Contingency management with community reinforcement approach to reduce cocaine and amphetamine use — evidence summary

Summary of the evidence

Likely to be beneficial

A systematic review (De Crescenzo et al 2018) comparing different types of psychosocial interventions for cocaine and amphetamine use found that contingency management in combination with community reinforcement approach showed superiority of results in:

  • the number of abstinent patients compared to treatment as usual at the end of treatment (OR 2.84, 95% CI 1.24-6.51, P=0.013), at 12 weeks (OR 7.60 95% CI 2.03-28.37, P=0.002), and at the longest follow-up (OR 3.08, 95%CI 1.33-7.17, P=0.008).
  • efficacy at the end of treatment when compared to cognitive beavioural therapy (CBT) (OR 2.44, 95% CI 1.02-5.88, P=0.045), non-contingent rewards(OR 3.31, 95% CI 1.32-8.28, P=0.010), and 12-step programme with non-contingent rewards (OR 4.07 95% CI 1.13-14.69 P=0.031).
  • efficacy at the longest follow-up when compared to CBT, contingency management alone, contingency management with CBT, and 12-steps programme with non-contingent rewards (ORs between 2.50, P=0.039, and 5.22, P <0.001)


Note: this evidence summary is only valid for the outcomes, target groups, settings and substances/patterns of use described below.

Name of response option:
psychosocial interventions
Desired outcome(s):
reduce substance use
Specific substance or pattern of use:
Target group(s) or setting(s):
dual-diagnosis patients
emergency department
ethnic minority
law enforcement
pregnant women
PWID – people who inject drugs
young people

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