More than 1,700 people died last year in Los Angeles County from an overdose involving methamphetamines, prompting the state to start a research program offering a reward—in this case, a $10 or $20 Target gift card—to encourage addicts to enter drug treatment. It’s a simple idea: giving individuals rewards, week by week, to get them to do difficult things, and there’s strong evidence suggesting that it can work with drug addicts. Such “contingency management” programs use the rewards system in the brain to nudge people away from drug use. Yet across the country, there are laws against paying patients under federal health programs, inhibiting wider use of such systems. Studies show that it can be highly effective, especially for meth, for which there are no FDA-approved medications. While there are some federal exceptions to drug programs, there are also philosophical objections to providing rewards for abstinence to those who have chosen to misuse or abuse drugs. Last year Governor Newsome vetoed a bill that would have placed incentive programs under Medi-Cal, saying he wanted a pilot program first. That will launch soon with state reimbursement, allowing people to earn up to $600 in gift cards to stay off meth and other stimulants. One question is whether the positive results have staying power or eventually wear off, with one study finding that 22 percent of patients in incentive programs were more likely to remain abstinent than people who received other treatments. Scientific data suggests that such programs provide an intervention that is worthy of continued investment and study.
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Rosenthal Center for AddictIon Studies