Contingency management, researchers like McDonell say, is that thing: It works, patients like it, and it’s cost-effective. Literature reviews and analyses often agree: A review of 69 reports released from 2009 to 2014 found “high levels of treatment efficacy” in contingency-management treatment. On average, it increased a patient’s odds of reaching abstinence by 117%. Here’s how the treatment works: You come in a few times a week, complete a urine test, and if it’s negative, you draw for a prize — at a trial McDonell is running in Wallingford, there are “small” prizes like shampoo or a toothbrush, “big” prizes like a coffeemaker, or rare “jumbo” prizes like a DVD player. The longer you’re sober, the more draws you get, but if the test comes back positive, the clinician says “see you next time.”

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