Headline
Contingency management shows lasting effectiveness in promoting substance use abstinence.
Background
Contingency management is an evidence-based behavioral therapy that uses tangible incentives to reinforce desired behaviors and is often used in substance use treatment settings. There is limited evidence, however, on long-term substance use abstinence when contingency management is discontinued. This meta-analysis examined if contingency management continues to help people stay off substances even after the incentives end, and how this compares to other treatments over time.
Findings
The meta-analysis included 23 randomized studies of prize- or voucher-based contingency management programs in substance use treatment settings, with comparison groups receiving other therapies, like cognitive-behavioral therapy and 12-step facilitation. Participants who received contingency management were 22% more likely to maintain abstinence at a median of 24 weeks following treatment than those in the comparison groups. These rates increased with longer contingency management treatment periods. These findings were consistent across various races, ages, and genders.
Policy/Program Takeaways
Behavioral health providers, health systems, health plans, and policymakers have a role to play in supporting the implementation of contingency management for serving people with substance use disorders. This evidence can support these stakeholders in understanding the long-term efficacy of contingency management on abstinence.