title: Contingency management for alcohol use reduction: a pilot study using a transdermal alcohol sensor.
abstract: BACKGROUND
  Contingency management (CM) has not been thoroughly evaluated as a treatment for alcohol abuse or dependence, in part because verification of alcohol use reduction requires frequent in-person breath tests. Transdermal alcohol sensors detect alcohol regularly throughout the day, providing remote monitoring and allowing for rapid reinforcement of reductions in use.
  
  
  METHODS
  The purpose of this study was to evaluate the efficacy of CM for reduction in alcohol use, using a transdermal alcohol sensor to provide a continuous measure of alcohol use. Participants were 13 heavy drinking adults who wore the Secure Continuous Remote Alcohol Monitoring (SCRAM) bracelet for three weeks and provided reports of alcohol and drug use using daily web-based surveys. In Week 1, participants were asked to drink as usual; in Weeks 2 and 3, they were reinforced on an escalating schedule with values ranging from $5 to $17 per day on days when alcohol use was not reported or detected by the SCRAM.
  
  
  RESULTS
  Self-reports of percent days abstinent and drinks per week, and transdermal measures of average and peak transdermal alcohol concentration and area under the curve declined significantly in Weeks 2-3. A nonsignificant but large effect size for reduction in days of tobacco use also was found. An adjustment to the SCRAM criteria for detecting alcohol use provided an accurate but less conservative method for use with non-mandated clients.
  
  
  CONCLUSIONS
  Results support the efficacy of CM for alcohol use reductions and the feasibility of using transdermal monitoring of alcohol use for clinical purposes.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI 02912, USA. Nancy_Barnett@brown.edu
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Barnett
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tidey
authors.forename: James G
authors.initials: JG
authors.lastname: Murphy
authors.forename: Robert
authors.initials: R
authors.lastname: Swift
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Colby
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D000437:Alcoholism / Q000628:therapy*; D001521:Behavior Therapy; D000431:Ethanol / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D057566:Self Report; D016896:Treatment Outcome
chemical_list: D000431:Ethanol