UCLA Integrated Substance Abuse UCLA Integrated Substance Abuse Programs (ISAP)Programs (ISAP)

CSAT MTP Project Goals:CSAT MTP Project Goals: To study the clinical effectiveness of the To study the clinical effectiveness of the

Matrix ModelMatrix Model To compare the effectiveness of the To compare the effectiveness of the

Matrix model to other locally available Matrix model to other locally available outpatient treatmentsoutpatient treatments

To establish the cost and cost To establish the cost and cost effectiveness of the Matrix model effectiveness of the Matrix model compared to other outpatient treatmentscompared to other outpatient treatments

To explore the replicability of the Matrix To explore the replicability of the Matrix model and challenges involved in model and challenges involved in technology transfertechnology transfer

Matrix Model vs TAUMatrix Model vs TAURawson et al., 2004, AddictionRawson et al., 2004, Addiction

978 Methamphetamine users seeking 978 Methamphetamine users seeking treatment treatment

CSAT multi-site study; 1998-2002CSAT multi-site study; 1998-2002 Costa Mesa; San Diego; Hayward; Concord; Costa Mesa; San Diego; Hayward; Concord; San Mateo; Billings; HonoluluSan Mateo; Billings; Honolulu

Matrix Model vs Treatment as UsualMatrix Model vs Treatment as Usual Random assignmentRandom assignment

Inclusion CriteriaInclusion Criteria

Males or females, 18 years of age or older.Males or females, 18 years of age or older. Must meet DSM-IV criteria for Must meet DSM-IV criteria for

methamphetamine dependence methamphetamine dependence Willing to complete study forms and Willing to complete study forms and

provide urine samples. provide urine samples. Able to understand and complete rating Able to understand and complete rating

scales and follow instructions (with or scales and follow instructions (with or without assistance). without assistance).

Inclusion CriteriaInclusion Criteria

Able to understand and sign an Able to understand and sign an informed consent (with or without informed consent (with or without assistance). assistance).

Have the ability to understand the Have the ability to understand the English language, as well as the ability English language, as well as the ability to participate in treatment and to participate in treatment and understand treatment materials (with understand treatment materials (with or without assistance). or without assistance).

Exclusion CriteriaExclusion Criteria

Current medical or psychiatric condition Current medical or psychiatric condition causing a degree of impairment or instability causing a degree of impairment or instability such that it would interfere with program such that it would interfere with program participation and functioning and/or would participation and functioning and/or would preclude the primary treatment focus on the preclude the primary treatment focus on the problem of methamphetamine dependenceproblem of methamphetamine dependence

Candidates who meet DSM-IV criteria for Candidates who meet DSM-IV criteria for

dependence to opioids, alcohol, dependence to opioids, alcohol, benzodiazepines or other sedative/hypnotics benzodiazepines or other sedative/hypnotics and who will require detoxification and who will require detoxification

Exclusion CriteriaExclusion Criteria

Candidates who have not used Candidates who have not used methamphetamine within 30 days prior to the methamphetamine within 30 days prior to the study participation (participation begins one study participation (participation begins one week prior to randomization), unless they week prior to randomization), unless they were in a controlled environment (i.e. jail). were in a controlled environment (i.e. jail).

Candidates who have participated in any Candidates who have participated in any other chemical dependency treatment other chemical dependency treatment (inpatient rehab; therapeutic community; (inpatient rehab; therapeutic community; sober living facility; structured outpatient sober living facility; structured outpatient program) within 30 days of study participation program) within 30 days of study participation for an episode of seven days or longer. for an episode of seven days or longer.

