CO-OCCURRING DISORDERS

Up to 46 percent of adults with serious mental illnesses, such as schizophrenia, bipolar and depressive disorders, experience an alcohol use disorder in their lifetime, contributing to high rates of homelessness, psychiatric hospitalizations, HIV infection, cigarette smoking, and drug use. These public health concerns call for health interventions that help people cut down or stop drinking alcohol.

In our previous studies we found that contingency management, an intervention in which small incentives are provided to people who demonstrate evidence of drug or alcohol dependence, is an effective intervention for adults with serious mental illnesses. However, in our last study we found that those who had more severe alcohol problems, as measured by a urine test, ethyl glucuronide, didn’t respond to the contingency management intervention. Therefore, the primary purpose of this project is to determine whether modifications to contingency management, including increasing the amount of rewards for abstinence or rewarding people for reducing their use, prior to requiring abstinence, are effective for people who are heavy drinkers and are also living with serious mental illnesses. In this project we will also investigate factors that predict positive outcomes and conduct a comprehensive economic evaluation.