Substance use disorders (SUDs) are conditions that lead to a clinically significant impairment caused by the chronic abuse of any form of addictive substance, like alcohol, drugs, etc. Given the adverse impacts of substance abuse, the development of more effective treatment approaches for SUDs has become a critically important public health priority. The contingency management therapy where incentives or rewards are provided based on the objective evidence of behavior change has shown an impressive level of efficacy in the case of SUDs.
Contingency management therapy is based on the behavioral principle that the administration of a reward for a particular healthy behavior increases the likelihood of repeating that behavior. It offers vouchers, different types of items, cash and clinical privileges as prizes to reduce the use of any form of substance during the treatment. Moreover, contingency management in addiction treatment differs from other psychological interventions as it directly influences the reinforcement mechanisms involved in addiction.
Many studies have emphasized the efficacy of contingency management therapy in addiction treatment. One of the earlier studies found that contingency management for substance abuse is a powerful approach that allows the incorporation of other clinical treatment components by promoting abstinence from substance abuse. This finding has been corroborated by many recent studies.
It revealed that the contingency management or financial incentive program delivered through internet improved short-term abstinence rates among patients compared to an internet program without the incentives. Another research conducted by Lois A. Benishek and other researchers from the Treatment Research Institute in the United States also supported the efficacy of voucher-based contingency management in reducing substance use. However, it raised the issue of the duration of this abstinence after the completion of the therapy. Therefore, it favored longer durations of contingency management therapy to ensure continuous abstinence and long-term recovery.
Role of contingency management therapy in treating smoking
Another study highlighted the efficacy of internet-based contingency management compared to internet-based monitoring without incentives in smoking cessation. Tobacco is responsible for approximately 7 million people’s death per year across the globe. In the absence of adequate action, annual death toll due to tobacco is predicted to rise up to 8 million by 2030. Moreover, the rate of smoking among individuals in opioid addiction treatment is five times more than others.
Compared to the nonsmokers, drug-addicted smokers have a fourfold greater premature mortality. In such a scenario, the contingency management therapy will play a pivotal role in controlling the problem. Another study conducted by Tom Stephen Ainscough and other researchers from the U.K. Centre for Tobacco and Alcohol Studies assessed the possibility of successfully adding contingency management therapy in the evidence-based smoking cessation treatment in people undergoing treatment for opioid addiction. It found that the addition of incentives is an effective intervention for those addicted to opioids.
Furthermore, smoking during pregnancy is the leading cause of maternal complications and poor birth outcomes. Despite being a preventable risk factor for adverse pregnancy outcomes, it is the most frequently abused substance during pregnancy. It can lead to multiple adverse fetal and maternal health outcomes like placenta previa, placental abruption, neonatal mortality, low birth weight, preterm birth and sudden death.
The risk of stillbirth and other complications is two to three times higher in women using substances like tobacco, marijuana, prescription pain relievers, illegal drugs, etc. during pregnancy. According to a national survey conducted in 2012 in the U.S., around 5.9 percent of pregnant women used illicit drugs, nearly 8.5 percent drank alcohol and about 15.9 percent smoked cigarettes. One of the recent studies found contingency management interventions very effective in reducing smoking and illicit substance use during pregnancy.
Besides reducing abstinence from substances, another study conducted by Alexa Lopez, Ph.D., and others showed decrease in depression rates among women suffering from antepartum or postpartum depression on receiving contingency management therapy for smoking abstinence. It not only assists women in smoking cessation but also in increasing breastfeeding duration that is beneficial for the maternal-infant dyad. It also increased adherence to prenatal care that improved infant and maternal outcomes. Therefore, contingency management therapy for substance abuse improved health of both pregnant women and the infant.
Behavioral treatment for long-term recovery
With the rising rate of substance abuse among people of all age, color and gender, it has become essential to spread adequate awareness about the repercussions. Among all, it is essential to deter women addicted to substances like alcohol, drugs and nicotine from abusing them during the critical phase of pregnancy. Their medical practitioners should appropriately guide them and provide behavioral treatments like contingency management therapy to avoid implications on them and their unborn child.
If you or your loved one is addicted to nicotine, drugs, etc. contact Sovereign Health for help. Our well-trained staff and state-of-the-art addiction treatment centers can assist you in finding the right treatment according to your requirements. Call at our 24/7 helpline or chat online with our representative for more information and guidance.
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