•Amphetamine use before total hip arthroplasty (THA) increases the risk of complications, including dislocation, infection, fracture, revision, and readmission.

•Our transitional pain service (TPS) implemented perioperative contingency management (CM), an evidence-based treatment for stimulant use disorder that rewards abstinence.

 

•A patient scheduled for THA is positive for methamphetamines on the day of surgery.

•Surgery was canceled and the patient was referred to the TPS for perioperative CM.

•Nurse-led CM sessions occurred twice weekly for 8 weeks preoperatively and 4 weeks postoperatively.

•The patient reported abstinence from methamphetamines for 9 weeks after completing the program.

 

•It is feasible for a TPS to implement perioperative CM to improve patient access to surgery while offering a life-saving treatment.

•Costs may limit implementation but are less than the economic impact of canceled elective surgeries and surgical complications after THA.