Contingency Management Approaches

Zajac, Kristyn; Alessi, Sheila M.; Petry, Nancy M.

doi:10.4324/9781315689197-37

Cited by 8 publications

(3 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, most addicts "mature out" without clinical intervention mostly around the late twenties and early thirties, because incentives as employment and family are probably enough to make them stop. Also addicted individuals can give up on drugs with the right incentive, for example monetary reward and small prizes on condition of a drug-free urine sample (Zajac et al, 2018). These studies suggest that addiction should not be treated as something over which subjects can't have control but as something over which subject's won't have control.…”

Section: Criticisms and Counter Arguments Against The Brain Disease M...mentioning

confidence: 99%

Addiction, cure or care?

Chinchella¹,

Hipólito²

2022

Preprint

View full text Add to dashboard Cite

Addiction has been historically conceived and widely researched as a brain disease. While there has been much criticism of brain-centred approaches to addiction, this paper aims to reject such an approach by applying insights from phenomenology of psychiatry. More precisely, the paper applies Merleau-Ponty’s insightful distinction between the biological and the lived body. In this light, the disease model emerges as an incomplete account of addiction because it captures only its biological aspects. When considering addiction as a brain disorder, it will be shown, research fails to account for the contextual, functional, and emotional aspects of subjective health. It is concluded that, while the disease model is fundamental to understand what happens in the brain, its brain-centred approach is cure-oriented. Tackling the lived body experience, what we label here as care-oriented, allows for a more encompassing therapeutical interaction: for it cares for understanding and treating the psychological feel as bodily experience situated in an environment.

show abstract

Section: Criticisms and Counter Arguments Against The Brain Disease M...mentioning

confidence: 99%

Addiction, cure or care?

Chinchella¹,

Hipólito²

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In forced‐choice laboratory studies offering the immediate opportunity to use crack cocaine or receive monetary reward, addicts frequently choose money over drugs (Hart, Haney, Foltin, & Fischman, 2000). In addition, contingency management treatment is highly effective (for a review see Zajac, Alessi, & Petry, 2018) offering positive rewards contingent on drug‐free urine samples in the form of money, prizes, and most recently and successfully, employment (Silverman, Holtyn, & Morrison, 2016); rates of use are cost‐sensitive (Ainslie, 2000); and correctional services can succeed in establishing abstinence by imposing costs for failure (Hawken & Kleiman, 2009; Levy, 2013). Lastly, large‐scale epidemiological data suggest that the majority of people meeting criteria for SUD (including those with physical dependence) recover without clinical intervention by their late 20s or early 30s (Heyman, 2009) – and of course, anecdotal (Heyman, 2009) and clinical (Pickard & Pearce, 2013) stories abound of people going “cold turkey”.…”

Section: Understanding Addictionmentioning

confidence: 99%

Addiction and the self

Pickard

2020

Nous

View full text Add to dashboard Cite

Addiction is standardly characterized as a neurobiological disease of compulsion. Against this characterization, I argue that many cases of addiction cannot be explained without recognizing the value of drugs to those who are addicted; and I explore in detail an insufficiently recognized source of value, namely, a sense of self and social identity as an addict. For people who lack a genuine alternative sense of self and social identity, recovery represents an existential threat. Given that an addict identification carries expectations of continued consumption despite negative consequences, there is therefore a parsimonious explanation of why people who identify as addicts continue to use drugs despite these consequences: they self‐identify as addicts and that is what addicts are supposed to do. I conclude by considering how it is nonetheless possible to overcome addiction despite this identity, in part by imagining and enacting a new one. Importantly, this possibility requires the availability of social support and material resources that are all too frequently absent in the lives of those who struggle with addiction.

show abstract

“…In forced‐choice laboratory studies offering the immediate opportunity to use crack cocaine or receive monetary reward, people with substance use disorder frequently choose money over drugs 37 . In addition, contingency management treatment is highly effective, 38 offering positive rewards contingent on drug‐free urine samples in the form of money, prizes, and most recently and successfully, employment 39 . Rates of use are cost sensitive, 40 and correctional services can succeed in establishing abstinence by imposing costs for failure 41 .…”

Section: The Myth Of Compulsionmentioning

confidence: 99%

What We're Not Talking about When We Talk about Addiction

Pickard¹

2020

Hastings Center Report

View full text Add to dashboard Cite

The landscape of addiction is dominated by two rival models: a moral model and a model that characterizes addiction as a neurobiological disease of compulsion. Against both, I offer a scientifically and clinically informed alternative. Addiction is a highly heterogenous condition that is ill‐characterized as involving compulsive use. On the whole, drug consumption in addiction remains goal directed: people take drugs because drugs have tremendous value. This view has potential implications for the claim that addiction is, in all cases, a brain disease. But more importantly, it has implications for clinical and policy interventions. To help someone overcome addiction, you need to understand and address why they persist in using drugs despite negative consequences. If they are not compelled, then the explanation must advert to the value of drugs for them as an individual. What blocks us from acknowledging this reality is not science but fear: that it will ignite moralism about drugs and condemnation of drug users. The solution is not to cleave to the concept of compulsion but to fight moralism directly.

show abstract

Contingency Management Approaches

Cited by 8 publications

References 1 publication

Addiction, cure or care?

Addiction, cure or care?

Addiction and the self

What We're Not Talking about When We Talk about Addiction

Contact Info

Product

Resources

About