California, Democratic Senator Scott Wiener (D-San Francisco) has introduced legislation to help those trying to get off drugs. He’s authored the Recovery Incentives Act (SB110) in the face of the growing meth and opioid crisis.
The legislation would allow Medi-Cal (the state’s Medicaid program) to cover “contingency management”.
The treatment gives those struggling with drugs financial rewards if they enter substance use treatment programs, stay in the program, and remain sober.
The support has been shown to help some of those in recovery, particularly in regard to methamphetamine. Whereas those struggling with opioids can be given alternative substances such as methadone to help them break their addiction, no medication alternatives exist for meth.
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Some regard “contingency management” as controversial. Medicaid programs have avoided it because the payments are considered illegal under some federal laws. However, the size of the problem is forcing some lawmakers to think again.
Related: Friend of Silvio Horta pens powerful account of TV exec’s battles with meth
San Francisco, like many other parts of the U.S., has seen a rise in substance misuse and overdose in recent years. Between January and November 2020, it recorded 630 overdose-related deaths, compared with 441 in the whole of 2019. Around 60% of these deaths were meth-related.
The San Francisco Department of Public Health (SFDPH) has reported that black and LGBTQ communities are hit hard by the meth crisis.
African American men represent the highest meth mortality rate in the area, while some gay men are known to use the drug to enhance their sexual experiences – often becoming hooked in the process.
Senator Wiener’s bill is being sponsored by the San Francisco AIDS Foundation, Equality California, and the City and County of San Francisco, among others.
The San Francisco AIDS Foundation already runs its own similar program, named PROP (Positive Reinforcement Opportunity Project). This gives gift cards to LGBTQ men who manage to get into recovery and stay sober.
Mike Discepola, Vice President of Behavioral Health at the San Francisco AIDS Foundation, told Queerty a little more about how it works.
“There are various levels of incentives including food and refreshments – available to each person each PROP day – and money credits,” he said.
“Every time a participant has a non-reactive urine test, they receive money credits in their incentive banks. A total of $340 money credits can be earned over the 12-week program for non-reactive urine tests if participants opt into the weekly urine testing (usually 3x per week). Once the credits are in their incentive banks, participants can withdraw the money for food, paying their bills, and other personal uses.”
The organization says the initiative has shown great success. Within one year of being on the program, 63% of participants stopped using meth entirely and another 19% reduced their use.
Related: Oregon votes to decriminalize all drugs, including meth, cocaine and magic mushrooms
These sort of figures encouraged Senator Scott Wiener, who is gay, to push for applying a similar approach more widely, and reimbursable by Medi-Cal.
“The rise of substance use and overdose deaths in San Francisco and California is a travesty and we must address it with every tool we have,” said Senator Wiener in a press statement.
“Meth addiction is particularly powerful and destructive. Meth harms those caught in its grip, as well as our larger communities who experience public safety issues because of the meth crisis. The Recovery Incentives Act will expand access to contingency management programs, which are the only proven treatment – particularly given the lack of medication-based treatments – for stimulant addiction.
“We have a moral obligation to do everything in our power to help those suffering with meth and other addictions.”
Discepola addedt: “Contingency management services at San Francisco AIDS Foundation have been effective and have reached many at-risk populations in our communities for whom traditional treatment is difficult to access – including communities of color, queer, and gender non-conforming individuals who are generally underserved by our treatment continuums.”
“Meth addiction is a major health emergency facing our LGBTQ+ community,” said Rick Zbur, the Executive Director of Equality California. “Everyone – especially vulnerable members of our LGBTQ+ community – deserves access to treatment and recovery.”
SB110 was introduced last week. Weiner says he is hopeful the legislation will become law.
“We’re cautiously optimistic that the bill will be well-received,” Weiner told Queerty, “but California’s legislative process is a complicated one and there’s never a guarantee that a bill will pass. We will work hard to build support for this important public health measure.”
