None listed
Conditions
Brief summary
In recent years, presentations to alcohol and other drug (AOD) treatment services by clients seeking treatment for problems with methamphetamine have increased dramatically in Australia. Withdrawal management (i.e. inpatient “detoxification”) is one of the most common treatments for people with severe methamphetamine use disorder (MUD). However, less than 20% of people who undergo withdrawal management remain abstinent from methamphetamine 3 months later. This highlights the need for brief, adjunctive treatments that can be delivered during inpatient withdrawal to help prevent relapse. “Approach bias modification” (ABM), a brief computerised cognitive training program designed to reduce impulsive tendencies to approach drug-related stimuli, has been shown to be effective for alcohol use disorders, but has not yet been trialed for methamphetamine. ABM involves repeated trials where patients respond to drug-related and neutral/healthy stimuli (e.g. pictures of alcoholic and non-alcoholic drinks, in the case of alcohol ABM) by “avoiding” drug-related stimuli and “approaching” other stimuli. Before executing costly randomised controlled trials applying ABM for MUD, it is important to establish whether it is acceptable (e.g., whether exposure to images of methamphetamine during ABM is well-tolerated or whether they are excessively triggering/distressing) and whether it is feasible in relevant treatment-settings, including inpatient withdrawal. The aim of the present study was to examine the feasibility and acceptability of ABM during inpatient withdrawal from methamphetamine. We predicted high rates of uptake and completion of training (demonstrating feasibility); and low rates of withdrawal, minimal triggering of cravings, and high ratings of the tasks’ acceptability from participants (demonstrating acceptability). Although this was a small, uncontrolled, open-label pilot study, we also examined rates of abstinence from methamphetamine at 2-week and 3-month follow-ups, expecting that it would compare favourably with those reported in multi-site treatment outcome studies of MUD patients undergoing inpatient withdrawal.
Interventions
We are testing an "approach bias modification" (ABM) training task. In this task, participants are exposed to 240 computerised images, including 40 images of methamphetamine and paraphernalia associated with its use and 40 different images of fruits and vegetables (each image repeated 3 times during the training) and instructed to respond with an approach or avoidance movement according to their orientation (landscape or portrait). While instructions are based on picture orientation, one orienta
We are testing an "approach bias modification" (ABM) training task. In this task, participants are exposed to 240 computerised images, including 40 images of methamphetamine and paraphernalia associated with its use and 40 different images of fruits and vegetables (each image repeated 3 times during the training) and instructed to respond with an approach or avoidance movement according to their orientation (landscape or portrait). While instructions are based on picture orientation, one orientation, which requires an avoidance movement (pushing of a joystick, which decreases image size), exclusively contains methamphetamine-related images. The other orientation, which require an approach movement (pulling the joystick, which increases image size), exclusively contains images of fruits and vegetables. The requirement to push away all of the methamphetamine-related images is intended to train participants to over-ride their pre-existing tendency to approach methamphetamine. Four sessions of this training are delivered to each participant, by a research assistant, on 4 consecutive days (i.e. 1 session per day), while participants are inpatients in an alcohol and other drug withdrawal unit (i.e. "detox"). Each session takes approximately 15 minutes. Since the intervention is an automated computer programme, fidelity on the part of the researcher delivering the intervention does not need to be assessed. However, if there are any interruptions that prevent a training session being completed as normal (e.g. a software or hardware malfunction during a session, or the participant feeling unable to complete all trials), the researcher conducting the session reports this to the study manager, and this is recorded along with other information about the participant.
Sponsors
Eastern Health
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Aged 18-65 2. Meets criteria for moderate or severe methamphetamine use disorder (i.e. at least 4 DSM-5 symptoms). 3. Report at least weekly use of methamphetamine in the month prior to admission to the withdrawal unit. 4. Able to understand English. 5. Able to provide a phone number for follow-up interviews.
Exclusion criteria
1. History of neurological illness or injury 2. History of traumatic brain injury involving loss of consciousness for longer than 30 minutes. 3. Diagnosis of intellectual disability. 4. Too acutely unwell to provide informed consent and/or safely participate, as judged by clinical staff.
Outcome results
None listed