Hot topic search results

Effectiveness bank home page. Opens new window Hot topic search results

You have found 35 entries after clicking the GO button or a search link in a hot topic. Sorted by the main topic addressed, the list shows in orange the type of entry, year the original document was published (or if one of our own documents, the year last updated), and the type of file you will download when you click on the title. In blue is the document’s title followed by a brief description.

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STUDY 2000 PDF file 155Kb
Achievable and avoidable rewards and punishments improve methadone outcomes

Contingency management regimes which systematically reward abstinence or penalise drug use generally improve outcomes in methadone programmes, but there are considerable ethical and practical limitations to the applicability of this approach.

STUDY 2010 HTM file
Using enhanced and integrated services to improve response to standard methadone treatment: changing the clinical infrastructure of treatment networks

Heroin addicts in Baltimore who still used drugs heavily despite being on methadone were sent to a special clinic for intensified care reinforced by sanctions and incentives and eventual discharge if still they failed to comply. Tough love perhaps, but does it really make sense to intensify compliance requirements on patients already not complying?

STUDY 2010 HTM file
Randomized trial of continuing care enhancements for cocaine-dependent patients following initial engagement

Unusually this US study took a set of patients who had generally already initiated abstinence from cocaine use and then used abstinence incentives and/or cognitive-behavioural therapy to extend and consolidate these gains. There was some evidence that offering the therapy and improving attendance via incentives prolonged the impact of those incentives.

STUDY 2011 HTM file
Contingency management for behavior change: applications to promote brief smoking cessation among opioid-maintained patients

Transfer of responsibility for monitoring and promoting addiction treatment to Public Health England seems likely to encourage broader health promotion among treatment services, placing smoking cessation higher up the agenda. The US studies reported in this article have paved the way, showing that at least initial non-smoking can be achieved via incentives.

REVIEW 2014 HTM file
Prize-based contingency management for the treatment of substance abusers: a meta-analysis

Systematically giving substance use patients a chance to win valuable prizes if they test abstinent offers a lower-cost alternative to ‘contingency management’ systems which provide rewards each time, but does it work? Across 18 studies the answer was ‘Yes,’ though effects soon faded.

DOCUMENT 2013 HTM file
Rewarding virtue

Can we dispense with counselling, therapy, treatment as we know it, and just punish or deprive patients of rewards when they use substances in undesired ways, and reward them when they behave as we/they would wish? British services are trialling an approach about which many clinicians express major ethical concerns – contingency management.

STUDY 2008 HTM file
Coping skills training and contingency management treatments for marijuana dependence: exploring mechanisms of behavior change

Rare glimpse 'under the hood' of contingency management suggests that unless the patient sees themselves as having actively mastered their dependence and has developed anti-relapse strategies, effects of rewarding abstinence will be short-lived.

HOT TOPIC 2016 HTM file
Prizes for not using drugs?

‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Contingency management programmes reward patients for complying with treatment or not engaging in undesired substance use. It works, but often only temporarily – and perhaps at the cost of eroding the patient’s confidence and motivation.

REVIEW 2016 HTM file
How can contingency management support treatment for substance use disorders? A systematic review

Rewarding people dependent on illegal drugs for not using those drugs is a controversial tactic, one this review from the EU’s drug misuse centre found patchily effective in extending retention and reducing substance use as a supplement to medication-based treatments.

STUDY 2018 HTM file
Remote alcohol monitoring to facilitate incentive-based treatment for alcohol use disorder: a randomized trial

Can new digital technologies do anything to boost the ‘limited, yet promising’ evidence base for incentivising abstinence among people with alcohol use disorders?


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