There is a long history of using a token economy to reward people for positive behaviors. It’s been practiced successfully for decades. Cash can be problematic as it may be used to purchase illicit substances. Rewards such as gift cards or small gift items have been demonstrated to be very effective in shaping positive behaviors as they mirror the small successes that patients experience in recovery.
There is definitely a roll and as a psychiatrist I would work collaboratively with a neurologist to order and interpret results.
We want to avoid excessive sedation when people have TBI so it’s best to start “low and go slow.” It is also important to avoid other potential CNS depressants. If a patient has co-occurring pain, consider dividing the usual buprenorphine dose into a TID schedule. In general the dose is the same and the goal is the same – to address craving and withdrawal while avoiding any significant side effects.
