Contingency Management (CM) for Substance Abuse Treatment

Placement on the Continuum of Evidence Promising Download icon Download PDF
Target Population: 
Adolescents, Adults
Military Sector: 
Veterans Affairs
Target Audience 

This program is for adolescents and adults who have substance use disorders.


The Contingency Management (CM) for Substance Abuse Treatment program, often used as an adjunctive program to other substance abuse treatment programs, is designed to encourage individuals with substance use disorders to change their maladaptive behaviors by offering incentives, such as tangible goods, as reinforcers.


A number of randomized controlled trials conducted on the CM for Substance Abuse Treatment program have shown significant effects on drug abstinence in populations using cannabinoids, nicotine, alcohol, opiates, opioids, and stimulants.   Positive and significant outcomes were also found for treatment retention, weeks of consecutive abstinence, aftercare attendance, compliance with prenatal visits/care (i.e., for pregnant populations), adherence to treatment goals, and increased time until relapse.  Program evaluations measuring opiate use have shown sustained effects up to 1 year post-treatment; whereas, for other substances the program has been shown to have sustained effects for up to 6 months post-treatment.


CM for Substance Abuse Treatment focuses on altering substance abuse behaviors in participants by utilizing behavioral principles. This program consists of three main parts.

  • Behavior targeted for change - Abstinence from substances, demonstrated by mandatory urinalysis or breathalyzer tests that come back negative, and adherence to treatment goals and meeting attendance expectations.
  • Reinforcers for the intended behavior - Provide money or vouchers that represent tangible items and can be redeemed at a later time.
  • Consequences for undesirable behavior - Eliminate reinforcers when participants submit substance-positive samples, do not attend meetings, or fail to comply with treatment goals.

Contingency Management programs can be adapted for diverse populations and audiences.   The CM for Substance Abuse Treatment manual provides guidelines for creating a customized program.

Previous Use 

CM for Substance Abuse Treatment has been used widely across the United States since the late 1960s.


CM for Substance Abuse Treatment training is suggested and available in a variety of formats. Please visit the training website for details


Considerations for implementing CM for Substance Abuse Treatment include purchasing reinforcers, considering attrition of participants, and managing fidelity of implementation.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email


If you are interested in implementing CM for Substance Abuse Treatment, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email


Duration of this program varies and depends on several factors such as needs of participants and requirements of the treatment program with which it is paired.


Material costs vary based on program length and the reinforcers used. The CM for Substance Abuse Treatment Manual is $49.95 and provides a guideline to help determine the costs of implementation.

Evaluation Plan 

To move CM for Substance Abuse Treatment to the Effective category on the Clearinghouse Continuum of Evidence, at least one additional randomized controlled trial should be performed demonstrating positive effects lasting at least two years from the beginning of the program or at least one year from program completion.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email


Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email:

You may also contact the Contingency Management University of Connecticut Health Center by mail 263 Farmington Avenue, Farmington, CT 06030-3944, email, or visit

*Resources and associated costs reflect those identified at the time of fact sheet publication.