Multivariate associations between sleep patterns and self-regulation in adolescence: Canonical correlation analysis across ABCD and NCANDA cohorts.

The majority of U.S. overdose deaths in recent years involved stimulants (59% of overdose deaths January 2021-June 2024) (). In 2024, over 4.2 million U.S. residents had stimulant use disorder (StUD) (). Ensuring the availability of effective StUD treatment is essential to countering the increasing harms of stimulant use. Contingency management (CM) is an evidence-based behavioral therapy in which abstinence from substances (or other health-promoting behaviors) is reinforced with incentives (financial or otherwise) (). CM is the most effective treatment currently available for StUD and is considered first-line treatment (; ). Clinical guidelines for StUD recommend CM as the primary component of the treatment plan in conjunction with other psychosocial treatments (). Unfortunately, CM provision is limited by multiple barriers, including U.S. policy-related barriers (e.g., lack of clarity around the federal Anti-Kickback Statute which seeks to prevent profit motives from improperly influencing provider behavior), lack of public and private payers that reimburse for CM, implementation barriers (e.g., lack of training in CM/behavioral interventions, required staffing), and stigma (). It is unclear to what extent recommended StUD treatment is available in substance use treatment facilities, as well as what factors might support or hinder availability. This exploratory analysis examined self-reported provision of recommended treatment for StUD in U.S. treatment facilities and associated facility characteristics.