Contingency Management for Opioid Use Disorder

(CM+ED+MOUD Trial)

Overseen By Eric A Thrailkill, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Vermont

Must be taking: Buprenorphine, Methadone

Disqualifiers: Pending incarceration, Leaving area, Others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 4 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a strategy called contingency management, a behavioral therapy, to determine if it helps people with opioid use disorder keep their clinic appointments after leaving the emergency room. Participants will receive either usual care or usual care plus incentives for attending outpatient clinic visits. The main goal is to determine if offering incentives increases the likelihood of obtaining prescriptions and continuing clinic attendance. The trial seeks adults who have received a referral to an outpatient clinic for medications like buprenorphine or methadone. As an unphased trial, this study offers an opportunity to contribute to innovative strategies that could enhance treatment adherence for many.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. It focuses on increasing attendance at clinics for those prescribed buprenorphine or methadone, so you may continue these medications.

What prior data suggests that this contingency management protocol is safe for increasing clinic attendance?

Research has shown that contingency management (CM) is generally safe for people with opioid use disorder (OUD). CM involves giving rewards for positive actions, such as attending clinic visits, and studies indicate it can effectively reduce drug use without serious side effects. One review found that using CM alongside medications for OUD can lower health risks and save money. Another report highlights that CM works well even for those who use both opioids and stimulants, helping them stay drug-free.

Overall, CM is well-tolerated and has improved treatment outcomes for individuals with OUD. These studies report no harmful effects linked to CM, making it a promising option for supporting recovery. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Contingency Management for opioid use disorder because it introduces a behavioral approach that complements existing treatments like medication-assisted therapy (MAT). Unlike standard care that primarily focuses on medications such as methadone or buprenorphine, Contingency Management provides tangible incentives to encourage patients to adhere to their treatment plans and engage consistently with outpatient services. This method not only aims to reduce opioid misuse but also promotes positive behavioral changes by rewarding patients for attending clinic visits and picking up their prescriptions, potentially leading to better long-term recovery outcomes.

What evidence suggests that contingency management is effective for increasing MOUD clinic attendance?

Research shows that Contingency Management (CM), which participants in this trial may receive, can help treat Opioid Use Disorder (OUD). Studies have found that CM reduces drug use and increases retention in treatment programs. When combined with medication for OUD, CM significantly reduces health issues and deaths related to OUD. Additionally, CM lowers healthcare costs, saving money. While results can vary, CM is considered a promising method to help individuals adhere to their treatment plans. ^{2 6 7 8 9}

Who Is on the Research Team?

Eric A Thrailkill, Ph.D.

Principal Investigator

University of Vermont

Are You a Good Fit for This Trial?

This trial is for adults who have started Medication for Opioid Use Disorder (MOUD) in the Emergency Department due to opioid dependence or use disorder. Participants must be willing to attend outpatient clinics after discharge.

Inclusion Criteria

Provide informed consent

I have been referred for addiction treatment and prescribed buprenorphine or methadone.

I am 18 years old or older.

Exclusion Criteria

Pending incarceration in the next 30 days

Plan to leave the area (Burlington/Chittenden County) in the next 30 days

I cannot go to the clinic due to a physical or health issue.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive usual care or usual care plus contingency management for 30 days to promote MOUD clinic attendance

4 weeks

Multiple visits as per outpatient clinic schedule

Follow-up

Participants are monitored for MOUD clinic attendance and opioid abstinence

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Contingency Management

Trial Overview The study tests if contingency management (CM), which offers financial incentives, improves clinic attendance and MOUD continuation compared to usual care alone. Thirty patients will be randomly assigned to either receive usual care or usual care plus CM.

How Is the Trial Designed?

Group I: Contingency Management Experimental Treatment 2 Interventions

Participants assigned to this arm will receive incentives when they complete their first outpatient MOUD clinic visit and when they complete subsequent visits to pick up their MOUD prescription for the 30-day study period.

Group II: Usual Care Active Control 1 Intervention

All participants will receive standard outpatient care at their clinic.

Who Is Running the Clinical Trial?

University of Vermont

Lead Sponsor

Trials

283

Recruited

3,747,000+

National Institute of General Medical Sciences (NIGMS)

Collaborator

Trials

315

Recruited

251,000+

Citations

1. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2827185

Smartphone App–Based Contingency Management and ... This cohort study compares treatment outcomes associated with augmented medication for opioid use disorder with smartphone app–based ...

2. case.edu case.edu/socialwork/centerforebp/sites/default/files/2024-11/CM%20for%20OUD%20Research%20Summary%20Report%2011.22.24.pdf

CONTINGENCY MANAGEMENT FOR THE TREATMENT ... Contingency Management shows promise in treating OUD, particularly in reducing drug use and improving treatment retention. However, results are mixed, ...

3. tandfonline.com tandfonline.com/doi/full/10.1080/07853890.2022.2068805

Rewarding recovery: the time is now for contingency ... When combined with medication for OUD, contingency management demonstrates significant reductions in morbidity and mortality from OUD, considerable cost savings ...

4. mental.jmir.org mental.jmir.org/2025/1/e73617/PDF

Digital Contingency Management for Substance Use ... Objective: This study aimed to evaluate the effectiveness of DCM in treating substance use disorder by examining 2 key outcome variables— ...

5. pcori.org pcori.org/research-results/2019/comparing-three-ways-help-people-opioid-use-disorder-take-medicines-prescribed

Comparing Three Ways to Help People with Opioid Use ... This study compares the clinical effectiveness of three approaches to help adults with opioid use disorder (OUD) meet treatment goals.

6. jamanetwork.com jamanetwork.com/journals/jamapsychiatry/fullarticle/2782768

Contingency Management for Patients Receiving ... Prior reviews noted that contingency management effectively reduced nonprescribed drug use among populations with OUD but are now dated or ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT05702021

Implementing Contingency Management for Stimulant Use ... At six intervals, each of the 10 opioid treatment programs will extract de-identified electronic medical record data on contingency management implementation ...

8. library.samhsa.gov library.samhsa.gov/sites/default/files/contingency-management-advisory-pep24-06-001.pdf

contingency-management-advisory-pep24-06-001.pdf CM is equally effective among those with concurrent stimulant and opioid use disorder, as well as in promoting abstinence from cannabis use (SAMHSA, 2021a).

9. rdw.rowan.edu rdw.rowan.edu/cgi/viewcontent.cgi?article=4119&context=etd

CONTINGENCY MANAGEMENT FOR OPIOID USE DISORDER For the primary outcome measure, 72.7% of the contingency management group ... treatment outcomes for persons with opioid use disorder. American ...