ArticleThe International journal on drug policy2026
Provision of recommended treatment for stimulant use disorder in United States substance use treatment facilities.
Article in The International journal on drug policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionStimulant-associated harms are increasing in the U.S. Contingency management (CM) is the most effective available stimulant use disorder (StUD) treatment; guidelines recommend CM in conjunction with other psychosocial treatments. Unfortunately, there are barriers to CM provision, and it is unclear to what extent recommended StUD treatment is available in substance use treatment facilities. We examined provision of recommended StUD treatment reported by U.S. treatment facilities and associated facility characteristics.
methodsWe used 2024 National Substance Use and Mental Health Services Survey (N-SUMHSS) data. Outcomes included facility report of frequent use of CM/motivational incentives (CM/MI) for non-opioid substances, and CM/MI plus other recommended treatments (cognitive behavioral therapy [CBT], community reinforcement approach [CRA], or Matrix Model [MM]). We estimated associations between facility characteristics and outcomes using multivariable logistic regression models.
resultsLess than half of facilities reported frequent use of recommended StUD treatment (42% CM/MI, 41% CM/MI+CBT, 8% CM/MI+CRA, 25% CM/MI+MM). In general, reported provision of CM/MI alone or in combination with other treatment was positively associated with state licensure/certification, accepting state-financed insurance, offering opioid agonist treatment, and higher state percent rural population (except CM/MI+CRA), and negatively associated with primarily providing substance use services (vs. mental health and substance use services), private non-profit ownership (vs. private for-profit), accepting Medicare or Medicaid, cash/self-pay only, and higher state-level stimulant-involved overdose mortality rate.
conclusionIncreasing the availability of recommended StUD treatments, especially CM, is crucial in U.S. substance use facilities. These exploratory findings can inform future research to help policymakers and administrators improve access.
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