Contingency Management

Studies of Contingency Management across a wide range of populations and settings suggest that it is a strong candidate for widespread scale-out.

Evidence for the intervention

Evidence supporting contingency management (CM) comes from more than ten systematic reviews and meta-analyses, drawn from over 100 randomized controlled trials. This evidence shows that CM helps patients with a range of different substance use disorders and is highly effective for patients with stimulant and opioid use disorders. For stimulant use disorders, CM is the most effective treatment available and is recommended as both a standalone treatment and an adjunctive treatment in combination with medication or other behavioral treatments. For opioid use disorders, CM is a highly effective adjunct to medication for opioid use disorder and is not recommended as a standalone treatment option. Based on its effectiveness as a standalone treatment for stimulant use disorder treatment and an adjunctive treatment for opioid use disorder, documented across multiple systematic reviews, CM earned our highest evidence rating.

Evidence-based Scale

Contingency Management (CM) has proven effective for people using opioids, stimulants, tobacco, alcohol, and a range of other substances. It has improved treatment outcomes for people across age groups, regions, socio-economic status, both rural and urban settings, and patient identity characteristics. It has also demonstrated effectiveness across a wide range of healthcare and non-traditional settings. In some studies, investigators have worked with specific communities (such as Native Americans) to ensure that the incentives and approach align with community norms and values.