Optimizing Mobile App Incentives to Support Abstinence in Adults with Opioid, Cocaine, or Methamphetamine Use Disorders

What this Trial Is About

This research aims to evaluate the effectiveness of different financial incentive schedules delivered via a mobile app to encourage abstinence from opioid and cocaine use. It addresses the rising drug overdose crisis in the U.S., focusing on substance use disorders including opioid-use disorder, cocaine use disorder, and methamphetamine abuse. Incentive programs have shown promise in improving abstinence, but scaling them has been limited by logistical challenges, which this study seeks to overcome with a novel mobile solution. Participants will use the DynamiCare app, which remotely monitors drug use through saliva tests verified by selfie videos and tracks treatment adherence. The study compares multiple incentive schedules escalating incentives that increase with success, de-escalating incentives that decrease with success, constant incentives, and a control group with no incentives. Incentive amounts vary by group and are delivered rapidly as cash to a linked debit card, aiming to maximize motivation and ease of access. During the study, participants submit saliva drug tests via the app and receive incentives accordingly. Researchers will assess outcomes such as the percentage of negative drug tests and app acceptability at 3 and 12 months. Additional measures include psychotherapy attendance, relapse rates, and treatment retention. The study involves randomized group assignment and continuous monitoring of abstinence behaviors, with the goal of informing optimal incentive designs for substance use disorder treatment.

Encouraging Abstinence Behavior in a Drug Epidemic: Optimizing Dynamic Incentives