Kaufman, V., Tomlinson, D. C., Hellman, L., & et al. (2025). The path forward for substance use disorder treatment using contingency management under Sect. 1115 demonstration waivers. Substance Abuse Treatment, Prevention, and Policy, 20, 37. https://doi.org/10.1186/s13011-025-00666-6
Substance use disorders (SUDs) are a prevalent issue in the United States (U.S.) and there is a need for innovative treatments to address this public health issue. As of March 2025, there are seven states either approved or in the process of applying for Sect. 1115 Demonstration Waivers to implement pilot contingency management (CM) programs for SUD treatment. This manuscript qualitatively summarizes these Sect. 1115 Demonstration Waivers and the different aspects of each U.S. state's program.
Coughlin, L. N., Tomlinson, D. C., Zhang, L., Kim, H. M., Frost, M. C., Khazanov, G., McKay, J. R., DePhilippis, D., & Lin, L. A. (2025). Contingency Management for Stimulant Use Disorder and Association With Mortality: A Cohort Study. The American journal of psychiatry, appiajp20250053. Advance online publication. https://doi.org/10.1176/appi.ajp.20250053
While opioid overdose has begun to decrease in recent years, stimulant overdose has continued to increase and has not been adequately addressed. Unlike opioid use disorder, there are no medications approved by the U.S. Food and Drug Administration to treat stimulant use disorder (StUD). The most effective treatment is contingency management (CM), a behavioral intervention that provides tangibled health system in the United States, the Veterans Health Administration (VHA), from July 2018 through December 2020. The primary outcome was mortality in the year following the index CM visit. All-cause mortality data were obtained from the National Death Index and linked to electronic health record data. Adjusted hazard ratios were estimated using stratified Cox proportional hazards models.
Lothumalla, S., Tomlinson, D. C., Duguid, I., Wilkins, C., Bayrakdarian, N. D., Hellman, L., Jannausch, M., Werner, P., Lapidos, A., & Coughlin, L. N. (2025). An exploration of Michigan certified peer support specialists' perceptions on tobacco use and additional future supports. Tobacco prevention & cessation, 11, 10.18332/tpc/200025. https://doi.org/10.18332/tpc/200025
Certified peer support specialists, recovery coaches and community health workers uniquely connect to individuals who smoke through shared experiences. This study examines peers' perceptions of tobacco cessation supports to enhance policy and intervention opportunities in rural and non-rural communities.
Rodriguez, C. R., Campbell, M., Bonar, E. E., Goldstick, J. E., Walton, M. A., Lin, L. A., & Coughlin, L. N. (2025). Improving data integrity in samples obtained from web-based recruitment: Protocol for the development of a novel system for assessing participant authenticity in a remote longitudinal cohort study of polysubstance use. JMIR Research Protocols, 14(1), e69956. https://doi.org/10.2196/69956
This protocol aims to outline authenticity concerns encountered via remote recruitment for a longitudinal cohort study of adults reporting polysubstance use. Stemming from these concerns, we describe the development of a novel system of participant authenticity checks, designed with the goal of maximizing data integrity and minimizing the introduction of additional barriers to participating in the research. Finally, we examine rates of passing each active authenticity check among participants recruited via web-based advertisements.
Tomlinson, D. C., Wilkins, C., Bayrakdarian, N., Dolecki, F., Jr, Bonar, E. E., Fernandez, A., Tzilos Wernette, G., & Coughlin, L. N. (2025). Michigan tobacco cessation champions: A rapid qualitative analysis. Preventive Medicine Reports, 49(102945), 102945. https://doi.org/10.1016/j.pmedr.2024.102945
Smoking is the leading cause of preventable death in the United States. We interviewed Tobacco Cessation Champions, multi-sector decision makers, across the state of Michigan to assess and identify barriers and facilitators of smoking cessation and the current smoking cessation landscape.
Bayrakdarian, N. D., Bonar, E. E., Duguid, I., Hellman, L., Salino, S., Wilkins, C., Jannausch, M., McKay, J. R., Staton, M., Dollard, K., Nahum-Shani, I., Walton, M. A., Blow, F. C., & Coughlin, L. N. (2024). Acceptability and feasibility of a mobile behavioral economic health intervention to reduce alcohol use in adults in rural areas. Drug and alcohol dependence reports, 11, 100225. https://doi.org/10.1016/j.dadr.2024.100225
At-risk alcohol use is associated with increased adverse health consequences, yet is undertreated in healthcare settings. People residing in rural areas need improved access to services; however, few interventions are designed to meet the needs of rural populations. Mobile interventions can provide feasible, low-cost, and scalable means for reaching this population and improving health, and behavioral economic approaches are promising.
