Contingency Management Helped People with Mental Health Disorders Reduce Cannabis Use | Research

The takeaway

A systematic review of 6 studies found that contingency management, which provides rewards for abstinence, was effective at reducing cannabis use in people with co-occurring psychotic disorders or major depression.

Addiction psychiatrists; dual-diagnosis treatment programs; therapists working with cannabis use disorder.

CM produced cannabis reduction and abstinence in psychosis and depression patients

What the researchers found

Contingency management produced cannabis use reductions and periods of abstinence in individuals with psychotic-spectrum disorders or major depressive disorder. The approach specifically reinforced target behaviors like confirmed abstinence from cannabis.

Why it matters

Cannabis use disorder in people with mental illness is associated with worse symptoms, poorer treatment response, and reduced functioning. Despite this, few treatments have shown efficacy for this specific population. Contingency management may fill this gap.

The numbers in context

6 studies met inclusion criteria. Diagnoses included psychotic-spectrum and major depressive disorders. CM was efficacious for cannabis use reduction and abstinence in these populations.

How the study worked

Systematic search of PubMed, PsycINFO, and EMBASE through November 2022. Identified 6 studies examining contingency management effects on cannabis use, clinical outcomes, cognitive function, and psychosocial functioning in patients with co-occurring CUD and mental health disorders.

What this study cannot tell us

Only 6 studies met criteria, reflecting limited research in this area. Studies were small and varied in design. Long-term follow-up data were lacking. Other psychiatric populations (anxiety disorders, PTSD) were not represented.

How to read the evidence

Moderate: systematic review methodology, but only 6 small studies were available.

When this study was published

Published in 2022.

The bigger picture

Contingency management has strong evidence for other substance use disorders but has been less studied for cannabis, especially in dual-diagnosis populations. These findings suggest it deserves broader implementation and further research.

Questions still open

Would CM be effective for cannabis use in people with anxiety disorders or PTSD? What reward schedules work best for cannabis abstinence? Can CM be combined with other interventions for additive effects in dual-diagnosis patients?

Common questions

What is contingency management?

Contingency management provides tangible rewards (like vouchers or prizes) when patients achieve specific goals such as confirmed drug abstinence. It leverages positive reinforcement to motivate behavior change.

Does it work for people with both cannabis problems and mental illness?

Yes. This review found contingency management reduced cannabis use in people with psychotic disorders and major depression, populations where standard treatments often have limited success.

Read the original research

Contingency Management for Treatment of Cannabis Use Disorder in Co-Occurring Mental Health Disorders: A Systematic Review.

Brain sciences, 13(1)

View on PubMed ↗Publisher’s paper ↗

Citation

Rodas, Justyne D; Sorkhou, Maryam; George, Tony P. (2022). Contingency Management for Treatment of Cannabis Use Disorder in Co-Occurring Mental Health Disorders: A Systematic Review.. Brain sciences, 13(1). https://doi.org/10.3390/brainsci13010036