PRO Health Group

Earlier this month at the East Coast Symposium, our Founder, Dr. Steve Proctor gave a keynote plenary about rewarding , particularly for people with addiction to m**hamphetamine/co***ne, for which no other treatment—psychosocial or pharmacological—has as strong an evidence base as contingency management.

When it comes to opioid addiction, while medications such as m**hadone & buprenorphine remain the gold standard, many people taking these medications drop out of treatment early and the overwhelming majority simply do not take their medication long enough to experience robust benefits. That is where contingency management—when delivered as an “add-on” to medication treatment—can reliably improve outcomes above-and-beyond medication alone.

Contingency Management Remains Underutilized Amid Addiction Crisis Often associated with treatment for stimulant addiction, contingency management programs can work as a complement to medication-assisted treatment for other substance use disorders as well, says Steven Proctor, PhD. Counseling News

No other treatment—psychosocial or medication—has as strong a research base for stimulant addiction than contingency management (i.e., rewarding ppl for achieving their goals).

We are proud to announce the release of the new clinical practice guideline by the American Society of Addiction Medicine - ASAM and the American Academy of Addiction Psychiatry (AAAP) aimed at fighting the rising stimulant use disorder (StUD) crisis. 💪 It's time to arm ourselves with knowledge and evidence-based strategies. Let's help bring change and improve the quality of care for those battling with StUD. 💡🌈 Download it now >> https://www.asam.org/quality-care/clinical-guidelines/stimulant-use-disorders

Dr. Proctor recently sat down with Luke Frazier of the SMART Recovery USA podcast to talk about all things & contingency management (i.e., rewarding people in addiction treatment for achieving their goals).

Topics of conversation included common barriers to scaling contingency management, calling out stigma, importance of continuing care, need for academic—industry partnerships to accelerate research, and the role of technology.

Listen here:

SMART Recovery® Podcast: Contingency Management Works! Dr. Steven Proctor is the founder and principal consultant of PRO Health Group and a Senior Program Director for . He is also a Licensed Clinical Psychologist who has studied and written about Contingency Management programs, most notably in his Annals of Medicine article,  Contingency Man...

Contingency management for works (i.e., rewarding people—often w/money—for achieving their goals) but it's rarely used by most treatment programs due to ethical, moral, and philosophical concerns regarding use of monetary incentives, as well as the lack of technological innovation. In light of surging opioid overdose deaths, there is a need for tech solutions leveraging the power of contingency management in a way that is viewed by both patients & providers as acceptable and feasible.

In a recent study led by Dr. Steven Proctor, we set out to determine the perceived acceptability & usability of *PROCare Recovery* — our new reward-based, recovery monitoring mobile app designed to automate contingency management by immediately delivering micropayments (e.g., $1) to patients for actively participating in their treatment via 'smart' debit card with blocking capabilities.

We found that both patients & treatment providers were overwhelmingly in favor of giving people small amounts of money ($1 to $5) for attending their appointments, taking their medication as directed, engaging in their treatment, and achieving their goals (up to $150 monthly).

As described by one patient: "People in recovery are broke. That is just the right amount. Not too much to hurt themselves. Small, which is good for ci******es, food, and other things."

Patients & providers also really liked the idea of using a 'smart' debit card as opposed to giving patients actual cash due to the option to turn on spending restrictions such as blocking ATM cash withdrawals and purchases at high-risk places like bars, liquor stores, casinos or online gambling, and strip clubs. Our findings also revealed that patients & providers found the PROCare Recovery app useful and easy-to-use.

According to another patient: "A lot of addicts will use the app just for the money, but it might save their life in the process."

Source: Proctor, S. L., Rigg, K. K., & Tien, A. Y. (2022). "Acceptability and usability of a reward-based mobile app for opioid treatment settings: Mixed m**hods pilot study." JMIR Formative Research.

Acceptability and Usability of a Reward-Based Mobile App for Opioid Treatment Settings: Mixed Methods Pilot Study Background: Contingency management is an evidence-based yet underutilized approach for opioid use disorder (OUD). Reasons for limited adoption in real-world practice include ethical, moral, and philosophical concerns regarding use of monetary incentives, and lack of technological innovation. In ligh...

According to Dr. Nora Volkow—Director of The National Institute on Drug Abuse - NIDA—science is an essential part of the solution to address America's growing drug overdose crisis.

However, we've now reached the point where the research on several strategies is so clear that to not put the science into action for the following 5 areas is considered unethical.

(1.) Naloxone (Narcan) opioid overdose antidote saves lives

(2.) Medications such as m**hadone or buprenorphine (Suboxone) for opioid use disorder work

(3.) Contingency management (rewarding people, often with money, for achieving their goals) is an effective treatment

(4.) Syringe services programs (free clean needles/syringes & referrals to treatment) can greatly mitigate harms

(5.) Prevention interventions can have a broad & lasting impact

Five Areas Where “More Research” Isn’t Needed to Curb the Overdose Crisis | National Institute on Drug Abuse Addiction and overdose continue to claim lives and fray communities, science is an essential part of the solution.

