Contingency management treatment for methamphetamine use disorder in South Africa

Chukwuemeka N. Okafor, Dan J. Stein, Lisa Dannatt, Jonathan Ipser, Lara J. van Nunen, Marilyn T. Lake, Tamar Krishnamurti, Edythe D. London, Steve Shoptaw

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Introduction and Aims: As South Africa, especially the Western Cape Province, faces an epidemic of methamphetamine use disorder, therapeutic approaches suited to the South African context are needed. This secondary analysis assessed retention and methamphetamine abstinence outcomes in response to an 8-week pilot contingency management (CM) intervention trial of neural correlates of methamphetamine abstinence, exploring sociodemographic and clinical differences between responders and non-responders. Design and Methods: Research participants provided thrice-weekly monitored urine samples, which were analysed by qualitative radioimmunoassay. The primary outcome for this analysis was therapeutic response, defined as abstinence from methamphetamine (≥23 of 24 possible methamphetamine-negative urine samples). Results: Data from 30 adults living in Cape Town, South Africa (34 ± 6.1 years of age, mean age ± SD, 21 men) were included. Sixty-three percent (12 men) were responders. In bivariate comparisons, baseline measurements showed fewer responders reported monthly household income ≥25 000+ South African Rand (ZAR; ~USD $1880; vs. ZAR < 25 000) than non-responders (15.8% vs. 63.6%; P = 0.007). Furthermore, responders had higher median years of education (12 vs. 10; Kruskal–Wallis χ2 = 4.25, DF = 1, P = 0.039) and lower median body mass index than non-responders (19 vs. 24; Kruskal–Wallis χ2 = 6.84, P = 0.008). Discussion and Conclusions: Therapeutic response in this study were comparable to those obtained with CM for methamphetamine use disorder in North America and Europe. Our findings suggest that CM may be a useful component of treatment strategies to boost retention and continuous abstinence from methamphetamine in Cape Town, South Africa. Larger efficacy studies are needed in this setting.

Original languageEnglish (US)
Pages (from-to)216-222
Number of pages7
JournalDrug and Alcohol Review
Issue number3
StatePublished - Mar 1 2020


  • South Africa
  • behavioural treatment
  • contingency management
  • methamphetamine use disorder
  • stimulants

ASJC Scopus subject areas

  • Health(social science)
  • Medicine (miscellaneous)


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