Financially Sustainable Remote Treatment for Alcohol Abuse: Feasibility

Directly reinforcing abstinence from alcohol with monetary incentives is an effective treatment for alcohol dependence, but barriers in obtaining frequent, verified biochemical measures of abstinence limit the dissemination of this treatment approach. The goal of this feasibility study is to use a breathalyzer and cost-controlling deposit contracts to facilitate a contingency-management intervention to reduce alcohol use that requires no in-person contact between the participants and the study staff during the intervention phase.

The Contingent group will receive nearly immediate monetary payments over the internet each day they remotely provide negative breathalyzer samples, but will not receive the payments if they provide positive samples or fail to provide samples in a timely manner.

The Noncontingent group will receive payments each day they successfully provide samples independent of the alcohol content of those samples.

Monetary incentives are delivered to participants contingent upon on- time breathalyzer submissions and verified abstinence from alcohol.

Monetary incentives are delivered to participants contingent upon on- time breathalyzer submissions only with no contingency on alcohol use.

Three breathalyzer assessments will be collected per day during the treatment period. This outcome measure will consist of the percent days when all three breathalyzers were on time and negative for alcohol.

Inclusion Criteria: At least 18 years old Provide written informed consent Meet Diagnostic and Statistical Manual criteria for alcohol use disorder Express a desire to cut down or quit drinking Be willing to pay a $75 deposit toward their incentive fund Exclusion Criteria: Pregnant or lactating Meet Diagnostic and Statistical Manual criteria for other substance use disorder (except caffeine or nicotine) Score 23 or greater on the Alcohol Withdrawal Symptom Checklist Have immediate plans to move out of the area

Final research data for this project will be made as available as possible, while safeguarding the privacy of participants and protecting all confidential and proprietary data. Data will be available for use after the main findings from the final dataset have been accepted for publication. The data and associated documentation will only be made available to users under a Data Use Agreement that provides for 1) a commitment to using the data only for research purposes and not to identify any individual participant and 2) a commitment to destroying or returning the data after analyses are completed. To ensure compliance with HIPAA regulations, only a Limited Data Set will be available for use. The method of data release will be determined on a case-by-case basis depending upon the amount and type of data required.

Koffarnus MN, Kablinger AS, Kaplan BA, Crill EM. Remotely administered incentive-based treatment for alcohol use disorder with participant-funded incentives is effective but less accessible to low-income participants. Exp Clin Psychopharmacol. 2021 Oct;29(5):555-565. doi: 10.1037/pha0000503. Epub 2021 Jun 10.