Using Money to Encourage Alcohol Abstinence Can Be Effective

Newswise — It is estimated that only 20 to 24 percent of individuals with an alcohol use disorder (AUD) ever receive treatment of any kind for their disease. Most of the reasons given for not seeking treatment relate to the person’s inability or unwillingness to attend traditional in-person treatment. One alternative may be “contingency management.”  This is a method in which a reward is given – for example, money, privileges, or prizes – once abstinence from alcohol or the drug in question is verified. This study examined the effectiveness of providing a financial reward for alcohol abstinence.

Researchers recruited 40 treatment-seeking participants with an AUD (28 males, 12 females) from a Virginia community and randomized them to either a contingent or non-contingent group (20 in each group). Study tools included a breathalyzer that allowed remote, user-verified collection of a breath alcohol sample, text messaging, and reloadable debit cards for remote delivery of financial rewards. Participants were asked to submit three remote breathalyzer assessments per day throughout the 21-day treatment phase. A participant in the contingent group received near-immediate monetary rewards each time he or she remotely provided negative breathalyzer samples, plus daily rewards for abstinence. (NOTE: A participant who never recorded a positive sample and never missed a screen earned $350 in abstinence rewards for the study.) The non-contingent group also received matched monetary payments each day they provided samples, whether or not the samples were alcohol-free.

The scientists found that a remotely delivered monetary reward can be an effective way to reinforce alcohol abstinence among adults with AUDs who do not require inpatient detoxification to manage alcohol withdrawal symptoms.  The contingent group was abstinent 85 percent of the 21-day test period, compared to 38 percent for the non-contingent group. In addition, adherence to the thrice-daily breathalyzer assessments was high in both groups, with an overall sample collection rate of nearly 96 percent. These findings suggest that this intervention has the potential for wide dissemination due to its positive results and low participant and provider burdens.