Contingency Management: Benefits and Challenges

Contingency management (CM) is a behavioral therapy for treating stimulant use disorders (SUD). Considered both beneficial and controversial, CM is based in operant conditioning, which reinforces desired behaviors with rewards, such as cash or prizes. This session will help attendees understand the advantages and challenges of CM.

Robert Childs will provide context by making clear the need for CM amidst changing drug use trends in the United States, as well as the need to overcome stigma associated with CM.

David Gastfriend will explain how CM works. His topics will include the scientific basis for CM; why it is the best evidenced, most clinically- and cost-effective behavioral approach for SUD, including for enhancing medication for opioid use disorders (MOUD); best practices for its delivery; and how it can advance access to care for a variety of populations, including in rural areas and other service deserts.

Sarah Wattenberg will identify obstacles to CM implementation and describe guardrails to avoid fraud and abuse.

Finally, Kim Nesbitt will highlight the Rural Communities Opioid Response Program (RCORP) Psychostimulant Support Program successes, challenges, and implementation of CM to reduce no-show rates of individuals referred to treatment for psychostimulant use.