Last month, CHLPI and 37 institutional and individual signatories sent a letter to the Office of National Drug Control Policy (ONDCP) urging inter-agency collaboration to address policy barriers to Contingency Management, the only evidence-based treatment for stimulant use disorder.
Contingency Management (CM) is a behavioral health intervention that rewards participants with incentives for achieving target behaviors. In the context of substance use disorder treatment, CM is most often used to target and reward abstinence from substance use. While CM has a proven track record with reduction or cessation in use of alcohol, nicotine, and other substances, it is particularly impactful as a treatment for stimulant use, as there is currently no medication-assisted therapy option for stimulant use disorder.
CM is a proven treatment for a growing health crisis. Overdose deaths involving stimulants have skyrocketed in recent years, rising 180% between 2015 and 2019. Overdose deaths involving multiple substances are also on the rise, driven largely by fentanyl contamination in stimulants and other substances. This crisis is felt most keenly in rural communities and communities of color: age-adjusted rates of stimulant-involved ODs were 1.4 times higher in rural counties than urban counties in 2019, and rates of fatal stimulant OD were higher among Black and Indigenous persons than their white counterparts.
Despite a proven track record in helping patients stay in treatment longer and reduce or stop substance use, CM is underutilized due in large part to policy barriers. For people with stimulant use disorder, these policy barriers are roadblocks on the only evidence-based path toward treatment. CHLPI’s letter calls on the ONDCP to work with HHS, SAMHSA, the IRS, and agencies that administer public benefits to ensure that evidence-based CM treatment is widely available without adverse economic consequences for participants.
To read the letter, click here.