Can Paying Meth Addicts Help Them Stop Using?

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SEPT 28, 2021-

DEMBOSKY: Studies show contingency management works. In the San Francisco program Billy Lemon did, 63% of participants stopped using meth entirely, and another 19% reduced their use. The small payments aim to rewire the brain’s reward system, so the person seeks the money or gift card to get a dopamine release instead of meth or coke.

LEMON: You’re like, oh, oh, oh, I can feel good without the daily use of that substance. Let me try and go one more week. And then all of a sudden, you’re at 90 days. And you’ve actually – you’ve made a change. DEMBOSKY: But the treatment is controversial. Critics have scoffed at the idea of paying drug users not to use drugs, calling it unethical or a bribe. Most insurers don’t cover it – neither do state Medicaid programs. The feds generally forbid them from offering financial incentives to patients as a protection against fraud and waste.

But a California bill, now on the governor’s desk, would make clear that the state’s Medicaid program is allowed to offer contingency management. State Senator Scott Wiener is the author.

SCOTT WIENER: We need to embrace this proven, effective approach, make it clearly legal and start reimbursing for it.

DEMBOSKY: But the treatment is controversial. Critics have scoffed at the idea of paying drug users not to use drugs, calling it unethical or a bribe. Most insurers don’t cover it – neither do state Medicaid programs. The feds generally forbid them from offering financial incentives to patients as a protection against fraud and waste.

But a California bill, now on the governor’s desk, would make clear that the state’s Medicaid program is allowed to offer contingency management. State Senator Scott Wiener is the author.