Is Rewards-Based Addiction Treatment On The Way?

By Lindsey Weedston 07/17/19

Though their long-term impact is still undetermined, researchers are working on creating short-term rewards programs for addiction treatment.

people looking at reward from addiction treatment on phone

Researchers are working on combining technology with the practice of contingency management (CM) in order to eventually treat addiction disorders and promote abstinence long-term.

A new report titled “Technology-Based Contingency Management in the Treatment of Substance Use Disorders” imagines remote alcohol, nicotine, and cannabis detection technology that can also deliver rewards like food vouchers for following the program.

CM uses operant conditioning, rewarding desired behaviors to replace negative ones such as substance abuse. This principle is most commonly used in substance use disorder treatment, giving out vouchers and prizes for urine samples that test negative for drugs.

Showing Up

However, these programs are often held back by the fact that the individual being treated has to show up on a regular basis to a physical location for testing and to receive their rewards.

Lead study author Jesse Dallery, PhD, of the University of Florida, envisions a future in which CM programs could be implemented remotely via mobile phone. According to a press release by the Association for Behavior Analysis International, companies are already working on this technology.

“In fact, several companies are even developing wrist-worn sensors for continuous alcohol monitoring, and at least one research group is considering an electrochemical tattoo for alcohol detection, making patients’ adherence to incentive programs even easier to monitor technologically,” the statement reads.

One of the advantages of CM is that its traditional forms have been thoroughly tested, at least when it comes to short-term programs. The study purports that “[l]iterally hundreds of prior studies and clinical trials have demonstrated the effectiveness of contingency management initiatives in substance abuse treatment.”

Does It Work Long Term? 

The only issue is the lack of study testing how effective CM is in the long term. These programs are designed to address behaviors that were learned over the course of many years and are meant to last a lifetime, but studies that follow people throughout their entire lives are tricky and, naturally, take a long time.

However, there is already an app called reSET, approved by the FDA in 2017, that uses principles from CM as well as cognitive behavioral therapy to help treat addiction disorders.

In late 2018, the FDA approved a new version of the app designed specifically to treat opioid use disorder: reSET-O. Used alongside medication-assisted treatment and behavior therapy, those who used reSET-O in a clinical trial were significantly more likely to stay in the program for the full 12 weeks.

“Often on the road to recovery, patients find their commitment to staying in treatment may wane,” said former FDA Commissioner Scott Gottlieb. “Providing Americans suffering from opioid use disorder with more options and proper support to address treatment challenges is key to helping them succeed.”

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Lindsey Weedston is a Seattle area writer focused on mental health and addiction, politics, human rights, and various social issues. Her work has appeared in The Establishment, Ravishly, ThinkProgress, Little Things, Yes! Magazine, and others. You can find her daily writings at Twitter: