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Subst Abuse Rehabil. 2018 Aug 13;9:43-57. doi: 10.2147/SAR.S138439. eCollection 2018.

A review of contingency management for the treatment of substance-use disorders: adaptation for underserved populations, use of experimental technologies, and personalized optimization strategies.

Substance abuse and rehabilitation

Sterling M McPherson, Ekaterina Burduli, Crystal Lederhos Smith, Jalene Herron, Oladunni Oluwoye, Katherine Hirchak, Michael F Orr, Michael G McDonell, John M Roll

Affiliations

  1. Department of Medical Education and Clinical Sciences, Elson S Floyd College of Medicine, Washington State University, [email protected].
  2. Programs of Excellence in Addictions Research, Washington State University, [email protected].
  3. Analytics and Psychopharmacology Laboratory (APPL), Washington State University, [email protected].
  4. Translational Addictions Research Center, Washington State University, [email protected].
  5. College of Nursing, Washington State University.
  6. Behavioral Health Interventions (BHI), Washington State University, Spokane, WA, USA.

PMID: 30147392 PMCID: PMC6095117 DOI: 10.2147/SAR.S138439

Abstract

This review of contingency management (CM; the behavior-modification method of providing reinforcement in exchange for objective evidence of a desired behavior) for the treatment of substance-use disorders (SUDs) begins by describing the origins of CM and how it has come to be most commonly used during the treatment of SUDs. Our core objective is to review, describe, and discuss three ongoing critical advancements in CM. We review key emerging areas wherein CM will likely have an impact. In total, we qualitatively reviewed 31 studies in a systematic fashion after searching PubMed and Google Scholar. We then describe and highlight CM investigations across three broad themes: adapting CM for underserved populations, CM with experimental technologies, and optimizing CM for personalized interventions. Technological innovations that allow for mobile delivery of reinforcers in exchange for objective evidence of a desired behavior will likely expand the possible applications of CM throughout the SUD-treatment domain and into therapeutically related areas (eg, serious mental illness). When this mobile technology is coupled with new, easy-to-utilize biomarkers, the adaptation for individual goal setting and delivery of CM-based SUD treatment in hard-to-reach places (eg, rural locations) can have a sustained impact on communities most affected by these disorders. In conclusion, there is still much to be done, not only technologically but also in convincing policy makers to adopt this well-established, cost-effective, and evidence-based method of behavior modification.

Keywords: contingency management; drug- and alcohol-use biomarkers; novel substance-use treatment technologies; substance-use disorder treatment

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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