Cam
So studies show this might work and they are trying it. Good.
Roy Ajax
You gotta be kidding me, pay people to get off drugs? I doubt the 63% success rate, I looked online but couldn’t find where that number came from. How long did this 63% stay clean because there is a very high rate of relapse.
Cam
So let’s see, the right wing troll account has zero proof that any numbers are wrong, but screams about it because it “doubts” the numbers. So it feels the number is wrong with no proof?
Sweetie, by all means, put up any proof that states the success rate is wrong. If you can’t do that, then please allow me to quote you and other Trump supporters “F**k your feelings”.
Roy Ajax
Cam
Don’t worry about my feelings, i’m not delicate. I went looking for the study but couldn’t find it, so there are a lot of questions. How many people were in this study? Which sub-group was more successful, and which is least successful. How long did this study go on for? Was there a follow up with any of the subjects and did any relapse and how long did it take them to relapse? How long did it take, on average, for someone to get drug free and how much money did they get? All i’m asking for is the “proof” you constantly demand.
Cam
@Roy Ajax
Translation: You made up a false point and are using that to make the argument.
Sweetie, we get it, you right wingers are ALWAYS against anything that is successful. As long as you get to hate LGBTQ people, Black people, Latinos, Women, etc… you’re happy.
Roy Ajax
Cam
No, I “get it”. You couldn’t argue against my points so you just call me a troll. Proof that I’m right.
Cam
@Roy Ajax
Except you had no point troll. Your point was to lie and claim that the numbers weren’t right. Except…..hmmmm, you couldn’t find any proof.
Look precious, we get it, you’re a right wing troll, so you’d rather just have people die than actually get treatment that works. Your main problem is thinking anything you say is worth reading.
Roy Ajax
Cam
That was NOT my point. I’m questioning HOW they got the 63% success rate, because HOW the stats are collected makes a big difference. What’s funny about you is that you either don’t understand what you’re reading or you try to twist it to mean something else so it could fit your agenda. If you’re so confident in the figure show me where i can go to see if it’s valid because I did a web search and found nothing.
Cam
@Roy Ajax
Awww, sweetie, look at you lying about something that we can check by looking right above here at your old post.
You said you didn’t buy the number as an excuse to say they shouldn’t do it. But it’s nice to know that me calling you out apparently freaked you out enough to try that pathetic lie.
Roy Ajax
Cam
Please copy/paste my words where I said I’m using the percentage as an excuse to say they shouldn’t do it. I didn’t say anything about if they should or shouldn’t do it. I said it was a dumb idea and i questioned the accuracy of the statistic provided. But seriously, do you misconstrue my words on purpose of out of laziness or are my jokes true and you really can’t read?
Cam
@Roy Ajax
You said “You gotta be kidding me, pay people to get off drugs? I doubt the 63% success rate, ”
So you tried to lie and claim the number wasn’t real, but exposed your real motivation in the first part. Even with 100% success, you were opposed to it from the beginning.
I get it, Republicans are happy to hand money to religious organizations that attack LGBTQ people. But something that would help cut down on drug addiction? Of course not. You are the death and treason party.
Mister P
We need to try new things like what is being introduced here. Treating it as a criminal problem has not worked. We are willing to spend a lot more to put addicts in jail. May as well try something.
Heywood Jablowme
Meth is the classic “hillbilly drug.” Meth is for toothless, drooling, sh*t-kicking, sister-f*cking, Trump-worshiping morons.
Gay organizations should stress the hillbilly angle more in their public service advertising.
Thad
Yet it’s California – San Francisco specifically – acknowledging the problem. Maybe Kentucky needs these programs more.
Joseph1971
You are kidding right? A Hillbilly drug? Obviously you have not spent anytime in San Francisco’s Castro or Tenderloin District and go online any night of the week. The number of employed men, with apartments, careers and yes their teeth- are using meth while having or looking for sex. You are totally delusional if you do not think this an epidemic. I can sign on and within five minutes some asks me do I parTy or am I into PNP. It is inexpensive but incredibly addictive. I can assure these men did not vote for Trump. You are an idiot.
