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A review of contingency management for the treatment of substance-use disorders: adaptation for underserved populations, use of experimental technologies, and personalized optimization strategies

Authors McPherson SM, Burduli E, Smith CL, Herron J, Oluwoye O, Hirchak K, Orr MF, McDonell MG, Roll JM

Received 19 December 2017

Accepted for publication 29 March 2018

Published 13 August 2018 Volume 2018:9 Pages 43—57

DOI https://doi.org/10.2147/SAR.S138439

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Professor Li-Tzy Wu


Sterling M McPherson,1–4 Ekaterina Burduli,1–5 Crystal Lederhos Smith,1–4 Jalene Herron,2,6 Oladunni Oluwoye,2,6 Katherine Hirchak,2–4 Michael F Orr,1–5 Michael G McDonell,1–5 John M Roll1–5

1Department of Medical Education and Clinical Sciences, Elson S Floyd College of Medicine, Washington State University, 2Programs of Excellence in Addictions Research, Washington State University, 3Analytics and Psychopharmacology Laboratory (APPL), Washington State University, 4Translational Addictions Research Center, Washington State University, 5College of Nursing, Washington State University, 6Behavioral Health Interventions (BHI), Washington State University, Spokane, WA, USA

Abstract: This review of contingency management (CM; the behavior-modification method of providing reinforcement in exchange for objective evidence of a desired behavior) for the treatment of substance-use disorders (SUDs) begins by describing the origins of CM and how it has come to be most commonly used during the treatment of SUDs. Our core objective is to review, describe, and discuss three ongoing critical advancements in CM. We review key emerging areas wherein CM will likely have an impact. In total, we qualitatively reviewed 31 studies in a systematic fashion after searching PubMed and Google Scholar. We then describe and highlight CM investigations across three broad themes: adapting CM for underserved populations, CM with experimental technologies, and optimizing CM for personalized interventions. Technological innovations that allow for mobile delivery of reinforcers in exchange for objective evidence of a desired behavior will likely expand the possible applications of CM throughout the SUD-treatment domain and into therapeutically related areas (eg, serious mental illness). When this mobile technology is coupled with new, easy-to-utilize biomarkers, the adaptation for individual goal setting and delivery of CM-based SUD treatment in hard-to-reach places (eg, rural locations) can have a sustained impact on communities most affected by these disorders. In conclusion, there is still much to be done, not only technologically but also in convincing policy makers to adopt this well-established, cost-effective, and evidence-based method of behavior modification.

Keywords: contingency management, novel substance-use treatment technologies, drug- and alcohol-use biomarkers, substance-use disorder treatment

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