Staying Clean Could Soon Pay Off for Some California Addicts—Literally

The State Assembly is looking to enact a so-called ”contingency management” program that would pay problem addicts to get sober
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Governor Gavin Newsom and members on both sides of the aisle in the State Assembly are looking to enact plans that would pay California addicts to get sober.

The proposals seek to decrease overdose deaths from stimulants like cocaine and methamphetamine—for which there are no pharmaceutical treatments—through “contingency management,” or paying problem users a small amount for each negative drug test they return over a period of time.

As KRON 4 reports, the federal government has been using the technique with veterans for several years and now Newsom has asked it to allow the state to spend Medicaid dollars to fund a similar program in California.

Meanwhile, a bill that would add contingency management to substance disorder treatments already covered by Medi-Cal has passed the state Senate without opposition and is awaiting approval in the Assembly, where its coauthors include Orange County Republican Laurie Davies and San Francisco Democrat David Chiu.

Scott Wiener, who authored the Senate bill, tells KRON 4, “I think there is a lot in this strategy for everyone to like. Most important of all, it works.”

Tyrone Clifford, a former meth addict who got clean through a contingency management program administered by the non-profit San Francisco AIDS Foundation, says that the small stipends—which amounted to $330 through payments that started at $2—were a strong encouragement even though he always had a job and didn’t need the money.

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

Clifford adds that while he didn’t make it through the program with no positive tests, it’s still been a success for himself and others.

“They are trying something,” he said.

Although some research indicates that contingency management becomes less effective over time after people leave the program, Jaycee Cooper, director of California Medicaid, tells KRON 4 that, so far, it’s as good as it gets.

“There is a clear kind of hole in regards to treatment services for individuals who have a stimulant use disorder,” she says. “At this point [contingency management] is the only thing people are pointing to that has been effective.”

One remaining hurtle is that it’s unclear whether or not the program violates state or federal law.

Wiener, whose plan would require California’s Medicaid to cover contingency management while Newsom’s would leave it up to the counties, says, “We don’t think it does.”


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