Headline
Prize-based contingency management in community-based substance use treatment clinics improved retention, attendance, and abstinence in individuals with stimulant use.
Background
Contingency management is a behavioral therapy that uses positive reinforcements to promote desired actions in people with substance use disorder (SUD). There are two common approaches to contingency management: (1) a voucher-based approach that involves giving vouchers that can be traded for goods or services; and (2) a prize-based approach that involves awarding items of varying value and incorporates an element of randomness. A barrier to the uptake of contingency management in community-based SUD clinics is the cost associated with voucher-based contingency management. This seminal study from 2005 compared retention, attendance, and abstinence in participants receiving standard treatment for stimulant use versus those receiving standard treatment plus prize-based contingency management for negative drug tests and counseling participation.
Findings
Four hundred and fifteen participants across eight clinics were randomly assigned to treatment only or treatment with prize-based contingency management. Those in the contingency management group attended more counseling sessions, stayed in treatment longer, and were more than twice as likely to be abstinent from stimulants for four and eight weeks consecutively.
Policy/Program Takeaways
Community-based SUD treatment settings can be an important access point for offering prize-based contingency management to improve retention, attendance, and abstinence among people seeking treatment for stimulant use. Health systems and SUD providers can use these findings to support implementation in local treatment clinics.