<https://www.drugaddictionnow.com/2017/02/01/tangible-rewards-can-useful-addition-addiction-treatment-programs/#newsarticle>
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"Contingency management (CM), a new form of behavioral intervention, has shown to be effective and useful when integrated into addiction treatment programs, according to recent research published in the Journal of Substance Abuse Treatment.     Researchers from the University of Connecticut Health Center compiled 16 articles that represented the most recent research into its effectiveness and found that CM programs can be administered to a wide range of people suffering from a substance use disorder, and can be an effective technique in addiction treatment.    CM provides tangible incentives for patients when they achieve certain recovery goals, such as negative urine tests, attendance at therapy sessions, and complete abstinence from drug use.    The two most common methods of CM are prize-based and voucher-based. The voucher method offers patients a set amount of money when goals are achieved, with the amount increasing after each consecutive milestone. The money can then be used for services chosen by patients.    The prize method, or fishbowl method, involves patients drawing a slip of paper from a fishbowl after each treatment goal achievement. Winning draws are exchanged for prizes patients may choose from, and the number of draws increases with each goal reached. The prizes could include free food, recreational activities or group therapy sessions.    Technology can also play an important role in CM therapy. Web-based techniques such as transdermal alcohol monitoring and remote objective monitoring have created new opportunities to administer CM therapy and cost savings in implementing CM programs. Smartphone-based interventions that use tools such as breath monitoring for heavy drinkers and smokers have proven effective as well.    The flexibility afforded by remotely administered CM therapy not only reduces the burden on patients, but also on public health organizations who may be searching for cost-effective, and efficacious treatment options.    Successful application of CM can benefit patients seeking treatment for cocaine and opioid use, alcohol and smoking cessation, and adherence to exercise or medication schedules, researchers stated. It showed efficacy across different patient demographics, including income, race, gender and prior substance use treatment.    Homeless patients and those living in recovery housing also appeared to greatly benefit from CM; access to housing as an incentive option can be a powerful motivator to remain abstinent from drugs. As a result, these individuals appeared to be the best candidates for... (continue reading) CM in their treatment programs.    Overall, the benefits and outcomes of CM were dependent on whether a patient had entered treatment with a positive or negative initial urine drug test. Those who tested negative for drugs at intake showed reduced drug use throughout their treatment program but were generally unaffected by the addition of CM. However, patients who entered a substance abuse treatment program with a positive drug test showed a marked improvement in maintaining abstinence when high-incentive prize-based CM was incorporated into their treatment, compared to those who did not receive CM.    It is important to note that incoming patients should not be made aware that positive initial drug tests may lead to high-level incentives and access to prizes throughout their treatment program, researchers stated.    Adoption is currently underway in health care systems including the U.S. Veterans Affairs Health Care System and the U.K. National Health Service. Increased adoption of CM intervention programs could provide additional data on the effectiveness of this emerging form of addiction treatment."
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