Overview
Using a randomized controlled trial (RCT), the goal of this study is to evaluate the ability of evidence based behavioral treatment (contingency management: CM) to significantly decrease alcohol use and cigarette smoking among treatment-seeking smokers with an alcohol use disorder (AUD) who have initiated pharmacotherapy (varenicline; VC) for smoking cessation.
Description
This randomized, placebo-controlled trial to determine the effectiveness of contingency management for reducing alcohol use and cigarette smoking among adults who want to quit or reduce their co-addiction. Contingency management is a powerful and cost-effective technique that has been used successfully for decades to promote abstinence from benzodiazepines, cocaine, tobacco, etc. Contingency management, and a non-contingent control condition will be used combined with varenicline (VC) and manualized counseling in the form of module videos.
Eligibility
Inclusion Criteria:
- 4 or more standard drinks on the same occasion for women (5 or more standard drinks on the same occasion for men) on at least 4 occasions in the prior 30 days
- Seeking AUD treatment
- Seeking smoking cessation treatment
- Aged 18+ years
- DSM-5 diagnosis of AUD
- Currently smoking daily according to PhenX Smoking Status (100 or more lifetime cigarettes plus current daily smoking)
- Ability to read and speak English
- Ability to provide written informed consent
- Breath alcohol of 0.00 during informed consent
- Provision of at least 1 EtG-positive urine test at any time during the induction period and at least one COT-positive urine test at any time during the induction period; and
- Attended at least 4 of 6 possible visits during the induction period.
Exclusion Criteria:
- Significant risk of dangerous alcohol withdrawal, defined as a history of alcohol detoxification or seizure in the last 12 months and expression of concern by the participant about dangerous withdrawal
- Currently receiving any pharmacotherapy for alcohol
- Currently receiving any pharmacotherapy for smoking
- No suicide attempt in the last 20 years and
- Any other medical (discernable by initial blood tests) or psychiatric condition that Drs. Layton or Rodin determine would compromise safe participation.