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By Substance
Stimulants
(cocaine, methamphetamine)
Over 100 randomized controlled trials support the effectiveness of CM. CM is widely regarded as the most effective intervention for stimulant use disorders. Multiple meta-analyses (studies of studies) found that CM is associated with medium to large reductions of stimulant use in treatment. People who receive CM for stimulant use are 21% more likely than others to still be abstinent from stimulants one year after treatment. The United States Department Veterans Affairs, as well as several states, are implementing CM as a treatment for stimulant use disorders.
Bentzley, B. S., Han, S. S., Neuner, S., Humphreys, K., Kampman, K. M., & Halpern, C. H. (2021). Comparison of Treatments for Cocaine Use Disorder Among Adults: A Systematic Review and Meta-analysis. JAMA network open, 4(5), e218049. https://doi.org/10.1001/jamanetworkopen.2021.8049
AshaRani, P. V., Hombali, A., Seow, E., Ong, W. J., Tan, J. H., & Subramaniam, M. (2020). Non-pharmacological interventions for methamphetamine use disorder: a systematic review. Drug and alcohol dependence, 212, 108060. https://doi.org/10.1016/j.drugalcdep.2020.108060
Petry, N.M., Peirce, J.M., Sitizer, M.L., Blaine, J., Roll, J.M., et al. (2005). Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: A national drug abuse treatment clinical trials network study. Archives of General Psychiatry, 62, 1148-1156. doi:10.1001/archpsyc.62.10.1148
Higgins, S. T., Delaney, D. D., Budney, A. J., Bickel, W. K., Hughes, J. R., Foerg, F., & Fenwick, J. W. (1991). A behavioral approach to achieving initial cocaine abstinence. The American journal of psychiatry, 148(9), 1218–1224. https://doi.org/10.1176/ajp.148.9.1218
Opioids
While CM is an effective treatment for opioid use disorder, there are effective medications for opioid use disorder with decades of support, such as buprenorphine and methadone that are widely available. Research supports that CM is effective at treating the co-use of stimulant drugs for people are using opioid or receiving medications to treat their opioid use disorder. CM is also an effective way to increase medication compliance for those who have difficulty adhering to their medications for opioid use disorder.
Bolívar, H. A., Klemperer, E. M., Coleman, S. R. M., DeSarno, M., Skelly, J. M., & Higgins, S. T. (2021). Contingency Management for Patients Receiving Medication for Opioid Use Disorder: A Systematic Review and Meta-analysis. JAMA psychiatry, 78(10), 1092–1102. https://doi.org/10.1001/jamapsychiatry.2021.1969
Holtyn, A. F., Koffarnus, M. N., DeFulio, A., Sigurdsson, S. O., Strain, E. C., Schwartz, R. P., Leoutsakos, J. M., & Silverman, K. (2014). The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: a randomized controlled trial. Preventive medicine, 68, 62–70. https://doi.org/10.1016/j.ypmed.2014.02.021
Peirce, J. M., Petry, N. M., Stitzer, M. L., Blaine, J., Kellogg, S., Satterfield, F., Schwartz, M., Krasnansky, J., Pencer, E., Silva-Vazquez, L., Kirby, K. C., Royer-Malvestuto, C., Roll, J. M., Cohen, A., Copersino, M. L., Kolodner, K., & Li, R. (2006). Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: a National Drug Abuse Treatment Clinical Trials Network study. Archives of general psychiatry, 63(2), 201–208. https://doi.org/10.1001/archpsyc.63.2.201
Alcohol
CM is associated with medium to large reductions in alcohol use. Urine ethyl glucuronide (uEtG) tests can be used to implement an outpatient CM intervention for alcohol use disorders. Other alcohol tests can be used to implement CM, such as alcohol breath tests (assessed by smartphone synced breathalyzers), phosphatidylethanol (PEth), and transdermal alcohol monitors, though there is less evidence for these approaches.
McDonell, M. G., Skalisky, J., Burduli, E., Foote, A., Sr, Granbois, A., Smoker, K., Hirchak, K., Herron, J., Ries, R. K., Echo-Hawk, A., Barbosa-Leiker, C., Buchwald, D., Roll, J., & McPherson, S. M. (2021). The rewarding recovery study: a randomized controlled trial of incentives for alcohol and drug abstinence with a rural American Indian community. Addiction (Abingdon, England), 116(6), 1569–1579. https://doi.org/10.1111/add.15349
McDonell, M. G., Hirchak, K. A., Herron, J., Lyons, A. J., Alcover, K. C., Shaw, J., Kordas, G., Dirks, L. G., Jansen, K., Avey, J., Lillie, K., Donovan, D., McPherson, S. M., Dillard, D., Ries, R., Roll, J., Buchwald, D., & HONOR Study Team (2021). Effect of Incentives for Alcohol Abstinence in Partnership With 3 American Indian and Alaska Native Communities: A Randomized Clinical Trial. JAMA psychiatry, 78(6), 599–606. https://doi.org/10.1001/jamapsychiatry.2020.4768
McDonell, M. G., Leickly, E., McPherson, S., Skalisky, J., Srebnik, D., Angelo, F., Vilardaga, R., Nepom, J. R., Roll, J. M., & Ries, R. K. (2017). A Randomized Controlled Trial of Ethyl Glucuronide-Based Contingency Management for Outpatients With Co-Occurring Alcohol Use Disorders and Serious Mental Illness. The American journal of psychiatry, 174(4), 370–377. https://doi.org/10.1176/appi.ajp.2016.16050627
Tobacco
CM for nicotine use disorder is associated with quite rates that are superior to other approaches like nicotine replacement treatment. Carbon monoxide monitors and urine cotinine tests can be used to implement CM for cigarette smoking. They can be used in combination with other pharmacological treatments, such as nicotine replacement treatment or varenicline.
Rash, C.J., Petry, N.M., & Alessi, S.M. (2018). A randomized trial of contingency management for smoking cessation in the homeless. Psychology of Addictive Behaviors, 32(2), 141-148. PMCID: PMC5858980. doi: 10.1037/adb0000350
Alessi, S.M. & Rash, C.J. (2017). Treatment satisfaction in a randomized clinical trial of mHealth smoking abstinence reinforcement. Journal of Substance Abuse Treatment, 72, 97-102. PMCID: PMC5154906. doi: 10.1016/j.jsat.2016.07.001
Alessi, S.M., Rash, C.J., & Petry, N.M. (2016). A randomized trial of adjunct mHealth abstinence reinforcement with transdermal nicotine and counseling for smoking cessation. Nicotine and Tobacco Research, ntw155. PMID: 27613901 PMCID: PMC6075519 doi: 10.1093/ntr/ntw155
Cannabis
CM is also an effective intervention for cannabis use disorders and is effective as a treatment for adults and youth. CM for cannabis use disorder can be complicated due to the long period of detection that of THC spell out in urine.