion: CM addressing alcohol misuse may be an effective strategy for decreasing cannabis use among AI/AN adults.

Trial registration: ClinicalTrials.gov number, Identifier: NCT02174315.

Keywords: American Indian and Alaska Native adults; Cannabis; Contingency management.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Adult
Alaska Natives*
Alcoholism*
American Indian or Alaska Native
Cannabis*
Dronabinol
Humans

Contingency management for alcohol use disorder reduces cannabis use among American Indian and Alaska Native adults

Authors

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Abstract

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Substances

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