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Rewards help people in treatment, new study says

It’s easy to forget that alcohol is a drug. Buying alcohol – in most states, anyway – is as simple as walking into a store and presenting some form of ID … if the clerk remembers to ask. Unlike most other abused drugs, alcohol is openly consumed at major events, with meals and among friends.

Alcohol is also addictive, and deadly. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that 88,000 people die from causes related to alcohol each year, making it the fourth-leading preventable cause of death in the U.S. Worse, not enough people seek treatment for alcohol abuse. Although the NIAAA also reports that 1.3 million adults received treatment for alcohol abuse at a specialized facility in 2015, that number was only 8.3 percent of the total adults who needed treatment.

Treatment for alcohol abuse can come in several forms – medications, therapy – but a new study from researchers based at Washington State University (WSU) in Spokane may have found a low-cost method to help patients get through treatment: Prizes.

Giving prizes or other rewards during treatment isn’t a new idea. Known as “contingency management,” the National Institute on Drug Abuse (NIDA) provides several examples of how these programs work, including:

  • Vouchers: Patients who progress through treatment receive vouchers, which they can exchange for things like movie passes, snacks or other activities.
  • Prize raffles: Patients can participate in a raffle for prizes such as cash cards or other desirable items.

A response to rewards

The study, published in the current issue of The American Journal of Psychiatry, examined 79 people with severe mental illness receiving outpatient treatment at a Seattle mental health clinic. Seriously mentally ill individuals often live dramatically shorter lives than their healthy counterparts. Data cited by the National Institute of Mental Health (NIMH) showed that the lifespan of the severely mentally ill can be dramatically shorter due to poor nutrition and addiction.

Roughly half of the 79 patients in the study participated in a three-month program in which rewards – which ranged from toiletries to electronic gadgets – were given for attending treatment sessions and having clean urine samples. Meanwhile, members of a control group were given rewards regardless of what they did or what their results showed.

Data from the test period showed that the patients in the first group were three times less likely to test positive for alcohol use than the control group. They were also three times less likely to test positive for cocaine use. Interestingly, the results extended to smoking – members of the test group were five times less likely to test positive for nicotine use.

“Our findings suggest that contingency management is a feasible approach for people with alcohol problems. And it may be particularly effective in those with serious mental illness – such as schizophrenia and bipolar disorder – a high-cost and difficult-to-engage population,” said study lead author Michael McDonell, Ph.D., in a WSU press release.

McDonell reports that only around 12 percent of mentally ill people who abuse alcohol receive treatment for their conditions at the same time. Instead, they receive treatment for both conditions separately, which McDonell says makes treatment less effective and negative outcomes – stopping treatment, health problems, homelessness – more likely.

“Using contingency management, we can treat their addiction at the same time as their mental illness, which can impact not only their alcohol and drug use but also reduce smoking and improve health,” said McDonell.

According to the American Psychological Association, people with mental illnesses are more likely to smoke.

A sober, healthier life is the best reward of all

Addiction and untreated mental disorders ruin lives – especially when they co-occur. Known as a dual diagnosis, the two disorders often strengthen each other, creating two potentially lethal problems for the patient.

Sovereign Health of Texas provides expert dual diagnosis treatment at our facility in El Paso. Located at the base of the Franklin Mountains, we offer a comfortable, welcoming environment for people to move past their problems and into a healthier life. Our English- and Spanish-speaking staff ensures that language is no barrier to treatment. A healthier life can start now. Please call our 24/7 helpline.

About the author

Brian Moore is a staff writer and graphic designer for Sovereign Health. A 20-year veteran of the newspaper industry, he writes articles and creates graphics across Sovereign’s portfolio of marketing and content products. Brian enjoys music, bicycling and playing the tuba, which he’s done with varying degrees of success for over 25 years. For more information and other inquiries about this media, contact the author and designer at

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