Exclusion CriteriaExclusion Criteria

Candidates who are currently Candidates who are currently involved in a clinical research involved in a clinical research treatment project treatment project

Candidates with any medical, legal, Candidates with any medical, legal, housing, or transportation problem housing, or transportation problem which would preclude either safe or which would preclude either safe or consistent participation consistent participation

TAUTAU Steering committee decided between:Steering committee decided between:

Standard TAU for all sitesStandard TAU for all sites TAU for each site based on actual TAU for each site based on actual

practicepractice 8 TAUs resulted in:8 TAUs resulted in:

More relevance to sitesMore relevance to sites More variabilityMore variability 8 studies8 studies

TAUs represented best available TAUs represented best available option vs minimal contact comparisonoption vs minimal contact comparison

Overview of TAUsOverview of TAUsDuration

of Treatmen

t Intensive

Phase

Individual Sessions

Group Sessions

12-Step Program

Involvement

Site 1Site 1 8 weeks8 weeks 1x/wk 4-8 wks

30-50 minutes

4x/wk4-8 wks3 hrs

Families1x/wk

required; 1x/wk

4-8 wks

Site 2Site 2 12 weeks12 weeks 1x/wk12 wks

1 hr each

5x/wk x 2wk,

3x/wk x 2wks,

2x/wk x 8 wks

RecommenRecommendedded

Site 3Site 3 12 weeks12 weeks 1x/wk12 wks

1 hr each

NoneNone RecommenRecommendedded

Duration of

Treatment

Intensive Phase

Individual Sessions

Group Sessions

12-Step Program

Involvement

Site 4Site 4 16 weeks16 weeks 1x/wk 16 wks

10-15 min

3x/wk 16 wks

1 hr

required; 3x/wk16 wks

Site 5Site 5 12 weeks12 weeks 1x/wk 12 wks

30-60 min

3x/wk x 12wks2x/wk x 12wks90 min

60-90 min60-90 min

required; 1x/wk12 wks

Site 6Site 6 12 weeks12 weeks 1x/wk--2x/mo

12 wks 1 hr

2x/wk 12wks90 min

60-90 min60-90 min

RecommenRecommendedded

Overview of TAUsOverview of TAUs

Duration of

Treatment

Intensive Phase

Individual Sessions

Group Sessions

12-Step Program

Involvement

Site 7Site 7 16 weeks16 weeks 1x/wk 16 wks

1 hr each

2x/wk16 wks2 hrs

RecommenRecommendedded

Site 8Site 8 12 weeks12 weeks 2x/wk12 wks

1 hr each

1x/wk12 wks2 hrs

RequiredRequired

6 meetings6 meetings

Overview of TAUsOverview of TAUs

Baseline DemographicsBaseline Demographics

AgeAge MaleMale EducationEducation Meth useMeth use Marijuana useMarijuana use Alcohol useAlcohol use

32.8 years32.8 years

55%55%

12.2 years12.2 years

7.5 years7.5 years

7.2 years7.2 years

7.6 years7.6 years

Ethnic Identification of Participants

60

2 3

17 18

0

10

20

30

40

50

60

Ethnic Identification

Perc

ent

caucasianafrican amernative amerasian/ pac islhispanic

Route of Methamphetamine UseRoute of Methamphetamine Use

24%

11%

64%

0%

10%

20%

30%

40%

50%

60%

70%

Route of Administration

Per

cent

Usi

ng b

y R

oute

nasalsmokeiv

Weeks in TreatmentWeeks in Treatment

5

8.2

0

1

2

3

4

5

6

7

8

9

Matrix TAU

Wee

ks

**

Weeks Continuous AbstinenceWeeks Continuous Abstinence

3

6

0

1

2

3

4

5

6

7

Matrix TAU

Wee

ks

**

Mean Number of UA’s that Mean Number of UA’s that werewere

MA-free during treatmentMA-free during treatment

0

2

4

6

8

10 MatrixTAU

Mean Number of Weeks in Treatment

02468

1012

SITE

mea

n nu

mbe

r of

vis

its MatrixTAU

11.3

4.3 4.4

0

2

4

6

8

10

12

Matrix

Day

s

Baseline

Discharge

6-month FU

Self-report of MA use during the past 30 daysat baseline, discharge, and 6-month follow-up.

Urine Results: % Meth-Urine Results: % Meth-freefree

66% 65%69% 67%

59%55%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Matrix TAU

% m

eth-

free

Discharge6 months12 months

Urine Results: % Meth-Urine Results: % Meth-freefree

66%69%

59%

25%30%35%40%45%50%

55%60%65%70%75%

Matrix

% m

eth-

free

Discharge6 months12 months