Runtime: 42:33
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SHOW NOTES
Summary
In this episode, host David P. Ball dives into the topic of contingency management (CM), an evidence-based behavioural treatment model for stimulant use disorder. David begins with Mark Haggerty, a peer navigator with St. Paul’s Rapid Access Addiction Clinic’s Rewarding Change program. Mark offers a rundown of the work happening in CM groups and shares how his lived experience guides the support he provides to participants. David is then joined by Dr. Paxton Bach, BCCSU’s medical director and an addiction medicine specialist, to discuss the clinical aspects of CM groups. Finally, they welcome Amanda Chapman and Dr. Anne Crawford of Island Health’s Rewarding Recovery program, who speak to operational considerations and share clinical takeaways.
Lineup
In this episode, you’ll hear:
- [1:43] – Mark Haggerty, Guest – Peer Navigator, St. Paul’s Rapid Access Addiction Clinic, Rewarding Change Program
- [14:22] – Dr. Paxton Bach, Co-host – BCCSU Medical Director, Clinical Assistant Professor – Department of Medicine at UBC, General Internist and Addiction Medicine Physician at St. Paul’s Hospital
- [17:06] – Amanda Chapman, Guest – Coordinator, Addiction Medicine Substance Use Program Island Health
- [17:06] – Dr. Anne Crawford, Guest – Psychiatrist, Island Health, Rewarding Recovery Contingency Management Program, and Our Place Society – New Roads Therapeutic Recovery Community of Victoria
Clinical Pearls
Here’s what listeners can take away from this episode:
- Contingency management is the strongest evidence-based treatment option for stimulant use disorder.
- The rewarded behaviour doesn’t have to be abstinence. Outcomes like attendance, follow-up appointments, or SMART goals can be incentivized and can make the program more approachable.
- Motivational interviewing framework can be helpful to assess whether a patient’s goals align and if they would be a good fit for the program.
- Running longer and flexible programs, like 20-week groups with rolling entry, paired with CBT relapse prevention and graduates welcomed to continue attending groups can help sustain gains.
Resources
Mentioned in episode
- Petry NM. Contingency management: what it is and why psychiatrists should want to use it. Psychiatrist. 2011;35(5):161-163. doi:10.1192/pb.bp.110.031831 https://pmc.ncbi.nlm.nih.gov/articles/PMC3083448/
- Providence Research. ASCME Clinical Trial. https://www.providenceresearch.ca/en/clinical-trial/ascme-clinical-trial
Supports for care providers
- BCCSU. 24/7 Addiction Medicine Clinician Support Line. https://www.bccsu.ca/24-7/
- Rapid Access to Consultative Expertise (RACE) Line. https://www.raceconnect.ca/use-race
Supports for patients
- Government of BC. Help Starts Here. https://helpstartshere.gov.bc.ca/
Videos and podcasts
- Supporting People Who Use Methamphetamines. BC ECHO on Substance Use. 2025. https://www.youtube.com/watch?v=oViYmW-YQUE&t=1s
- Treatment and care for stimulant use disorder. Addiction Practice Pod. 2023. https://bcechoonsubstanceuse.ca/podcast/s3-ep2-treatment-and-care-for-stimulant-use-disorder/
Reports, statistics, and guidance
- British Columbia Centre on Substance Use. Stimulant Use Disorder Practice Update. 2022. https://www.bccsu.ca/wp-content/uploads/2022/06/Stimulant-Use-Disorder-Practice-Update_June2022.pdf
- CATIE. Methamphetamine: An overview of trends in Canada, its role in the drug poisoning crisis and other health issues. https://www.catie.ca/prevention-in-focus/methamphetamine-an-overview-of-trends-in-canada-its-role-in-the-drug-poisoning
- Vancouver Coastal Health. Low-barrier Contingency Management: How-To Guide. August 2024. https://www.vch.ca/en/media/18666
Articles
- Bach P, Garrod E, Robinson K, Fairbairn N. An Acute Care Contingency Management Program for the Treatment of Stimulant Use Disorder: A Case Report. J Addict Med. 2020;14(6):510-513. doi:10.1097/ADM.0000000000000643
- Hartsook S, Crawford A. An evaluation of a two-year virtual contingency management group. University of British Columbia Department of Psychiatry. 2023. https://med-fom-psychiatry-sandbox2019.sites.olt.ubc.ca/files/2023/05/Hartsook-Stuart-An-Evaluation-of-a-Two-year-Virtual-Contingency-Management-Group-1.pdf
- Ronsley C, Nolan S, Knight R, et al. Treatment of stimulant use disorder: A systematic review of reviews. PLoS One. 2020;15(6):e0234809. Published 2020 Jun 18. doi:10.1371/journal.pone.0234809