Sterling McPherson

Dr McPherson is a Professor and Director at Washington State University Elson S. Floyd College of Medicine. He is the Lead Principal Investigator of the Analytics and Psychopharmacology Laboratory (APPL). His focus is on treatment development projects (e.g. Phase I/II trials) focused on alcohol, opioid, methamphetamine, and tobacco use disorders for pharmacological, behavioural, and technological-based investigations. He has published more than 130 peer-reviewed research articles in these domains. He is on the Editorial Boards of Experimental and Clinical Psychopharmacology, Drug and Alcohol Dependence Reports, Addiction, and is Associate Editor (Human Psychopharmacology) at American Journal of Drug and Alcohol Abuse.

Contingency management as a leverageable therapeutic for the treatment of cigarette smoking co-addiction among those with alcohol or stimulant use disorders

Background / Aims: Contingency management (CM) has demonstrated decades of evidence as a therapeutic for the treatment of addictions. Our aim was to investigate its therapeutic potential for the treatment of cigarette smoking co-addiction across studies among those with serious mental illness (SMI), and alcohol or stimulant use disorders.

Methods: Four CM studies conducted in the US (Washington and California) were included. This analysis included people who smoke cigarettes regularly at baseline among those with an alcohol use disorder and SMI (S1, n=54), stimulant use disorder and SMI (S2, n=126), methamphetamine use disorder (S3, n=61), and heavy drinkers (S4, n=34). Generalised estimating equations were used to examine the impact of CM, compared to the control conditions, on off-target cigarette smoking (i.e. smoking was not the target of CM) over time. Expired carbon monoxide (<3 ppm) or urinary cotinine (<100 ng/ml) samples were the primary outcomes in the logistic regression analyses.

Results: There was a significant off-target effect (p<0.05) of CM that resulted in increased negative cigarette smoking samples among people with SMI and an alcohol use disorder (S1, OR=5.39, 95%C.I.=1.93-15.00) people with SMI and a stimulant use disorder (S2, OR=1.79, 95%C.I.=1.34-2.39) methamphetamine use disorder (S3, OR=2.40, 95% C.I.=1.07-5.35) and heavy drinkers (S4, OR=37.55, 95%C.I.=4.86-290.17).

Conclusions: CM is an evidence-based therapeutic for the treatment of addiction with documented off-target, clinically meaningful effects that can be leveraged for cigarette smoking. While not to be considered a panacea for addiction, future studies should consider CM in combination with other treatments (e.g. pharmacotherapy) for smoking co-addiction.