Care Navigation Failed to Improve Methamphetamine Treatment Linkage

A care navigation program incorporating contingency management did not significantly improve linkage to treatment within 30 or 90 days among adults enrolled after a methamphetamine-related acute care encounter, according to a randomized clinical trial published in JAMA Network Open.

The prospective, single-site, nonblinded BEAT Meth trial enrolled 192 adults at Denver Health’s safety-net health system between April 2023 and September 2024. Eligible patients had a methamphetamine-related encounter at a withdrawal management program or psychiatric emergency service. Investigators assigned 96 participants to the intervention and 96 to usual care.

The 3-month intervention combined needs-based, trauma-informed care navigation with contingency management principles, an initial needs assessment, weekly follow-up, and assistance accessing social supports. Usual care included counselor-assisted discharge planning that identified potential treatment options, shelters, and Medicaid resources. The primary outcomes were linkage to treatment within 30 and 90 days, measured as a composite of Denver Health electronic health record encounters and self-reported treatment outside the system.

At 30 days, 24 participants (25.0%) in each group had linked to treatment (risk ratio [RR], 1.00; 95% CI, 0.61-1.63). At 90 days, linkage occurred in 32 intervention participants (33.3%) and 24 control participants (25.0%); the difference was not statistically significant (unadjusted RR, 1.33; 95% CI, 0.85-2.09). In the intervention group, 60 participants (62.5%) engaged in at least 2 navigation sessions. The 90-day study visit was completed by 47 intervention participants (49.0%) and 37 control participants (38.5%).

Investigators noted that the intervention could not be blinded, low follow-up survey response limited those data, and the single setting and location may limit generalizability. They concluded that incorporating contingency management principles may have increased engagement with the navigator but did not increase the likelihood of treatment linkage.

Source: Al-Tayyib A, Rinehart DJ, Duarte KG, et al. Care navigation for methamphetamine use disorder: a randomized clinical trial. JAMA Netw Open. 2026;9(9):e2631628. doi:10.1001/jamanetworkopen.2026.31628