Earlier this week, Governor Gavin Newsom asked the federal government for permission to use tax dollars to pay for a program that would incentivize negative drug tests with money.

Frustrated with the ever-increasing drug overdose death rate in California, leaders want to pay people to stay sober. The federal government has been doing it for years with ex-military veterans, and studies have shown that it’s one of the most effective ways to get people to stop using hard drugs like cocaine and meth, which have no available pharmaceutical treatments.

Essentially, addicts would receive money or small incentives for every negative drug test over a period of time. If they can complete treatment without ever testing positive, they can earn a few hundred dollars. This is known as “contingency management”.

Governor Gavin Newsom proposed to use tax dollars and pay for it through Medicaid, which covers nearly 14 million people in California. A similar proposal is also moving through California’s legislature, passing the Senate with no opposition. It’s currently pending in the Assembly and even has a Republican co-author.

“I think there is a lot in this strategy for everyone to like,” said state Sen. Scott Wiener, a Democrat from San Francisco and author of the bill. “Most important of all, it works.”

Depending on how many people participate, the cost would vary. For example, if the program covered 1,000 people, it could cost as much as $286,000, though this number is just a drop in the bucket when it comes to California’s operating budget of over $262 billion.

In some areas, contingency management programs are already in effect. For example, The nonprofit San Francisco AIDS Foundation has seen success. In one case, Tyrone Clifford, who was formerly addicted to meth, enrolled because they promised to pay him for every negative test over 12 weeks.

He received $2 for his first negative test, and with every subsequent negative test, he received a total of about $330.

“I thought, I can do 12 weeks. I’ve done that before when my dealer was in jail,” he said. “When I’m done I’ll have 330 bucks to get high with.’”

However, Clifford made it through the program without testing positive and it changed his mind. Instead of buying more drugs with the money, he bought a laptop so he could get back into school. Now he hasn’t used meth in over 11 years and works as a counselor at the San Francisco AIDS Foundation where he’s helping people who had the same struggle with addiction that he did.

Clifford said that earning money didn’t matter that much, but watching his account grow with each negative test motivated him to stay clean more than any other treatment or 12-step program ever did.

“You watch those dollar values go up, there is proof right there that I am doing this,” he said. “By no means is anyone getting rich off this program.”

While the program doesn’t work for everyone, treatment includes extensive group and one-on-one counseling sessions that keep people accountable and make them feel like they’re part of a community. If California starts contingency management treatments through Medicaid, similar programs would explode across the state.

Like most of the country, California has struggled with the grip of opioid abuse, but more so with stimulants like meth and cocaine. Between 2010 and 2019, deaths from stimulants quadrupled and have gotten worse ever since.

In the first nine months of 2020, stimulant overdose deaths lept 42% from the data in 2019. While there are treatment options for opiates, there are currently none available for stimulants, leaving people to their own power of will to kick the habit.

“There is a clear kind of hole in regards to treatment services for individuals who have a stimulant use disorder,” said Jacey Cooper, director of California’s Medicaid program. “At this point (contingency management) is the only thing people are pointing to that has been effective.”

In a state where psychedelics might soon be fully legalized and the cannabis industry is booming, it’s important to look at this area and fill the gaps to promote a safer environment in California. Cannabis has also been shown to help addicts recover from addiction, but with the laws and the red tape, it’s a far cry to ever consider cannabis in a state or federally funded program.



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