176 - Contingency Management for Substance Use Disorders: Rewarding Recovery

Session Description: Contingency management for substance use disorders (i.e., rewarding people, often with money, for achieving their recovery goals) is backed by decades of research support yet remains highly underutilized in the midst of an escalating drug overdose crisis with deaths topping 100,000 last year (CDC, 2022). Unlike opioid use disorder, there are currently no FDA-approved medications for the treatment of stimulant use disorder, underscoring the need for greater adoption of effective psychosocial treatments like contingency management. Contingency management is associated with numerous benefits, including improved treatment engagement, retention, and outcomes. Despite strong evidence, motivational incentives are rarely used in real-world practice due to a number of concerns, including most notably, the apparent lack of innovation, as well as moral, philosophical, ethical, and economic concerns, and even federal rules meant to prevent illegal inducements in health care. Still, other opponents argue that some patients will try to "game" the system by simply doing whatever it takes to earn monetary rewards. An up-to-date review of the current evidence base for contingency management is presented with a particular focus on stimulant and opioid use disorders. Common barriers and solutions to implementation, as well as implications for routine clinical practice and future research are discussed. Attendees will learn how to implement contingency management, an evidence-based intervention, into their own practice.