Contingency Management

Contingency Management is effective for patients from a variety of backgrounds and works for virtually all types of substance use. It is the front-line treatment for patients with stimulant use disorders and is highly effective when used with medications like methadone and buprenorphine for patients with opioid use disorder.

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, and demographic characteristics. Common misconceptions about CM are that it should not be offered to patients with a history of gambling disorder and that it might not be as effective for affluent patients. In reality, CM targeting substance use is fine to offer to persons with a history of gambling disorder, and it is effective for people of all economic backgrounds.