Perspectives and sentiments on contingency management from people who use methamphetamine

Author:

Clay Simon1ORCID,Wilkinson Zachary1,Ginley Meredith2,Arunogiri Shalini3ORCID,Christmass Michael4,Membrey Dean5,MacCartney Paul5,Sutherland Rachel1ORCID,Colledge‐Frisby Samantha16ORCID,Marshall Alison D.78,Nagle Jack9,Degenhardt Louisa1ORCID,Farrell Michael1,McKetin Rebecca1ORCID

Affiliation:

1. National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia

2. East Tennessee State University Johnson City Tennessee USA

3. Turning Point & Monash Addiction Research Centre, Eastern Health Clinical School Monash University Melbourne Australia

4. Next Step Community Alcohol and Other Drugs Service Mental Health Commission Perth Australia

5. CoHealth, Western Health Melbourne Australia

6. National Drug Research Institute Melbourne Australia

7. Centre for Social Research in Health UNSW Sydney Sydney Australia

8. Kirby Institute UNSW Sydney Sydney Australia

9. Connections Based Living Melbourne Australia

Abstract

AbstractIntroductionContingency management (CM) is currently the most efficacious treatment for methamphetamine use, yet it is rarely available in routine care. We examined the viewpoints of people who use methamphetamine on CM as a potential treatment for methamphetamine use disorder.MethodsSemi‐structured qualitative interviews with 30 Australians aged 18 years or older who had used methamphetamine at least weekly in the past 6 months.ResultsParticipants reported overall positive attitudes towards CM as a potential treatment option for methamphetamine use disorder. However, there was need for greater flexibility in meeting participant treatment goals (e.g., reduced use or complete abstinence), with particular concern about the viability of initiating abstinence, both in terms of the sufficiency of the initial financial incentive and managing withdrawal symptoms. There was strong interest in the use of digital technologies to provide remote CM, particularly around the convenience and flexibility this offered. Despite this, participants remained keen to access adjunctive treatment and support services but stressed that engagement with these additional services should not be mandatory. Marketing of CM will need to address preconceptions about drug‐testing used in abstinence‐based CM being punitive (especially urine testing) and its connotations with criminal justice interventions.Discussion and ConclusionPositive attitudes towards CM bode well for potential uptake should CM be made available in routine clinical practice. However, there is a need to adapt CM to ensure it is feasible and attractive to people who are seeking treatment for methamphetamine use disorder.

Publisher

Wiley

Subject

Health (social science),Medicine (miscellaneous)

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