RELEVANCE: Methamphetamine (MA) addiction is a global health problem with high prevalence and great social and health costs in the United States and in the Republic of South Africa and there is a strong need for development and implementation of effective MA treatment approaches.

DESCRIPTION: This study will enroll treatment-seeking, MA-dependent individuals into an 8-week contingency management (CM) program. At the beginning and end of the program, participants will participate in MRI scans while performing a working memory task and will complete a battery of select neurocognitive and psychological assays to address two specific aims: (1) to determine whether changes in neural function within frontostriatal circuitry (neural pathways that connect frontal lobe regions with the basal ganglia (striatum)) that mediate motor, cognitive, and behavioral functions within the brain from baseline to end of the 8-week CM program are associated with parallel changes in measures of cognitive control and impulsivity and with MA abstinence outcomes; (2) to determine whether structural changes in frontostriatal circuitry over the 8-week CM intervention correspond with neurocognitive, psychological and MA abstinence measures. Findings from this study will describe associations between functional and structural indices of brain areas that support working memory, cognitive control/inhibition; performance on select neurocognitive and psychological assessments; and associations between these with MA abstinence outcomes. Study activities and the neuroscience data generated will provide preliminary data for a larger, adequately powered study that will test ways to optimize behavioral therapies for treating stimulant use disorder.

OUTCOMES: While some data continues to be analyzed, we have successfully published three papers to date.

  1. Chukwuemeka N. Okafor, Dan J. Stein, Lisa Dannatt, Jonathan Ipser, Lara J. van Nunen, Marilyn T. Lake, Tamar Krishnamurti, Edythe D. London, Steve Shoptaw. Contingency management treatment for methamphetamine use disorder in South Africa. Drug and Alcohol Review. March 2020, 39, 216-222.
  2. Marilyn T. Lake, Steven Shoptaw, Jonathan C. Ipser, Sae Takada, Lara J. van Nunen, Gosia Lipinska, Dan J. Stein and Edythe D. London. Decision-Making by Patients With Methamphetamine Use Disorder Receiving Contingency Management Treatment: Magnitude and Frequency Effects. Psychiatry, 18 February 2020.
  3. Tamar Krishnamurtia, Kimberly Ling Murtaugh, Lara Van Nunen, Alexander L. Davis, Jonathan Ipser, Steven Shoptaw. Spending money to make change: Association of methamphetamine abstinence and voucher spending among contingency management pilot participants in South Africa. Journal of Substance Abuse Treatment. Volume 112, May 2020, Pages 60-67