Contingency management (CM) involves participants receiving something of value such as a gift card, voucher or chance to win a prize as a reward for the achievement of a specific and measurable desired behaviour, most commonly a negative urine drug test for stimulants when implemented for the treatment of stimulant use disorder.
CM alone was found in a systematic review of reviews (Ronsley et al., 2020, 29 systematic reviews examining eleven intervention modalities) to be effective in improving:
However the effect was not sustained at longest follow up (OR 1.10, 95% CI 0.83, 1.46).
Another more recent systematic review with meta-analysis (Bentzley et al., 2021) statistically compared all the different treatment options (157 studies comprising 402 treatment groups and 15 842 participants) looking for the interventions associated with an objective reductions in cocaine use among adults. Excluding other therapies, the largest treatment groups across all studies were psychotherapy (mean [SD] number of participants, 40.04 [36.88]) and contingency management programs (mean [SD] number of participants, 37.51 [25.51]). The analysis found that:
A systematic review without meta-analysis (Hayley et al., 2020) described the broad benefits of contingency management, including greater drug abstinence, higher utilization of other treatments and medical services, and reductions in risky sexual behavior specifically for methamphetamine users.