Gift Cards to Combat Meth Addiction

California has introduced a novel approach to combating methamphetamine addiction: using gift cards to incentivize sobriety. Known as “contingency management”, this method offers financial rewards to individuals for each drug test they pass. Despite its success in clinical trials and use by the U.S. Department of Veterans Affairs for over a decade, it has remained largely unused in California due to Medicaid’s refusal to cover it. A recent waiver by the federal Centers for Medicare & Medicaid Services will now allow the program to be funded, making California the first state to win approval for a contingency management program under Medicaid. The state will launch pilot programs in 24 counties, financed through its recent expansion of Medi-Cal services.

However, there are concerns that this form of treatment might not work for everyone and that patients could relapse once the program ends. The hospital will offer six additional months of counseling post-program to mitigate this.

Stimulant use, particularly methamphetamine, poses a significant issue in California, accounting for 65% of drug-related deaths in 2021. The state’s homelessness crisis has worsened the situation, with a high proportion of unhoused individuals resorting to amphetamines to stay alert during the night.

Main Takeaways

• California is launching a program that rewards people with gift cards for staying sober, a method known as “contingency management”. This is a response to the methamphetamine crisis in the state, where traditional treatment methods have shown limited effectiveness.
• The program will be funded through the recent expansion of Medi-Cal services and is possible due to a waiver by the federal Centers for Medicare & Medicaid Services.
• Pilot programs will be launched in 24 counties, including San Francisco, Sacramento, and Los Angeles.
• Contingency management has previously shown success in clinical trials and has been used by the U.S. Department of Veterans Affairs for over a decade.
• Despite the potential effectiveness of this method, there are concerns about patient eligibility due to bureaucratic hurdles and the risk of relapse once the program ends.

Sources:

California Department of Health Care Services

UCSF Benioff Homelessness and Housing Initiative

National Institute on Drug Abuse

JAMA Psychiatry