Rewarding recovery: the time is now for contingency management for opioid use disorder.
Rewarding recovery: the time is now for contingency management for opioid use disorder.
复制标题
DOI：
10.1080/07853890.2022.2068805
复制
发表时间：
2022-12
影响因子：
4.4
通讯作者：
Proctor, Steven L.
中科院分区：
文献类型：
--
作者：
Proctor, Steven L.
应急管理非常有效，但利用率很低。低吸收率主要归因于缺乏创新以及道德，伦理和经济问题等障碍。技术支持的解决方案和学术界与工业界的伙伴关系对于推进阿片类药物使用障碍的治疗至关重要。应急管理（即奖励人们，通常是金钱，以实现他们的恢复目标）得到了几十年的经验支持，但仍然高度利用不足。奖励很少用于现实世界的临床实践，由于一些问题，包括最值得注意的是，明显缺乏创新，以及道德，哲学，伦理和经济问题，甚至联邦规则，旨在防止医疗保健中的非法诱导。尽管如此，其他反对者认为，一些患者将试图通过简单地做任何事情来赚取金钱奖励来“游戏”系统。本文提供了一个简洁的，最新的阿片类药物使用障碍的应急管理的现有证据基础的概述。常见的障碍和解决方案的实施，以及对未来的研究和临床实践的影响进行了讨论。虽然重要，但更多地采用应急管理干预措施不仅仅是立法和法规;它是关于认识耻辱，塑造态度和提高认识。提供者参与各级宣传工作以及涉及学术-行业伙伴关系的合作对于推动新兴的数字医疗保健空间和改善阿片类药物使用障碍患者的结果是必要的。
Contingency management is highly effective but highly underutilized. Low uptake is largely attributed to a lack of innovation and moral, ethical, and economic concerns, among other barriers. Technology-enabled solutions and academic–industry partnerships are critical to advance opioid use disorder care. Contingency management (i.e. rewarding people, often with money, for achieving their recovery goals) is backed by decades of empirical support yet remains highly underutilized. Rewards are rarely used in real-world clinical practice due to a number of concerns, including most notably, the apparent lack of innovation, as well as moral, philosophical, ethical, and economic concerns, and even federal rules meant to prevent illegal inducements in health care. Still, other opponents argue that some patients will try to "game" the system by simply doing whatever it takes to earn monetary rewards. This paper provides a succinct, up-to-date overview of the current evidence base for contingency management for opioid use disorder. Common barriers and solutions to implementation, as well as implications for future research and clinical practice are discussed. Although important, greater uptake of contingency management interventions is about more than legislation and regulations; it’s about recognizing stigma, shaping attitudes, and increasing awareness. Provider involvement in advocacy efforts at all levels and collaboration involving academic–industry partnerships is necessary to advance the burgeoning digital health care space and improve outcomes for people with opioid use disorder.
登录
查看更多内容
影响因子：
7.4
作者：
Ashford RD;Lynch K;Curtis B
通讯作者：
Curtis B
影响因子：
12.7
作者：
Cicero, Theodore J.;Ellis, Matthew S.;Kasper, Zachary A.
通讯作者：
Kasper, Zachary A.
影响因子：
3.8
作者：
Cameron, Jacqui;Ritter, Alison
通讯作者：
Ritter, Alison
影响因子：
4.4
作者：
Jennings, Larissa;Lee, Nicole;Cheskin, Lawrence J.
通讯作者：
Cheskin, Lawrence J.
影响因子：
3.7
作者：
Branson, Christopher E.;Barbuti, Anna Maria;Bhutia, Phintso
通讯作者：
Bhutia, Phintso