Training as Implementation: Embedding Contingency Management into Medical Education

Abstract

Contingency Management is a highly effective behavioral intervention for Substance Use Disorders, yet its adoption remains limited outside of well-funded institutions—especially among marginalized populations. This editorial argues that a key barrier to Contingency Management implementation is its absence from medical education and clinical training, which perpetuates provider skepticism, ethical concerns, and poor integration into diverse care environments. Drawing from a narrative review of literature from 2000–2024, we identify systemic and provider-level obstacles to Contingency Management adoption and propose a roadmap for embedding it into the training pipeline for future healthcare providers. Our aim is to position medical education, and specifically early equity-focused training, as a critical intervention point for scaling Contingency Management use across clinical settings. We outline practical strategies such as early curricular inclusion, elective coursework, simulation-based learning, culturally responsive training modules, and interdisciplinary community partnerships. Ultimately, we argue that reimagining Contingency Management as a flexible, culturally adaptable tool embedded in medical training can help close the implementation gap and expand access to equitable addiction care.