title: Using contingency management procedures to reduce at-risk drinking in heavy drinkers.
abstract: BACKGROUND
  Treatments for alcohol use disorders typically have been abstinence based, but harm reduction approaches that encourage drinkers to alter their drinking behavior to reduce the probability of alcohol-related consequences, have gained in popularity. This study used a contingency management procedure to determine its effectiveness in reducing alcohol consumption among heavy drinkers.
  
  
  METHODS
  Eighty-two nontreatment-seeking heavy drinkers (ages 21 to 54, M = 30.20) who did not meet diagnostic criteria for alcohol dependence participated in the study. The study had 3 phases: (i) an Observation phase (4 weeks) where participants drank normally; (ii) a Contingency Management phase (12 weeks) where participants were paid $50 weekly for not exceeding low levels of alcohol consumption as measured by transdermal alcohol concentrations, <0.03 g/dl; and (iii) a Follow-up phase (12 weeks) where participants (n = 66) returned monthly for 3 months to self-report drinking after the contingencies were removed. Transdermal alcohol monitors were used to verify meeting contingency requirements; all other analyses were conducted on self-reported alcohol use.
  
  
  RESULTS
  On average 42.3% of participants met the contingency criteria and were paid an average of $222 during the Contingency Management phase, with an average $1,998 in total compensation throughout the study. Compared to the Observation phase, the percent of any self-reported drinking days significantly decreased from 59.9 to 40.0% in the Contingency Management and 32.0% in the Follow-up phases. The percent of self-reported heavy drinking days reported also significantly decreased from 42.4% in the Observation phase to 19.7% in the Contingency Management phase, which was accompanied by a significant increase in percent days of self-reported no (from 40.1 to 60.0%) and low-level drinking (from 9.9 to 15.4%). Self-reported reductions in drinking either persisted, or became more pronounced, during the Follow-up phase.
  
  
  CONCLUSIONS
  Contingency management was associated with a reduction in self-reported episodes of heavy drinking among nontreatment-seeking heavy drinkers. These effects persisted even after incentives were removed, indicating the potential utility of contingency management as a therapeutic intervention to reduce harmful patterns of drinking.
authors.affiliation: Department of Psychiatry , The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Dougherty
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Lake
authors.forename: Nathalie
authors.initials: N
authors.lastname: Hill-Kapturczak
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Liang
authors.forename: Tara E
authors.initials: TE
authors.lastname: Karns
authors.forename: Jillian
authors.initials: J
authors.lastname: Mullen
authors.forename: John D
authors.initials: JD
authors.lastname: Roache
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D001521:Behavior Therapy; D005260:Female; D040261:Harm Reduction; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D055815:Young Adult
keywords: Contingency Management; Excessive Alcohol Use; Harm Reduction; Self-Report; Transdermal Monitors
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