Patients with diabetes respond well to contingency management treatment targeting alcohol and substance use

Abstract

Alcohol and drug use contribute to the pathogenesis of diabetes and are associated with adverse health outcomes, but little research exists on treatments for substance use disorders (SUDs) in patients with diabetes. The aim of this study was to evaluate contingency management (CM) treatments targeting substance use in patients with diabetes. A secondary analysis evaluated the main and interactive effects of diabetes status and treatment condition on outcomes of 681 substance abusers. All participants were enrolled in randomized clinical trials comparing CM to standard care (SC). Overall, CM treatment improved outcomes. There was also a significant treatment condition X diabetes status interaction effect in terms of duration of abstinence achieved and proportion of negative samples submitted; patients with diabetes responded even more favorably than their counterparts without diabetes when receiving CM. Analyses of post-treatment effects revealed that patients with diabetes, regardless of the type of SUD treatment to which they were earlier assigned, were more likely than those without diabetes to be abstinent at the nine-month follow-up. The findings suggest CM may be an effective treatment for this vulnerable subgroup of substance-abusing patients.

Keywords:

• substance abuse treatment
• contingency management
• diabetes
• alcohol
• cocaine

Additional information

Funding

This study and preparation of this report were supported in part by National Institutes of Health [grant number P30-DA023918], [grant number R01-DA027615], [grant number P50-DA09241], [grant number P60-AA03510], [grant number R01-HD075630], [grant number T32-AA07290], [grant number DP3-DK097705], [grant number M01-RR06192].