Neurocognitive outcomes in adolescents with and without four weeks of cannabis abstinence: a randomized clinical trial using contingency management

Schuster et al. (2025) asked teens with cannabis use disorder to stay clean for four weeks. Half the teens got a token system: each clean urine earned points they could swap for gift cards. The other half only got drug tests and check-ins.

All teens took computer tests of memory, attention, and the ability to stop a wrong action. The team wanted to know if paid abstinence would sharpen thinking skills.

The paid-abstinence group got better at stopping impulsive clicks. Memory and attention scores did not move. The gain was small but real compared with the teens who were only watched.

In short, money for clean urine helped teens think before they hit the button.

Goldman et al. (1979) did something similar with adults who drank too much coffee. They paid people to cut caffeine week by week. Coffee drinking dropped two-thirds and stayed down for almost a year. The same simple idea—cash for less drug—works across ages and drugs.

Fradet et al. (2025) and Chan et al. (2025) also ran remote teen RCTs, but they used mindfulness and parent groups instead of money. All three 2025 studies show you can reach teens through screens and still move clinical numbers. Schuster adds the piece that concrete rewards, not just calm breathing, can change behavior and brain scores.

No clash here: mindfulness helps mood, tokens help drug abstinence and self-control. Use the right tool for the target.

If you work with teens who use cannabis, you now have an easy telehealth plan: urine test, instant gift-card points, and a quick game to track self-control. The money keeps them clean long enough for the brain to practice stopping. You can start Monday with a $5 e-gift code and a laptop go/no-go task.