CM Treatment for Alcohol Dependence Using New Technology

Contingency management (CM) is highly efficacious for reducing substance use, and recent data
suggest that reinforcing attendance at treatment can significantly improve treatment
outcomes. Importantly, CM interventions that reinforce attendance are more likely to be
adopted clinically than those that reinforce abstinence. Having objective indicators of
drinking outcomes, nevertheless, is critical for quantifying the benefits of attendance-based
CM treatment in alcohol abusing populations. New technology is now available to gauge alcohol
use in patients' natural environments. The Secure Continuous Remote Alcohol Monitor (SCRAMx®)
continuously monitors alcohol consumption 24 hours a day. As such, it may be ideal for
objective evaluation of alcohol consumption during treatment intervention studies, including
those that involve CM.

In this study, 114 patients participating in community based outpatient treatment programs
for alcohol use disorders will wear SCRAMx for a 12-week period. They will be randomized to
standard care or standard care plus CM, with reinforcement contingent upon attendance at
treatment. The investigators will assess treatment attendance and alcohol use via SCRAMx and
self reports. The investigators expect that patients randomized to the CM intervention will
remain in treatment longer and show reductions in both SCRAMx assessed and self reported
drinking days relative to those randomized to standard care.