Interest in and Perceived Effectiveness of Contingency Management Among Alcohol Drinkers Using Behavioral Economic Purchase Tasks

Contingency management (CM), in which financial incentives are provided upon verification of abstinence from alcohol, cigarettes, and/or illicit substances, is one of the most highly effective and empirically supported treatments for substance use disorders. However, the financial cost of implementation has been identified as a major barrier to implementation of this treatment. The purpose of this study was to develop behavioral economic purchase tasks to assess interest in CM as a function of treatment cost and perceived effectiveness ofCMas a function of abstinence incentive size in alcohol drinkers. Alcohol drinkers recruited from Amazon Mechanical Turk (MTurk) completed behavioral economic purchase tasks measuring demand for CM based on targeted abstinence intervals and treatment effectiveness and alcohol use disorder severity assessments. Nonlinear mixed-effects modeling was used to fit demand curves and assess the relationship between individual characteristics and demand metrics for CM. Results reveal that participants reported higher probability of remaining abstinent from drinking when offered larger incentives and required larger incentives when duration of abstinence required to earn the incentive was increased. Additionally, willingness to pay for treatment increased as effectiveness of treatment increased. Abstinence interval and treatment effectiveness are important features to consider when developing effective CM for widespread use, as these variables affected participants’ likelihood of being abstinent and their interest in treatment.