Contingency Management with pharmacologic treatment for Stimulant Use Disorders: A review

Abstract

Objectives: Stimulant Use Disorders (SUDs) are an emergent public health concern in the United States and worldwide. However, there is still a lack of consensus for best-approaches regarding treatment of SUD. Recent trials have evaluated combinations of medications and psychosocial treatments to enhance efficacy. Contingency Management (CM) is a behavioral intervention that has shown effectiveness in treating SUDs. Our aim was to review studies using a combined methods approach such as CM and medications for the treatment of SUD.

Design: We performed a qualitative literature review of clinical trials that combined CM with any pharmacological treatment for SUDs.

Results: Among twenty-one publications included, ten reviewed a combination of CM and medications was superior to each intervention alone. In three of studies patients receiving CM showed better outcomes than those with no CM, regardless of their medication status. In one, groups receiving medication with or without CM had better outcomes than groups that received no medication. Finally, seven of the studies found no difference in the outcomes of interest for either CM, medication, or the combination of CM and medication.

Conclusions: CM and medication as treatment for SUD could act synergistically and enhance each other's effect. Combining CM and medications may be a key strategy for effective SUD treatment. Future studies should further investigate the efficacy of the combined approach of medications and CM.

Keywords: Behavior therapy”; Cocaine; Contingency management; Crack; Pharmacotherapy; Substance-related disorders.