“Thriving Mind’s trauma recovery network connects people exposed to violent trauma to free mental health services in order to treat possible symptoms of post-traumatic stress disorder. Dr. Proctor says victims of gun violence are likely to exhibit a range of symptoms, including intrusive thoughts, trouble sleeping, difficulty concentrating, flashbacks, hypervigilance, anxiety, depressive episodes or suicidal thoughts.”

“But sometimes, Dr. Proctor says, victims don’t experience those at all. Sometimes, they just need help getting back on their feet. As a result, the trauma recovery network in part works to link victims with food baskets, housing vouchers and vocational assistance programs.”

Mass shootings renew trauma Looking to mental health as a solution to combat gun violence

Our Founder, Dr. Steven Proctor, joined Manny Munoz this morning on his news radio talk show WIOD to chat about the latest data released by the CDC showing over 100,000 Americans died last year of a drug overdose and the need for compassion & treatment, not punishment & jail for those struggling with addiction.

Listen to 3-min clip here: https://www.iheart.com/podcast/53-first-news-with-jimm-28270573/episode/05-12-22-overdose-epidemic-96807178/

Congrats to Dr. Khary Rigg from University of South Florida & our founder, Dr. Steven Proctor, on receiving a $1.3 Million grant from the Foundation for Opioid Response Efforts (FORE). Dr. Rigg and Dr. Proctor are working to improve treatment for families dealing with opioid addiction. Their project was one of only 9 grants awarded nationally out of over 400 proposals submitted.

MHLP researcher receives $1.3 million to break the cycle of intergenerational addiction Khary Rigg, PhD, an associate professor in the Department of Mental Health Law and Policy is focusing on a new project to facilitate wider adoption of a program designed for families with a parent in m**hadone treatment that simultaneously addresses both recovery for parents and prevention for child...

What’s one thing you love…

about you? 💚

Don’t give up. Don’t ever give up.

— Coach Jim 'Jimmy V' Valvano

Leadership at Thriving Mind South Florida and Jackson Health System met this week to kick off the opening of the Trauma Recovery Network for violent crime survivors & their families in Miami-Dade County and the Florida Keys. Dr. Steven Proctor, as the Program Director, will lead the effort to bring these much-needed trauma services to South Florida families impacted by violence. This program has been 3 years in the making, so please join me in congratulating everyone on the launch!

Thriving Mind’s President CEO John W. Newcomer, M.D. and Program Director Steven L. Proctor, Ph.D., met this week with Jackson Health System to scale up referrals into our multi-center Trauma Recovery Network for violent crime survivors and their families. The effort is funded by a $2.3 million Victims of Crime Act (VOCA) grant from the Florida Attorney General’s Office.

Don't give up.

93,000+ people died last year of a drug overdose—255 people every day—representing the greatest overdose-involved loss of life in a single year to date. Each overdose death is a tragedy and is someone's son, mom, best friend, brother, daughter, co-worker, cousin, etc.

It's also important to pay attention to the *psychological footprint* of the overdose crisis, which is far-reaching when you think about all the bereaved families & friends, first responders, law enforcement/others involved in death notification, 911 operators, neighbors, hospital nurses & doctors, medical examiners, and the community at large.

On this International Overdose Awareness Day, it is important to humanize the overdose crisis & bring attention to the role of compassion in medicine. This poem draws from the lived experiences of people w/opioid use disorder as well as national trends. In particular, there is one individual who shared that even momentary, seemingly insignificant acts of kindness by hospital staff in the context of his treatment had a lasting impact on his life. Important life events & milestones such as marriage, kids, and birthdays also begin to take on new meaning in recovery.

Despite current conceptualizations of addiction as a chronic, relapsing condition, it is treatable—effective treatments exist & recovery is possible. It is everyone's responsibility to speak out on behalf of people struggling with addiction, share our experiences with them, and hopefully reduce stigma along the way.

This poem is an open invitation to *everyone* to be an advocate. It requires no formal training & education to be kind.

Overdose is preventable. Addiction is treatable. Recovery is possible.


Thriving Mind South Florida

Last year was the highest number of drug overdose deaths *ever.* 2020 U.S. drug overdose deaths by the numbers:

🖤 93,331 moms, sons, friends, & loved ones died
🖤 256 people every day
🖤 10+ people every hour

US overdose deaths hit record 93,000 in pandemic last year NEW YORK (AP) — Overdose deaths soared to a record 93,000 last year in the midst of the COVID-19 pandemic, the U.S. government reported Wednesday. That estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to a 29% increase.

In this article from Filter Magazine, Drs. Steven Proctor & Khary Rigg discuss 4 common misconceptions when it comes to harm reduction & . First up, is the *myth* that responding to overdose calls with naloxone (Narcan) is a waste of resources.

Opponents of equipping police with naloxone (not to be confused with the opioid maintenance medication naltrexone) to respond to opioid overdose emergency calls often claim this falls outside the scope of law enforcement duties.

