Pharmacists expand access to contingency management in patients with substance use disorders

Introduction: Contingency management (CM) is a behavioral intervention that offers incentives to individuals who meet their goals in a substance use disorder (SUD) treatment program. This review highlights CM for abstinence, which is related to abstaining from using a target substance, and CM for adherence, which is related to adherence to receiving injectable medications for SUD. Clinical pharmacist practitioners (CPPs) are well-suited to serve as resources for the growth of CM. Practice Description: Standardized protocols for CM are used across the Department of Veterans Affairs (VA) healthcare facilities involving various interprofessional team members. All patients receiving CM for abstinence or CM for adherence to injectable medications for SUD involving a CPP at 3 VA facilities from November 13, 2017, to December 31, 2023, were retrospectively reviewed to describe patient characteristics and key outcomes. Patients receiving CM for adherence to injectable medications (n = 98) completed 88.3% of appointments on time, with a total of 574 injections of either naltrexone extended-release injection (XR) or buprenorphine XR given. Patients enrolled in CM for abstinence (n = 51) provided 566 total urine samples within the study period, 80% of which were negative for the targeted substance. Conclusion: CPPs are expanding access to CM for abstinence and adherence to injectable medications for SUD, with similar rates of abstinence and adherence seen in the current literature. Continued expansion of the CPP provision of CM in various outpatient settings would further expand access to these evidence-based treatments for patients with SUD.