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Contingency Management: What is it and why does it work?

Winning rewards keeps you motivated to win your life back from addiction

Have you ever considered the power your brain holds in shaping your behaviors, especially when it comes to substance use? Contingency Management (CM) is an evidencebased approach in addiction treatment that taps into this neurobiological power to achieve lasting recovery from alcohol and drugs.

Did your mom ever offer you an allowance for cleaning your room? A dessert for eating your vegetables? Have you ever been encouraged to buy that extra $25 dollars of stuff to get free shipping from your favorite online store? Did you love the applause and cheers when you scored a basketball goal or a touchdown?

The addiction cycle and the areas of the brain involved. The brain's rewards center is hijacked by drugs and alcohol, which produce chemicals like dopamine.
The addiction cycle starts with intoxication when the brain’s rewards center is activated by drugs or alcohol. The next stage is withdrawal when the effects wear off. The last stage is anticipation and craving for the drug. Contingency Management’s rewards activate the brain without substances. (from the Surgeon General’s Report on Drugs, Alcohol, and Health)

If you said yes to any of those things, then you received a “contingent incentive,” an immediate reward that was predicated on you exhibiting a certain behavior. An incentive is contingent when it depends upon something being done first. Contingency Management means you learn to manage your substance use by receiving rewards after you have achieved goals that help you reduce your use and develop healthy behaviors.

How does Contingency Management Work?

CM is anchored in the concept of “operant conditioning,” a fundamental principle of behavioral psychology. This principle states that our actions are largely guided by their consequences. Positive consequences encourage the repetition of a behavior, while negative consequences discourage it. CM harnesses this principle by providing tangible rewards for positive behaviors like reducing substance use. You get a reward for attending an appointment, completing a challenge in our app, or testing negative for substances.

From the scientific perspective of neurobiology, CM affects the reward pathways in the brain that are often hijacked by substance use. The brain learns to associate substance use with pleasure due to the release of neurotransmitters like dopamine. Drugs and alcohol make us feel good because of what they’re doing to our brain. Over time, this association can drive compulsive behavior and substance dependence. In the addiction cycle, after you’ve used a substance, you experience withdrawal and feel bad when you don’t have the alcohol or drug inside you. Then, you are preoccupied and crave the substance until you use it again.

Here’s where CM comes in: By providing rewards for healthier behaviors, CM helps to rewire these neural pathways. The brain begins to link positive behaviors with rewards, which can gradually shift the balance away from the compulsive cycle of substance use. Little by little, your brain starts supplying itself with the chemicals that make you feel good and you don’t depend on drugs or alcohol anymore.

Rewards and Technology Beat Substance Use Disorders

Modern technology now allows us to deliver CM conveniently through our smartphone app, making it easier than ever to receive this type of treatment. Think about how many times you look at your phone every day to see if someone has sent you a message or liked your post on social media. This acknowledgement is a reward that triggers dopamine, much like a contingent incentive.

When you play a game on your smartphone, you keep playing each time you get a win or beat a battle. The game is rewarding you and triggering dopamine. This isn’t necessarily a bad thing because this powerful mechanism can be used in very positive ways. Science and research have proven that games are very effective educational tools that help people learn through motivation.

Going to a drug rehab clinic near you is like sitting in a classroom and listening to a teacher for hours. Compare that to playing a game where you keep getting little wins and the hours just fly by. You can get an idea of why a recovery program like Affect’s motivates people to work on their recovery journey with enthusiasm and excitement.

Affect’s app was built with principles of game design and the power of social reinforcement, as well as the rewards of CM. But, it not only provides the platform for delivering rewards, it also integrates expert medical care and counseling in a way that can be conveniently and confidentially accessed from anywhere. As an integrated program, Affect’s use of positive incentives along with therapy and medical support is proven by science to be one of the most effective ways to guide people to lasting sobriety. The data from treating thousands of people shows our program is twice as effective as traditional addiction treatment methods. People reduce their use by half in just the first month. They value the program so they stay in it longer. Most people who stay with it achieve sustained sobriety in 16 weeks.

By embracing CM, you’re not just adopting a new treatment strategy; you’re working with the natural mechanisms of your brain to foster healthier habits. It’s proof of the power of neurobiology and behavioral psychology in shaping our actions, and a tool that can empower you on your path to recovery.

To find out more about our approach and how it can work for you, reach out and talk to one of our treatment consultants. You can also just download our app and try it for free. When you enroll in the program, which is covered by many insurance plans and Medicaid, you can start redeeming the rewards you earn and get the full support of an expert care team delivered right to your phone. It won’t be long before those CM rewards add up and you win the greatest reward of all – a life free from addiction to alcohol and drugs.