Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine)

Research has demonstrated the effectiveness of treatment approaches using contingency management principles, which involve giving patients in drug treatment the chance to earn low-cost incentives in exchange for drug-free urine samples. These incentives include prizes given immediately or vouchers exchangeable for food items, movie passes, and other personal goods. Studies conducted in both methadone programs and psychosocial counseling treatment programs demonstrate that incentive-based interventions are highly effective in increasing treatment retention and promoting abstinence from drugs.

Some concerns have been raised that a prize-based contingency management intervention could promote gambling—as it contains an element of chance—and that pathological gambling and substance use disorders can be comorbid. However, studies have shown no differences in gambling over time between those assigned to the contingency management conditions and those in the usual care groups, indicating that this prize-based contingency management procedure did not promote gambling behavior.

Further Reading:

Budney, A.J.; Moore, B.A.; Rocha, H.L.; and Higgins, S.T. Clinical trial of abstinence-based vouchers and cognitivebehavioral therapy for cannabis dependence. Journal of Consulting and Clinical Psychology 74(2):307-316, 2006.

Budney, A.J.; Roffman, R.; Stephens, R.S.; and Walker, D. Marijuana dependence and its treatment. Addiction Science & Clinical Practice 4(1):4-16, 2007.

Elkashef, A.; Vocci, F.; Huestis, M.; Haney, M.; Budney, A.; Gruber, A.; and el-Guebaly, N. Marijuana neurobiology and treatment. Substance Abuse 29(3):17-29, 2008.

Peirce, J.M., et al. 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, 2006.

Petry, N.M., et al. 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(10):1148-1156, 2005.

Petry, N.M., et al. Prize-based contingency management does not increase gambling. Drug and Alcohol Dependence 83(3):269-273, 2006.

Prendergast, M.; Podus, D.; Finney, J.; Greenwell, L.; and Roll, J. Contingency management for treatment of substance use disorders: A meta-analysis. Addiction 101(11):1546-1560, 2006.

Roll, J.M., et al. Contingency management for the treatment of methamphetamine use disorders. The American Journal of Psychiatry 163(11):1993-1999, 2006.

This page was last updated April 2009