Symposium: Contingency Management: Implementation of a Highly Effective Intervention for the Treatment of Stimulant Use Disorder-Contingency Management: Implementation of a Highly Effective Intervention for the Treatment of Stimulant Use Disorder

Contingency Management: Implementation of a Highly Effective Intervention for the Treatment of Stimulant Use Disorder

Video Transcription

Video Summary

The symposium, chaired by Dr. Larissa Mooney, focused on contingency management (CM) as a highly effective intervention for stimulant use disorder, particularly underscored by its robust evidence base and limited utilization. Despite its efficacy, CM has been under-utilized due to funding challenges outside the Veterans Affairs (VA) system, which has long supported CM. Recent developments see states like California, Washington, and Montana arranging Medicaid reimbursements to fund CM programs. The symposium featured speakers with hands-on experience in implementing CM, including Dr. Richard Rawson, who explored CM's foundations in positive reinforcement, and Dr. Thomas Freese, who delved into California's extensive implementation efforts. California's program stands out as a comprehensive, state-funded initiative for training and implementing CM in real-world settings, achieving significant scale with over 4,800 enrollments in 18 months. Dr. Sarah Parent discussed similar statewide implementations in Washington and Montana, shared lessons learned, and highlighted the importance of understanding logistical and philosophical fit for CM adoption. Challenges included ensuring sustainable funding, training, and overcoming philosophical barriers, while successes were evident in client engagement and positive outcomes. The discussion addressed potential applications of CM beyond stimulant use, including alcohol and opioid use disorders, though stimulant use remains the primary target due to lack of effective medications. The symposium underscored the transformative potential of CM while highlighting the need for continued support and advocacy to expand its reach and application.

Keywords

contingency management

stimulant use disorder

evidence-based treatment

Richard Rawson

stimulant-related overdoses

opioids

fentanyl

funding restrictions

Thomas Freese

California implementation

voucher system

Sarah Parent

community settings

training and support

substance use disorders

Dr. Larissa Mooney

Veterans Affairs

Medicaid Reimbursement

California

Washington

Montana

Dr. Richard Rawson

Positive Reinforcement

Dr. Thomas Freese

State-funded Initiatives

Client Engagement

Alcohol Use Disorder

Opioid Use Disorder

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