The Dopamine Dialogues

How can real-world implementation — and hard-won lessons from failure — make contingency management more effective at scale?In Episode 8 of Dopamine Dialogues, Larry Klemchuk speaks with JK Costello, Director of Behavioral Health Consulting at Stedman Group and a person in long-term recovery, about the practical realities of implementing contingency management (CM) across health plans, Medicaid agencies, and provider networks.Drawing from years of hands-on consulting across Colorado and beyond, JK shares what separates programs that succeed from those that struggle — and why the next frontier for CM may be alcohol use disorder.In this episode, we discuss:✅ What makes CM succeed in real-world settings — high fidelity and strong recruitment✅ Lessons learned from both program failures and major wins✅ Why immediacy and verifiability are non-negotiable in CM design✅ The case for expanding CM to alcohol use disorder✅ How JK helped secure $750K in Colorado state funding for CM✅ Scaling CM uniformly across funders, substances, and providersOne powerful takeaway from the episode:"We don’t need to build additional evidence for it. It’s already out there." — JK Costello🎧 Watch now and discover how contingency management is moving from research into real, scalable impact across behavioral healthcare systems.#ContingencyManagement #BehavioralHealth #AddictionRecovery #StimulantUseDisorder #AlcoholUseDisorder #DopamineDialogues #EvidenceBasedCare #PublicHealth #MedicaidInnovation #SubstanceUseDisorder

In Episode 7 of Dopamine Dialogues, Larry Klimchuk sits down with Dr Rick Rawson, one of the leading experts in addiction recovery and contingency management research.This conversation explores how contingency management can support stimulant recovery, improve patient engagement, and create measurable public health impact when implemented at scale.Dr. Rawson shares insights on:Why contingency management works for stimulant use disorderThe importance of proper implementation and protocol fidelityHow positive clinician interaction supports recoveryResearch showing reduced overdose deaths and healthcare costsFunding opportunities for CM programsWhy scaling CM is critical for the future of addiction treatmentThe episode also highlights how contingency management goes far beyond incentives—it creates structure, accountability, encouragement, and measurable progress for people in recovery.🎧 Listen now to discover why contingency management continues to be one of the most promising evidence-based approaches in behavioral healthcare.

In Episode 6 of Dopamine Dialogues, Dr. Faye Taxman, University Professor at George Mason University and a nationally recognized expert in health services criminology and implementation science.This conversation explores how contingency management (CM) can shift correctional and healthcare systems away from punishment-based approaches and toward positive behavior change, recovery, and improved quality of life.Dr. Taxman discusses:Why positive reinforcement is effective in correctional settingsHow implementation and organizational culture impact successThe importance of staff engagement and measurable outcomesCommon misconceptions surrounding contingency managementWhy CM should play a larger role in healthcare and preventionThe episode also highlights how small behavioral changes can create long-term ripple effects across individuals, families, and communities.Whether you work in behavioral health, healthcare, criminal justice, or policy, this episode offers valuable insights into building systems that support sustainable change.🎧 Listen now to learn how contingency management is helping reshape the future of care and recovery.

Contingency management has decades of proven research—but making it work in the real world is where most programs struggle.In this episode of The Dopamine Dialogues, Stephen Jenkins shares how the key to success lies in execution. From reducing clinical burden to improving engagement and delivering real-time incentives, he breaks down what it takes to build scalable, sustainable CM programs.Learn how technology, training, and thoughtful design can transform contingency management from a concept into a practical, high-impact solution that improves outcomes and drives long-term value.

What drives real, lasting change in addiction treatment?In Episode 4 of The Dopamine Dialogues, we are joined by Dr. Thomas Freese, a leader in behavioral health, to explore how contingency management (CM) supports engagement, retention, and long-term recovery in substance use disorder treatment.Contingency management is one of the most effective evidence-based interventions in addiction treatment. In this episode, Dr. Freese explains how CM works beyond incentives, helping individuals recognize the value of change in their own lives.In this episode, we discuss:✅ How contingency management improves engagement and retention✅ Why consistency and structure are key to behavior change✅ The role of reinforcement in sustaining recovery✅ Common challenges in implementing CM programsThis episode is designed for clinicians, program leaders, and public health professionals working to improve outcomes in addiction treatment.

Why is one of the most effective interventions in addiction treatment still underused?In Episode 3 of The Dopamine Dialogues, we are joined by Sir John Strang, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, a leading expert in addiction medicine, to explore the role of contingency management (CM) in modern substance use disorder treatment.Contingency management is widely recognized as one of the most effective evidence-based approaches for improving engagement and outcomes. However, many healthcare systems still face challenges when implementing and scaling CM programs.In this episode, we discuss:✅ The scientific evidence behind contingency management✅ Why CM shows strong effect sizes compared to other interventions✅ The importance of fidelity in delivering CM programs✅ Barriers to adoption across healthcare systems✅ What is needed to scale CM effectively in real-world settingsThis conversation is designed for clinicians, program leaders, and public health professionals working to improve addiction treatment and recovery outcomes.

In Episode 2 of The Dopamine Dialogues, we are joined by Dr. Lara Coughlin, Associate Professor of Psychiatry at the University of Michigan Medical School and researcher at the University of Michigan Addiction Center.Dr. Coughlin’s work focuses on the intersection of behavioral economics and addiction treatment, exploring how incentive-based approaches such as contingency management can improve engagement and outcomes for people with substance use disorders.In this episode we discuss:• Why access to addiction treatment remains limited• The behavioral science behind contingency management• Evidence supporting incentive-based treatment models• Insights from large-scale implementation programs• The future of digital approaches to contingency managementThe Dopamine Dialogues features conversations with researchers, clinicians, and policymakers exploring the science and real-world implementation of evidence-based addiction treatment.

In this first episode of The Dopamine Dialogues, Dr. Brian Hurley, Medical Director, Substance Abuse Prevention and Control at Los Angeles County Department of Public Health, breaks down why contingency management is strongly recommended in national guidelines for stimulant use disorder and why adoption still lags behind the evidence.We discuss real-world implementation, California’s 93% patient satisfaction rate, cost-effectiveness, and what states must get right to scale programs with fidelity.If you care about evidence-based addiction treatment, this conversation is essential listening.