Creating Positive Change for Persons Who Use/d Stimulants through Contingency Management Programs

People who use Stimulants (PWUS) are one of the most stigmatized groups and their deaths, especially in tandem with unintentional exposure to fentanyl, are increasing across America. In 2019, of the 30,173 Americans who lost their lives to stimulant involved deaths, those in rural areas had the highest age-adjusted rate of stimulant-involved death. While stimulant use alone can cause fatal toxicity, opioids are now increasingly involved in most stimulant-related overdoses. This has only worsened during the COVID-19 pandemic due to (1) unpredictability in the drug supply, (2) isolation and mental distress, and (3) interruption of employment, housing, exercise, social life, and key services like harm reduction, medications for opioid use disorder, contingency management, primary care services, behavioral health, and recovery supports. The result has been a jump in stimulant-involved death and hospitalizations following 2020’s lockdowns and interruptions in daily life. Despite dramatic increases in stimulant-involved deaths, many service providers are not providing tools to assist people using stimulants to reduce or end stimulant use. Contingency management is a lifesaving intervention for this population, which includes connecting PWUS to services and promoting positive change.

In this session, technical experts, rural Appalachian service providers and a Health Resources and Services Administration (HRSA) representative will discuss the evidence-based intervention contingency management and provide a case scenario from a peer-led CM program in rural North Carolina. HRSA will discuss promising early results from programs serving PWUS through its fall 2021 investment of $7,500,000 in the RCORP-Stimulant Support Program, which strengthens and expands prevention, harm reduction, treatment, and recovery services for rural PWUS. The content for this session can be applied to non-rural settings.