Contingency Management for Patients With Substance Abuse

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Contingency management

Contingency management is a behavioral treatment for patients with substance abuse problems (Hart & Ksir, 2015). Patients may receive immediate rewards in the forms of vouchers that can be changed for special goods or personal services. People with drug-free urine samples get vouchers (Hart & Ksir, 2015). The peculiar feature of this treatment is the possibility to increase a reward in case drug-free urine samples repeat.

When urine tests are positive, rewards are withheld. Contingency management drawbacks are the cost of rewards that makes this therapy available to a small population and the necessity to use a gambling-based method for patients who already suffer from a certain type of dependence. It is hard to be confident in the effectiveness of this behavioral treatment and give guarantees that drug abusers cannot return to their habits as soon as they receive rewards. Still, this system has certain benefits, including the possibility to affect the patients behavior without their awareness and the increase of motivation to avoid harmful substance use.

Effects of contingency management

Festinger, Dugosh, Kirby, and Seymour (2014) investigated the effects of contingency management among patients with cocaine dependence through a clinical research study. The participants were Philadelphia citizens recruited from consecutive admissions from a local program. They had to recognize themselves as cocaine users.

In general, 222 participants were randomly chosen for urine tests being taken three times per week and being rewarded with vouchers or cash in case of negative tests. Cash- and voucher-based contingency treatment turned out to be both effective for patients who demonstrated a reduction of cocaine use and improved attendance (Festinger et al., 2014). Such treatment can be effective for small populations due to the price that has to be spent on rewards for all participants. Therefore, other psychological treatments like motivational enhancement or cognitive-behavioral therapies can be offered for learning and supporting patients.

Prevention

Drug prevention is a task for many organizations (Hart & Ksir, 2015). Is a pro-drug site were credible and non-judgmental information about various plants, chemicals, and other related issues is presented from academic, medical, and experimental points of view.  Is a governmental source where much information about the negative aspects of drugs and their impact on human lives is given.

The main comparison includes the directions chosen by the developers of such sites. Only negative stories and the impact of drugs without the possibility to recognize drugs positive sides. Is a loyal source where developers try to inform people but not to explain why drugs are dangerous.

Both sites have a positive impact on me because they help to understand how unpredictable the nature of drugs can be. Still, misleading information can be found in both sources. Erowid does not contain any negative comments or persuasions. Dry facts are given providing people with an opportunity to develop a positive attitude to substances. Just Think Twice is full of negative stories and pictures with no possibility to understand that drugs can be used for medical purposes. Therefore, people younger than me may be confused by the information given and the inability to comprehend what kind of conclusion they should make or what goal should be achieved.

To develop a good anti-drug site, I would like to focus on both, positive and negative, aspects of drugs to educate people and underline that drugs cannot take one side. It is always a choice, and people should not be prevented from taking it, but have to be aware of how to make the right choice and evaluate a situation. The legalization of drugs is a serious issue that has to be considered in a new site to inform about the outcomes of illicit drug use.

References

Festinger, D.S., Dugosh, K.L., Kirby, K. C., & Seymour, B.L. (2014). Contingency management for cocaine treatment: Cash vs. vouchers. Journal of Substance Abuse Treatment, 47(2), 168-174.

Hart, C., & Ksir, C. (2015). Drugs, society and human behavior (16th ed.). New York, NY: McGraw-Hill Education.

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