Coughlin, L. N., Campbell, M., Wheeler, T., Rodriguez, C., Florimbio, A. R., Ghosh, S., Guo, Y., Hung, P. Y., Newman, M. W., Pan, H., Zhang, K. W., Zimmermann, L., Bonar, E. E., Walton, M., Murphy, S., & Nahum-Shani, I. (2024). A mobile health intervention for emerging adults with regular cannabis use: A micro-randomized pilot trial design protocol. Contemporary clinical trials, 145, 107667. https://doi.org/10.1016/j.cct.2024.107667
Emerging adult (EA) cannabis use is associated with increased risk for health consequences. Just-in-time adaptive interventions (JITAIs) provide potential for preventing the escalation and consequences of cannabis use. Powered by mobile devices, JITAIs use decision rules that take the person's state and context as input, and output a recommended intervention (e.g., alternative activities, coping strategies). The mHealth literature on JITAIs is nascent, with additional research needed to identify what intervention content to deliver when and to whom.
Coughlin, L.N., Bonar, E.E., Wieringa, J., Zhang, L., Augustiniak, A.N., Goodman, G.J. & Lin, L.A. Pilot trial of a telehealth-delivered behavioral economic intervention promoting cannabis-free activities among non-treatment seeking adults with cannabis use disorder. Journal of Psychiatric Research, (2023); 163: 202-210. PMID: 37224772 https://pubmed.ncbi.nlm.nih.gov/37224772/
Cannabis is increasingly consumed and increasingly perceived as harmless. Among those whose use develops into a cannabis use disorder (CUD), <5% initiate and engage in treatment. Thus, novel options for low-barrier, appealing treatments are needed to foster engagement in care.
Coughlin, L.N., Jennings, C.J., Hellman, L., Florimbio, A.R., Jannausch, M. & Bonar, E.E. Development and pilot testing of an experimental cannabis marketplace: Toward evaluating the impact of cannabis policy on consumer choices. Cannabis and Cannabinoid Research. (2023); https://pubmed.ncbi.nlm.nih.gov/37347989/
The legal landscape of recreational cannabis production and consumption is rapidly expanding, driving a need to inform empirically supported cannabis regulatory policy. A behavioral economic framework integrating economic constructs (e.g., price, substitutability) with psychology and decision-making sciences, has previously been applied to tobacco regulatory sciences through the use of experimental marketplaces. However, experimental marketplaces have not yet been applied to understand cannabis choice behaviors or study ways to minimize risks from use. Herein, we describe the development and initial feasibility testing of an Experimental Cannabis Marketplace (ECM). The ECM can serve as an experimental platform relevant to evaluating the impact of regulatory policies on cannabis choices and use behavior.
Coughlin, L. N., Salino, S., Jennings, C., Lacek, M., Townsend, W., Koffarnus, M. N., & Bonar, E. E. (2023). A systematic review of remotely delivered contingency management treatment for substance use. Journal of Substance Use and Addiction Treatment, 208977. https://pubmed.ncbi.nlm.nih.gov/36804352/
Substance use and related consequences (e.g., impaired driving, injuries, disease transmission) continue to be major public health concerns. Contingency management (CM) is a highly effective treatment for substance use disorders. Yet CM remains vastly underutilized, in large part due to implementation barriers to in-person delivery. If feasible and effective, remote delivery of CM may reduce barriers at both the clinic- and patient-level, thus increasing reach and access to effective care. Here, we summarize data from a systematic review of studies reporting remote delivery of CM for substance use treatment.
Coughlin, L. N., Bonar, E. E., Walton, M. A., Fernandez, A. C., Duguid, I., & Nahum-Shani, I. (2022). New Directions for Motivational Incentive Interventions for Smoking Cessation. Frontiers in digital health, 4, 803301. https://doi.org/10.3389/fdgth.2022.803301
Motivational incentive interventions are highly effective for smoking cessation. Yet, these interventions are not widely available to people who want to quit smoking, in part, due to barriers such as administrative burden, concern about the use of extrinsic reinforcement (i.e., incentives) to improve cessation outcomes, suboptimal intervention engagement, individual burden, and up-front costs.