Contingency Management: Prizes For Staying Sober
Medically Reviewed By: Dr. Patricia Sullivan, MD MPH
In the world of drug addiction, staying sober is a reward. But sometimes, physical rewards do not hurt either. That is the basis of contingency management. People in recovery programs get prizes for how long they stay sober. And research says it works. Researchers have found that a rewards system motivates those recovering from addiction.
However, just because the method works doesn’t make it entirely accepted. There are many challenges while trying to implement contingency management in recovery programs.
Learn more about the benefits of contingency management at Better Help Addiction Care. Call us at (385) 327-7418. Talk to one of our specialists about getting the help you need to beat your addiction. You are not alone. Call us today and get the help you need now.
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Read more about contingency management works below. However, if you require more information, please contact our experts today.
Therapy Through Contingency Management
Contingency management may sound like the latest fad. In actuality, it’s a tool standard in behavioral adjustment therapy. So, what does it mean? For instance, let’s break it down with this definition:
- “Contingency” means that a physical reward is possible when performing the desired action.
- “Management” is the art, science, or practice of arranging these rewards to shape behavior.
In short, this type of therapy is a positive reinforcement tool.
Also, it was applied first to alcohol-use disorders. Now, it is being used consistently with most regulated drug abuse approaches. Also, it increases sobriety significantly.
How Contingency Management Helps Addicts
As Harvard Medical School points out, drug use can positively support people with addiction.
In behavioral terms, using a drug like alcohol, heroin, or cocaine is an unconditioned positive reinforcer, that is, a reward that users do not have to learn to enjoy. The action is reinforced: The results make them want to do it again.
Contingency management takes people’s direct positivity from taking drugs and moves it in another direction. The theory is that drug users are more interested in reinforcements. Meanwhile, they overlook the restricted rewards.
Likewise, under this therapy, the high associated with drug use gets replaced with small and immediate rewards. As the addict progresses in their ability to resist drugs, the rewards become more significant.
However, it’s important to remember that the prizes are only part of the overall treatment.
The Rewards
There are two central contingency management reward systems used as positive reinforcers for addicts in rehab.
The first is Voucher-Based Reinforcement. VBR increases other community-based treatments for adults who primarily abuse opioids. For instance, this can include heroin, or stimulants, such as cocaine. In VBR, the patient receives a voucher for every drug-free urine sample they provide. For example, you can use the voucher for:
- Food
- Movie passes
- Drug-free activities
At first, the VBR values are low. But the value increases as the number of consecutive drug-free urine samples increases. However, get a positive urine sample, and the value of the vouchers drops to the initial low cost. VBR is effective in promoting sobriety in patients going through detox.
Next, the second reward system is the prize incentives. The prize incentives apply similar principles as VBR. However, it becomes a game of chance to win cash prizes instead of getting vouchers. Over three months, patients who supply drug-negative urine, or breath tests, draw from a bowl; they can win a cash prize between $1 and $100.
In addition, patients also get the opportunity to enter the drawing to attend counseling sessions.
The number of draws starts at one and increases with consecutive negative drug tests and counseling sessions attended. But just like the VBR system, the number of draws goes back to one with any positive urine sample or unexcused absence from counseling.
On the other hand, some practitioners worry that the prize option could promote gambling addiction. However, studies examining this concern found that the prize incentives did not encourage gambling behavior. Contact our specialists today for more information about getting the treatment you need.
Research Supports Contingency Management
Research shows that human studies confirm the effectiveness of contingency management therapy in reducing drug use. It also improves treatment attendance and reinforces other goals. For instance, these goals can be: complying with a medication regimen or getting a job.
Often, contingency management is through written contracts. For example, they might look at:
- The desired behavior change
- The duration of the intervention
- Monitor frequency of therapy
In addition, it is effective in reducing drug and alcohol use.
However, the therapy also keeps patients in treatment, improves medication compliance, and promotes participation. Furthermore, rewards can also include:
- Special privileges
- Methadone dose
- Money prizes
Researchers have also found that it has been incredibly useful among those with cocaine use disorder. Researchers randomly assigned cocaine-dependent adults to one of two conditions: Community Reinforcement Approach (CRA) therapy with contingency management vouchers; or CRA therapy alone.
In conclusion, seventy-five percent of the CRA plus contingency management patients completed the 24-week study. In comparison, only 40 percent of the patients who received CRA alone made it through.
Crucial to Meth Recovery
While medications effectively treat some substance use disorders, there are currently none that counteract the effects of meth.
The most effective treatments for meth addiction are behavioral therapies. These include contingency management interventions. Fortunately, these have proven to be effective. Through the National Institute for Drug Abuse’s National Drug Abuse Clinical Trials Network, contingency management methods have worked well with meth addicts.
But are the effects lasting? According to one study, they are. The study found that:
- Treatment attendance and the number of participants who remained 100 percent sober throughout the therapy plan were higher.
- An increase in meth abstinence shows during the 16 weeks of the treatment
- Attendance and avoidance became even more vital when analyzing only those who completed treatment.
- During follow-up, participation rates were similar to previous studies.
Do not suffer from addiction alone. If you are ready to receive help, then call us today. Our team of professionals is standing by, ready to help you get your life back on track.
Barriers to Contingency Management Therapy
Research finds that contingency management works for many people with drug use disorders. But in real-life, politics throw in a significant roadblock to regulating it throughout state rehabs. Convincing policymaker’s contingency management to be put more into treatment has proven complicated.
Contingency management is rarely available as part of community-based treatment in the United States. The main reason is it is unlawful to provide it to patients who have health plans. In addition, it is illegal for programs that are also funded by federal or state dollars. The Centers for Medicare and Medicaid Services (CMS) require annual limits of $75.
Facing a growing meth epidemic with few known treatments, one California lawmaker is fighting to make public funding available. This funding is for programs that provide financial incentives to get people into state rehab.
According to the San Francisco Chronicle, Democratic Sen. Scott Wiener has introduced a bill that expands the addiction treatment options. These options qualify for Medi-Cal to include contingency management.
Wiener also states clinics are discouraged from adopting the contingency management model because of fraudulent rehab facilities. These facilities pay people to enroll so they can collect insurance payments. Wiener’s bill clarifies that it is not considered an illegal kickback. Also, it is eligible for Medi-Cal reimbursement. That way, providers can expand treatment without relying on private funds.
Wiener said this is a science-based approach to treating meth addiction, and it’s time for California to embrace it.
The Best Reward
Contingency management is supposed to help addicts determine whether they want to stop using drugs. The rewards provided for clean drug tests can help feel like validation for people’s efforts. These programs can be more widely available. They could be a lifeline for people trying to quit their addiction.
To help yourself or a loved one beat addiction, call us today. Our professionalists will help you find the right treatment option for you. Also, we will help you start on your journey to a happier and healthier life.
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Sources
- https://www.health.harvard.edu/newsletter_article/Contingency_management
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095117/
- https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/contingency-management-interventions-motivational-incentives
- https://pubs.niaaa.nih.gov/publications/arh23-2/122-127.pdf
- https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-treatments-are-effective-people-who-misuse-methamphetamine
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696502/
- https://www.healthaffairs.org/do/10.1377/hblog20200305.965186/full/
- https://www.sfchronicle.com/politics/article/California-bill-would-fund-rewards-for-meth-15085453.php
