Date Approved
4-4-2025
Embargo Period
4-4-2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy (Ph.D.)
Department
Clinical Psychology
College
College of Science & Mathematics
Advisor
Bethany Raiff, Ph.D.
Committee Member 1
Tom Dinzeo, Ph.D.
Committee Member 2
Michelle Soreth, Ph.D.
Committee Member 3
Alice Ely, Ph.D.
Keywords
contingency management;incentives;opioid use;opioids;substance use;treatment
Disciplines
Clinical Psychology | Psychology | Social and Behavioral Sciences
Abstract
Individuals with opioid use disorder exhibit difficulty sustaining prolonged buprenorphine treatment engagement. Contingency management (CM; incentives) may serve to increase the reinforcing value of treatment itself, but most buprenorphine CM studies delivered incentives more frequently than in typical outpatient practice. This study sought to compare CM with treatment as usual (TAU; regular clinic procedures) in visit attendance and adherence (defined as urine samples positive for buprenorphine and negative for other opioids) in new outpatients at a hospital opioid treatment clinic. Participants (46 per group) were randomized to either CM or TAU and monitored by medical record for 12 weeks; for CM participants, incentives were delivered on a reloadable debit card. The CM group, compared to TAU, had higher rates of attendance and adherence at first follow-up after intake (attendance: CM = 67.4% vs. TAU = 45.7%; adherence: CM = 30.4% vs. TAU = 26.1%), and perfect attendance and adherence over all 12 weeks (attendance: CM = 22.2% vs. TAU = 8.7%; adherence: CM = 17.8% vs. TAU = 4.3%). The CM group, compared to TAU, had 1.56 times higher average attendance (95% CI [1.28, 1.91]), 1.63 times longer continuous attendance streak (95% CI [1.31, 2.02]), 1.98 times higher average adherence (95% CI [1.35, 2.14]), and a 1.94 times longer continuous adherence streak (95% CI [1.46, 2.59]). This study supports CM to increase early buprenorphine engagement delivered as standard clinic practice.
Recommended Citation
Goodwin, Shelby Renee, "CONTINGENCY MANAGEMENT FOR OPIOID USE DISORDER BUPRENORPHINE TREATMENT ENGAGEMENT: 3-MONTH OUTCOMES" (2025). Theses and Dissertations. 3344.
https://rdw.rowan.edu/etd/3344
