Learning objectives:

1. Understand current trends in stimulant use and the need for contingency management.
2. Review the evidence behind Project CARAs intentional contingency management program design that targets patient engagement over urine drug screen results. Explore the Nurse’s role in creating, implementing, and sustaining a clinical contingency management program.
3. Apply solutions-based strategies to overcome barriers to implementing contingency management programs.

Abstract:

Although the overall rate of substance use disorders in the United States has remained stable since 2016, the rates of opioid use and stimulant use have continued to increase. Unlike medication for opioid use disorder (MOUD), there is currently no pharmacological treatment option for stimulant use disorder. Contingency management (CM), a behavioral health intervention based on operant conditioning, is one of the few efficacious treatment options for stimulant use. In order to provide an evidence-based treatment option for stimulant use, the Lead Nurse at Project CARA implemented a CM program in 2020. Project CARA is a perinatal substance exposure clinic in Western North Carolina that services 16 + counties and over 250 unduplicated patients per year. Project CARAs CM program is patient-centered, and was created using a co-design approach. CARAs CM program targets appointment attendance, not expected urine drug screen results, and patient incentives are tailored to parents and newborns. This presentation will review the tools needed to create and sustain the CM program in the clinical space, preliminary findings from the first 2 years of implementation, the nurses role in educating staff about using CM, as well as the clinical and patient experience since the implementation of CM.