Last updated: March 20, 2023
In August 2021, Gov. Gavin Newsom proposed a revolutionary idea. He wanted to use taxpayer money to pay meth addicts, or those suffering from other specific drug addictions, to stay sober. If successful, California will be the first state in the nation to provide this type of incentive.
The cost of the program will run into hundreds of thousands of dollars. Gov. Newsom isn’t expecting California citizens to foot the bill on their own though. He asked the federal government for permission to pay for the program through Medicaid.
As you would suspect, some taxpayers aren’t happy about the idea. However, if the result is saving lives, won’t it be worth it?
Drug overdose deaths in California linked directly to substances like methamphetamine and cocaine had nearly quadrupled between 2010 and 2019. And, since the onset of COVID—and the lockdown that ensued for much of the state soon after—preliminary data shows that deaths due to drug overdose raised dramatically. Case in point, stimulant overdose deaths increased by more than 42% from 2019 t0 2020.
How would it work?
In short, those suffering from drug addiction—say, meth addicts who would suffer uncomfortable, even dangerous, withdrawal symptoms causing many to stay trapped in the cycle of addiction, for instance—would receive a small payment or other incentives for every negative drug test result. Program participants test periodically throughout a specific period of time.
Those that complete the treatment without any positive test results would earn a few hundred dollars. The plan is to hand out payments via gift card.
They call it “contingency management” and the federal government has been doing it since about 2011 within the veteran community. Research shows that it’s one of the most effective ways to help vets suffering from addiction to cocaine, methamphetamine, and other stimulants for which there aren’t any available pharmaceutical treatments.
Others have tried it
The San Francisco AIDS Foundation, a nonprofit organization, runs a small contingency management program. The foundation deems it a success.
They call it the PROP program. Participants involved in the program say they feel comfortable. And, the number one reason given is because they can make a mistake. That’s right. Even if someone participating in the program tests positive, they aren’t penalized for it. Well, other than the fact that they don’t receive that payment. They are allowed to continue in the program and that motivates many of them to move toward success.
In fact, an evaluation of the program found that the majority of those participating reduced their drug use. And, 47% of meth addicts who completed the program said they felt confident in their ability not to turn to the drug when triggered.
Is the federal government picking up the tab?
No word yet if the federal government is backing the program. This, despite the fact that they had announced making a decision by the end of 2021.
However, in October of last year, a bill introduced by Senator Scott Wiener (D) passed unanimously that would have put the contingency management program in place. To the surprise of many, Governor Newsom vetoed the bill. At the time, he stated he wanted to test the program to rate its success before signing it into law.
“The outcomes and lessons learned from the pilot project should be evaluated before permanently extending the Medi-Cal benefit,” Newsom wrote in a veto message. “As such, this bill is premature.”
The pilot program begins this month though and ends in March 2024. The Biden Administration has shown interest in the program. But, to date, there still hasn’t been any word on whether or not the federal government will participate.
As in other successful payout programs, people taking part in the program get tested multiple times per week over a set period of time. Each time they test negative, they are rewarded. It may be as little as $2 but over the course of the program, people who only test negative can earn a few hundred dollars.
Something’s got to give
With deaths caused by drug overdose rising astronomically across the country since the pandemic struck our nation in 2020, the need to reach out to those struggling with addiction is more imperative than ever before.
If offering payment to stay sober is a way to get someone to make the attempt to take control over their addiction, California may be heralded as discovering the means to the end one day.
In the meantime, the country will be watching to see how the pilot program plays out. It’s likely other states will consider following suit if it’s deemed a success.
We may all decide that if contingency management programs save lives, it’s definitely worth it to offer to pay addicts to stay sober.