Interest in contingency management and reducing stimulant use among syringe service program participants

Expanding access to effective treatment for stimulant use disorder (StimUD) is increasingly urgent as US fatal drug poisonings involving stimulants have rapidly increased. Limited information is available regarding interest in StimUD treatment among syringe service program (SSP) participants including interest in contingency management (CM).

We surveyed SSP participants in Burlington, Vermont regarding their interests in reducing and stopping stimulant use, participating in CM, and examined associations between sociodemographics, drug use, and health/treatment variables with interest in reducing and stopping stimulant use using multivariable logistic regression.

Among 139 participants, 64.6 % reported interest in reducing and 59.7 % in stopping stimulant use. Overall, 82.8 % of participants reported interest in CM to reduce or stop stimulant use. Interest in reducing use was greater (odds ratio[95 % CI]) among participants currently receiving substance use disorder (SUD) treatment (3.84[1.61-9.14], p < .01), without Hepatitis C viral (HCV) infection (2.61[1.14-5.98], p = .02), and being somewhat (19.29[2.25-165.65], p = .01) or very (19.65[2.34-164.84], p = .01) concerned about anxiety. Interest in stopping use was greater among participants currently receiving SUD treatment (4.98[1.97-12.62], p < .01), without HCV infection (2.87[1.22-6.74], p = .02), participants whose primary drug was opioids compared to both stimulants and opioids (28.13[2.95-267.93], p < .01), and participants whose primary drug was stimulants compared to both stimulants and opioids (12.81[1.45-113.43], p = .02).

Results demonstrate interest in stimulant use treatment among this sample of SSP participants, with strong interest in CM. As community-based programs with high social acceptability for their non-judgmental services, SSPs are a novel setting to examine providing evidence-based CM for StimUD.