Prize-based contingency management is efficacious in cocaine-abusing patients with and without recent gambling participation.

Prize-based contingency management (CM) is efficacious in treating cocaine abuse, and the chance-based procedures of prize CM may be appealing to those who gamble. Using data from three randomized trials, including National Drug Abuse Treatment Clinical Trials Network protocol CTN-0007 (Motivational Incentives for Enhanced Drug Abuse Recovery: Methadone Clinics), researchers evaluated whether cocaine-abusing patients who had wagered in the month before treatment (n=62) responded more favorably to prize CM than those who had not (n=278). Participants were randomized to standard care (SC) or SC plus prize CM. Although prize CM was related to better outcomes overall, recent gambling was not associated with outcomes across or within treatment conditions. Gambling participation before treatment entry was associated with reductions in gambling over time, and this effect was more pronounced among those assigned to CM.

Although these results are limited by the short timeframe over which gambling was evaluated and the overall low rates of gambling in this sample, these data suggest that prize CM is efficacious in substance-abusing patients who do and those who do not gamble before entering substance abuse treatment, and they extend prior studies indicating that prize CM does not increase gambling.

Related protocols: CTN-0007