Targeting Addiction Treatment Engagement: A Canadian Randomized Effectiveness Trial of Remotely Administered Contingency Management for Treatment Attendance: Cibler l'engagement en matière de traitement des dépendances : essai d'efficacité à répartition aléatoire mené au Canada portant sur la gestion des contingences mise en œuvre à distance pour la participation au traitement.

IntroductionContingency management (CM) is an evidence-based treatment used as a stand-alone treatment or an adjunct to usual care for individuals with substance use disorders (SUDs). However, its use in clinical practice is limited, particularly in Canada. This study implemented and evaluated the effectiveness of CM for SUDs in 2 outpatient addiction clinics in Alberta.MethodsA 3-month, 2-armed, parallel-group, unblinded intervention comparing attendance-based CM (n = 43) with a treatment-as-usual (TAU) control group (n = 45). Participants in the CM group were incentivized using a hybrid prize-and-voucher method. Specifically, treatment attendance was rewarded with virtual prize draws, the number of which accrued incrementally based on consecutive attendance.ResultsParticipants in CM were retained in treatment for longer durations and attended more treatment sessions with greater consistency compared to participants in TAU. No differences between groups were observed for substance use outcomes or quality of life. The small sample size limits the generalizability of the results.ConclusionOur results support the adaptability of CM in the Canadian context to improve treatment retention and attendance. The remote capabilities of CM reduce the barriers to access, allowing for greater reach of this intervention. The results highlight how CM can be tailored to be more economical through its focus on attendance, a focus consistent with improving addiction recovery in Canada.