Colin MacKenzie M.D.
January 5, 2020

Most of us are familiar with the change in motivation that can come from receiving tangible rewards for good performance.  Whether providing an allowance to a child for doing chores or giving a stock options bonus to a corporate CEO, rewarding positive performance works in a variety of settings and circumstances.  Performance rewards have also been demonstrated to work in an addiction treatment setting as well.  A study by McDonnell and Colleagues published in the American Journal of Psychiatry used a urine toxicology test (ethyl-glucuronide (EtD)) to assure adherence to sobriety and performance rewards of varying type and magnitude including monetary payments from $0.05 up to $80.00. Each participant was tested three times per week and received the chance to get a reward for each negative urine test. 


Those participants in the contingency (reward) management group had twice the duration of abstinence compared to those in the control group (without contingency (reward) management) and were three times more likely to submit a negative urine test and three times less likely to report heavy alcohol use.  These results persisted during the three-month follow-up period after contingency management termination.


So another study demonstrates benefits to contingency (reward) management in the treatment of addiction treatment.  These results suggest benefits using these methods in addiction management programs. Implementing rewards for progress are likely to produce longer periods of sobriety.  


McDonell MG1, Leickly E1, McPherson S1, Skalisky J1, Srebnik D1, Angelo F1, Vilardaga R1, Nepom JR1, Roll JM1, Ries RK1:  A Randomized Controlled Trial of Ethyl Glucuronide-Based Contingency Management for Outpatients With Co-Occurring Alcohol Use Disorders and Serious Mental Illness. Am J Psychiatry. 2017 Apr 1;174(4):370-377. doi: 10.1176/appi.ajp.2016.16050627. Epub 2017 Jan 31.