In the United States, only around 20% of people meeting criteria for having an alcohol use disorder ever receive treatment. Many of the top 10 reasons commonly cited for not seeking treatment come under the umbrella of an inability or unwillingness to attend traditional in-person treatment, for example: “I should be strong enough to handle it alone”; “I’m too embarrassed”; “I can’t afford it”; “I don’t want to go to treatment”; “I hate answering questions”; “I don’t think anyone can help”; “I don’t know any place to go”.

Contingency management is an approach to substance use treatment that involves repeatedly testing a client to see if they have used the target substance recently, and giving them a reward or incentive each time the test shows that they have been abstinent. Studies have shown that while itis an effective approach for reducing drinking and drug use, considerable logistical barriers prevent contingency management from being disseminated widely. The featured US study developed and tested the efficacy, acceptability, and feasibility of a remotely-delivered contingency management intervention to encourage abstinence, which in theory carried the potential for broad dissemination due to the low burden on people involved, including professionals supporting delivery of the intervention.

Key points From summary and commentary
• A US study tested the efficacy, acceptability, and feasibility of remotely-delivered contingency management.
• The chance that someone in contingency management would abstain from drinking was nine times that of people not in contingency management.
• Due to the low burden on researchers and participants, contingency management supported by new digital technologies seems to have potential for broad dissemination.