Enhancing Motivation, MAT Adherence & Retention with Routine Use of Contingency Management (1.5 CME)
(1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn that Contingency Management (CM) is the best-researched, most effective -- yet least utilized -- treatment innovation in addiction. After a half-century of research, clinicians still have numerous concerns: ethics (is it enabling to pay patients money?), resources (where will the money come from?), testing (frequent and visually witnessed drug testing?) & management (who will do the intricate accounting?). Technology can surmount each of these obstacles, with the added plus of patient engagement & relapse/dropout prediction. Providers will describe technology's potential for enhancing motivation, improving MAT adherence, & extending treatment retention. Data from thousands of patient events with several different technologic tools indicates that these approaches are feasible with many types of: Substance use disorders (from tobacco smoking to opioids) Subpopulations (from pregnant women to criminal justice-involved returning citizens to corporate executives) Providers (from counselors to case managers to recovery coaches), and Settings (from medical centers to recovery homes to national insurance companies). Finally, large data (e.g., < 90,000 financial transaction events from 1,400 patients) can generate imminent dropout and relapse indicators with good validity (e.g., 70% positive predictive value) that can be used to issue real-time alerts to providers to intervene -- even prior to a patient's return to drug use, allowing rapid treatment intensification without the need for repeat detoxification to address withdrawal. Impacts range from decreased drinking, to longer treatment retention to meaningful program completion (e.g., improving graduation rates from 67% to 87% within a justice-system involved long-term rehabilitation). Attendees will workshop how to achieve practical implementation within busy, oversubscribed and scarcely-resourced practices and treatment programs in the midst of an epidemic.
1.) Explain the obstacles that have prevented wide-spread adoption of contingency management in routine care.
2.) Describe the research foundation for enhancing treatment outcomes in patients with substance use disorders using contingency management.
3.) Analyze the utility of various new technologies that have been proposed and implemented to overcome the obstacles to adoption of contingency management.
David R. Gastfriend, MD, served on the faculty of Harvard Medical School for 25 years, most recently as Director of the Addiction Research Program at Massachusetts General Hospital (MGH). His studies of the Patient Placement Criteria published by the American Society of Addiction Medicine (ASAM) have been supported by the NIH's National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the U.S. Centers for Disease Control, U.S. state governments, managed care corporations, including Aetna Behavioral Healthcare, and foreign governments, including Belgium, Finland, Iceland, Israel, Norway, Switzerland, and the World Health Organization. The author of over 125 scientific publications, he has served on the Boards and Editorial Boards of a number of societies and journals, including ASAM and the International Society of Addiction Medicine (ISAM). He is co-editor of the leading book on treatment matching in the field, The ASAM Patient Placement Criteria for Substance-Related Disorders and editor of Addiction Treatment Matching. In addition to his role at RecoverySearch, Dr. Gastfriend is also Vice President for Scientific Communications at Alkermes, Inc. (NASDAQ: ALKS) where he is involved in research, education and scientific publication on extended-release naltrexone (VIVITROL®) and the company's efforts in the field of addiction treatment.
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABPM Maintenance of Certification (MOC)
The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1.5 LLSA credits towards ABPM MOC Part II requirements.
ABAM Transitional Maintenance of Certification (tMOC)
This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 1.5 AMA PRA Category 1 Credit(s)™ for completing this course.
ABIM Maintenance of Certification (MOC)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.