Inclusion Criteria:  Age 18 and older Patients treated for opioid use disorder in the Outpatient Based Opioid Treatment (OBOT) Clinic and who also struggle with stimulant use disorder but failed conventional treatment (positive urine drug screen for substances other than THC and buprenorphine) Ideal candidates will test positive for 3 out of 4 weeks or more prior to starting contingency management  Exclusion Criteria:  Persons under the age of 18 Persons not able to attend follow-up clinic visits Persons not able to consent