The Effect of Contingency Management on the Recovery of Patients with Substance Use Disorder: A Systematic Review of the Literature

Substance use disorder (SUD) is traditionally managed with behavioral therapy and medication. Contingency management (CM), a therapeutic method that reinforces positive behaviors with incentives, may be a useful adjuvant to enhance treatment engagement and efficacy for those who struggle with SUD. This systematic review of literature was conducted using databases CINAHL, Cochrane, and PubMed from January 2010 to July 2021. The search yielded 132 initial records. Studies were included if they were written in English, peer reviewed, and randomized control trials. Six final studies rendered results for 650 patients with varying substance use disorders including cannabis, tobacco, and opioids. Studies were appraised for quality and risk of bias using a critical appraisal tool developed by the authors. Results focused on the efficacy of CM in addition to standard care or as a means to enhance results of CBT and/or individualized assessment and treatment programs. Three out of six studies endorse CM as an effective method of prolonging abstinence. The remaining three studies had varied results. Limitations include small sample sizes and homogenous patient profiles, impacting the generalizability and replicability of the results. There is limited applicability of CM in general practice to provide consistent and predictable means of establishing abstinence. This study indicates room for additional research evaluating CM as a treatment modality of SUD in a larger, more diverse patient population with long-term follow up