Perspectives and sentiments on contingency management from people who use methamphetamine

Simon Clay, Zachary Wilkinson, Meredith Ginley, Shalini Arunogiri, Michael Christmass, Dean Membrey, Paul MacCartney, Rachel Sutherland, Samantha Colledge-Frisby, Alison D. Marshall, Jack Nagle, Louisa Degenhardt, Michael Farrell, Rebecca McKetin

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Introduction: Contingency management (CM) is currently the most efficacious treatment for methamphetamine use, yet it is rarely available in routine care. We examined the viewpoints of people who use methamphetamine on CM as a potential treatment for methamphetamine use disorder. Methods: Semi-structured qualitative interviews with 30 Australians aged 18 years or older who had used methamphetamine at least weekly in the past 6 months. Results: Participants reported overall positive attitudes towards CM as a potential treatment option for methamphetamine use disorder. However, there was need for greater flexibility in meeting participant treatment goals (e.g., reduced use or complete abstinence), with particular concern about the viability of initiating abstinence, both in terms of the sufficiency of the initial financial incentive and managing withdrawal symptoms. There was strong interest in the use of digital technologies to provide remote CM, particularly around the convenience and flexibility this offered. Despite this, participants remained keen to access adjunctive treatment and support services but stressed that engagement with these additional services should not be mandatory. Marketing of CM will need to address preconceptions about drug-testing used in abstinence-based CM being punitive (especially urine testing) and its connotations with criminal justice interventions. Discussion and Conclusion: Positive attitudes towards CM bode well for potential uptake should CM be made available in routine clinical practice. However, there is a need to adapt CM to ensure it is feasible and attractive to people who are seeking treatment for methamphetamine use disorder.

Original languageEnglish
Pages (from-to)1427-1437
Number of pages11
JournalDrug and Alcohol Review
Volume42
Issue number6
DOIs
Publication statusPublished - Sept 2023

Keywords

  • contingency management
  • methamphetamine
  • qualitative
  • substance use
  • treatment

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