But while other emergency personnel also respond to such calls, police are often the first on the scene. As such, the ability for police to rapidly administrator naloxone—the antidote that has saved thousands of lives—is critical because administration must take place soon after opioid consumption to be effective. Minutes can sometimes be the difference between life and death.

Police are tasked with two of the most challenging and important responsibilities: (1.) to instill law & order, and (2.) to protect & serve their communities. The latter responsibility is becoming increasingly vital in light of the escalating . We need an “all hands on deck” approach, and as part of that, the role of police must evolve. As opioid-involved overdoses continue to spiral out of control, police now have an obligation to respond to overdose calls and save the lives of people who use drugs.

Let’s Address Four Common Myths About Harm Reduction The US has historically been resistant to supporting harm reduction programs for people who use drugs. While some object to ...

A total of 36 states now allow ma*****na to be used medically and 17 states allow recreational use. Yet researchers who wish to study the drug’s health effects have been limited since 1968 to a single legal supplier of the drug. After more than 50 years, however, the federal government is lifting a roadblock to research that has hindered rigorous scientific studies.

It's a move that promises to accelerate understanding of the plant's health effects & possible therapies for treating certain medical conditions—chronic pain, the side effects of chemotherapy, multiple sclerosis, and mental illness, among many others—that are yet to be well-studied.

After 50 Years, U.S. Opens The Door To More Cannabis Crops For Scientists Until recently, plants from only one U.S. facility were approved for use in research. Adding new suppliers will accelerate understanding of cannabis' health effects and possible therapeutic uses.

Miami Beach — come for the fun in the ☀️ stay for the 💉 with a view.

*Addiction* is giving up everything for one thing.

*Recovery* is giving up one thing for everything.

Contingency management for addiction involves rewarding people—often w/small amounts of money—for achieving their recovery goals. Despite hundreds of research studies supporting its effectiveness, a common criticism is "they'll just use the money to buy drugs."

For those sharing that sentiment, is your problem w/the money itself or the person? Do people w/addiction not need money for groceries, rent, childcare, bills, etc? Is employment (i.e., earning an income) not encouraged by most treatment programs for those able to work, especially early on in their ? We could all use a little help now & then 💜

Recent National study finds the top 2 addiction treatment outcomes patients & families care about most are:

(1) staying alive

(2) improving quality of life.

A recently published research article by Dr. Steven Proctor found that screening for using as few as 2 questions can be a very valid & efficient strategy, especially in settings such as county jails where fast-paced & high-volume workflow is common to standard booking/classification procedures.

📋 The top 2 screening questions were re: "difficulty concentrating" & "lack of energy"

Far too many addiction treatment program websites & marketing strategies use words like "effective," "best-in-class," "proven," "evidence-based," etc. to describe their services in the absence of empirical data to support such claims.

People struggling with addiction & their families deserve better than that.

"Positive Reinforcement Opportunity Project" (PROP) is an treatment approach in San Francisco for people who want to reduce their use of stimulants such as m**h, co***ne, etc.

Participants show up every Monday, Wednesday, & Friday for a drug test. Every time they have a negative drug test, they are rewarded w/money that is deposited into an account managed by the San Francisco AIDS Foundation. Participants can request to cash out at any time. After three consecutive negative drug screens, there’s a bonus. The more a behavior is rewarded, the theory goes, the more likely a person is to repeat it.

What If We Pay People to Stop Using Drugs? Traditional treatments often take place in expensive facilities, demand total abstinence, and rely on punitive m**hods of control. A harm reduction model turns all of that on its head.

Together, let’s pause & remember.

Today, January 27th we mark International Holocaust Remembrance Day. "The Holocaust, which established the standard for absolute evil, is the universal heritage of all civilized people" - Our Living Legacy. ⁠
Source World Jewish Congress Yad Vashem: World Holocaust Center, Jerusalem
With The Blue Card Claims Conference (Conference on Jewish Material Claims Against Germany) Greater Miami Jewish Federation United Way of Miami-Dade Thriving Mind South Florida The Children's Trust JCS Latino

Contingency management for addiction—i.e., rewarding ppl for achieving their recovery goals—is highly effective but highly underutilized. Opponents argue that some patients will try to "game" the system by simply doing whatever it takes to earn $ rewards.

If a patient w/hypertension, diabetes, obesity, etc. earns $1 for each day they engage in 30 mins of exercise, solely motivated by the modest financial incentive, will they not still experience positive health benefits over time (lower blood pressure, weight loss, etc.)?

When it comes to addiction, what if we rewarded patients w/both monetary (50¢, $1, $5) & non-monetary incentives for attending therapy appts, taking their medication (buprenorphine, m**hadone) as directed, participating in community-based mutual-help support groups, & engaging in other recovery-oriented behaviors?

With ~197 Americans dying of a drug overdose every single day, we should be less concerned with a patient's underlying motivation re: *why* they're engaging in treatment care & more focused on keeping them alive so that they can achieve .