Contingency Management

Contingency Management can be delivered by a range of professionals in healthcare settings. It is recommended to have at least two staff trained in Contingency Management at each site in case of turnover.

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) can be delivered by various health care professionals, including substance use disorder counselors, social workers, psychologists, care managers, and peer support specialists. In many research trials of CM, it is delivered by research staff, though more recent studies have shown that it can also be delivered by community clinicians. Due to high levels of staff turnover in opioid treatment programs and other programs targeting opioids and stimulants, it is recommended to have at least two staff members trained in CM.

In an ongoing rollout of CM across the state of California, programs are encouraged to have a designated “CM Coordinator,” a designated “CM Supervisor,” and at least one designated “Back-up CM Coordinator.”