Contingency management is a type of addiction therapy that encourages behavior change through positive reinforcement.
In contingency management programs, people in recovery from drug abuse regularly take drug tests. For every urine sample that shows a drug-free result, the client receives a reward.
People may also receive rewards for attending group therapy sessions, reaching specific milestones, and keeping up with medication schedules.
Rewards can include cash, vouchers for movies and other activities, and tokens that can be exchanged for prizes of increasing monetary value.
Contingency management is rooted in psychological evidence.
It uses the principle of operant conditioning, which means that the immediate effects of a behavior will impact whether a person decides to repeat it.
When people in addiction recovery receive an immediate reward for a negative urine sample, the act of receiving the prize encourages continued sobriety.
Dopamine And The Willpower Gap
One of the many benefits of contingency management is that it works with dopamine, the brain’s primary reward chemical.
Dopamine And Drug Use
Dopamine induces feelings of motivation, accomplishment, and happiness. Our brains release dopamine when we eat, exercise, engage in sex, or finish a task.
Because dopamine makes us feel good, it makes us more likely to repeat actions that release it.
Addictive substances hijack this process by flooding the brain with unhealthy amounts of dopamine, causing euphoria.
Dopamine And Addiction Recovery
One reason why drug addiction is such a difficult disorder is that the brain gets used to heightened dopamine levels.
For a person with an addiction, ordinary activities such as eating and exercising may no longer feel rewarding because they don’t produce the same amount of dopamine as drugs or alcohol.
As a result, people often find it difficult to maintain desired behaviors and avoid relapse.
Motivation In Substance Use Disorder Treatment
When providers offer contingency management as part of a treatment plan, they reinforce positive behavioral change by leveraging dopamine.
When people receive prize incentives for target behaviors, the brain releases dopamine and creates a sense of accomplishment.
This can be especially helpful for people who are in the middle of their recovery journeys.
Because the early stages of addiction treatment programs offer some novelty, and novelty induces dopamine, many people feel highly motivated at the start of their addiction treatment.
However, as the sense of novelty wanes, so does dopamine production, and many people experience a dip in motivation.
Contingency management interventions, with their motivational incentives, can help people continue meeting their treatment goals during this period.
Dopamine And Stimulant Addiction
Contingency management has shown success in multiple types of drug addiction treatment. For example, some methadone clinics, which treat opioid addiction, have used it in pilot programs.
However, this behavioral treatment may be most effective for people with stimulant addictions.
Stimulant drugs such as methamphetamine have the most direct impact on the brain’s dopamine production, causing a profound impact on the brain’s reward pathways.
Therefore, voucher-based reinforcement and other contingency management plans can improve outcomes for people dealing with this type of drug dependence.
Contingency Management In Cocaine Addiction Treatment
Multiple randomized trials reveal that contingency management is an effective treatment for cocaine use disorder.
For example, in one review of cocaine dependence programs, contingency management produced better retention rates than programs that used cognitive behavioral therapy (CBT) alone.
Substance Abuse And Motivation Difficulties
Contingency management may improve treatment retention for people with disabilities that impact motivation.
For example, people with attention-deficit/hyperactivity disorder (ADHD) often struggle to internalize motivation because their brains do not use dopamine effectively.
Likewise, people with fatigue-inducing mental health conditions, such as depression, may struggle to find motivational energy.
When treatment centers provide contingency management treatment, they offer an external source of motivation that can fill in the gap.
Barriers To Contingency Management Treatment For Addiction
While contingency management shows several benefits for people with drug and alcohol dependence, it can be difficult to find providers who offer it.
In spite of its successes and cost effectiveness, fewer clinicians have contingency management training than treatment providers who have other forms of addiction treatment training.
Often, moral opposition also creates barriers. Much like methadone maintenance programs, contingency management programs are sometimes viewed with suspicion.
When people fail to understand that addiction is a mental illness and not a choice, they sometimes oppose rewarding behaviors that they believe come naturally to everyone.
As a result, neither public nor private healthcare insurance programs cover contingency management.
Discover Substance Abuse Treatment Options
Although some treatment programs do have barriers, there are many addiction care options for people who want to begin their recovery.
If you or a loved one are dealing with drug or alcohol use, contact Detox Rehabs today to find treatment.Article Sources
- Journal Of Addictive Disease
- National Institute On Drug Abuse
- National Library Of Medicine
- The New York Times