Mar 10, 2022 – A new legal opinion from the Biden administration appears to clear the way for wider use of an underutilized harm reduction technique: paying people addicted to drugs for staying clean.

Known as “contingency management,” the idea is supported by decades of research that shows providing repeated small payments for meeting goals in the recovery process has an outsize impact in helping people remain sober.  Contingency management is considered especially valuable for treatment of people addicted to stimulants such as methamphetamine and cocaine because there are no proven medications for that disorder. Opioid abuse is best treated with medications such as buprenorphineand methadone, though far too few people receive them. The technique also has been used to help people quit smoking, lose weight and change other unwanted behaviors.  But until last week when the inspector general’s office for the Department of Health and Human Services posted an advisory legal opinion, its use was sharply limited by concern that any such program would run afoul of a federal law that bars kickbacks to patients. At the request of a company that has been using the method and conducting research on the effectiveness of payments to drug users, people addicted to alcohol and smokers, the government for the first time allayed those fears.