Heywood Jablowme
@Joseph1971: I’m referring to de-glamorizing it. Of course I’m aware it’s common among gay men. Hillbillies generally don’t use meth to make anal sex less painful; they use it just because they’re dumba**ses. .
yup5hioop
there are a lot of functional addicts everywhere on every substance but putting rotting teeth on cigarette packs sure takes some of the Hollywood glamor away 🙂 People always go into binary thinking with drugs when clearly for most it’s not a black and white issue. It’s sad when people die but people like indulging their freedom too. The problem is like drunk driving – how do you respect people’s decisions while protecting the larger populace.
Liquid Silver
“63% of participants stopped using meth entirely and another 19% reduced their use.”
How does that compare to other programs, though? (Hint: citation required, name-calling ignored). The reason we don’t direct-pay people is because it’s bribery, which does, indeed, make me a little uncomfortable for obvious reasons (the stakes to find ways to cheat go up accordingly).
“340 bucks isn’t enough for people to cheat…”
Then it isn’t enough for people to be motivated. Try again.
In the above, I don’t see any increased security in testing or monitoring to assure that the payouts are protected proportionately.
Heywood Jablowme
Skepticism is in order about where all the money goes in “Recovery Inc.”
Residential rehabs are poorly regulated (and in some states, almost unregulated). Relapse rates are sky-high. Almost everyone who works in the “recovery” field is a recovering addict too, and they’re always relapsing too. It’s quite a racket.
Cam
Except it’s working.
We pay farmers not to farm, we give subsidies to oil companies that are already making massive profits, we give subsidies to coal companies that can’t sustain themselves anymore.
I have no problem with something like this that actually benefits people.
Heywood Jablowme
There’s a different “we” here. Fortunately, San Francisco supervisors don’t have to vote on subsidizing farmers, oil & coal companies, etc.
If this program really DOES work in the longer-term, great! That would be a first, though.
Liquid Silver
Heywood: Yeah, I have direct secondhand(? I observed it directly…) knowledge of that one. My cousin played that game for some decades. I am actually not displeased to report that he’s no longer with us (alcohol, minor drug use, not meth). My worst offenses were nicotine and food and I had a hard enough time with those, thanks, but am now a 150 pound non-smoker…
I never saw that bribing worked, or that anything else much did, either, with him or with any of his associates or “friends” (those people weren’t friends). Hence the request for citations here, and with other programs.
I don’t know what the answer is, and don’t pretend to have any answers. I just doubt that this is it given the fact that the changes are only cosmetic. It’s the literal definition of what government of any stripe likes to do–put lipstick on a pig and call it done.
Addiction science runs so much deeper than that and we understand so little about it.
moretruth
Focus on needy people who want to live. Let those that one to leave this world do so on a high.
TheAbsoluteTRUTH
Here’s a start ban capital T’s and balloons ? on grindr that might help…lol
yup5hioop
the classic carrot versus stick arguments,. Clearly everybody needs a bit of both. Since meth impacts subconscious parts of the brain it’s hard to make a logical argument to people that they should get clean. A bit like talking to Q folks hahaha. Social stigma however seems to mostly isolate and create an anti hero mythology around drugs in America so why not fold them in with boring do gooder social programs. You’re not a rebel you’re just sick approach.
Openminded
When did it become “substance misuse” instead of “substance abuse”? Misuse implies there is a proper use for the substance. How do you properly use Meth?
jniceny
What is defined as success. If 63% of the people who completed the program had gone 12 weeks without meth, then that doesn’t tell you how many people started the program and dropped out. Also, how many of the 63% were meth and relapse free after a year? I bet not not that many, but that doesn’t mean the program is a failure. Relapse is common among addicts trying to stay clean, and many if not most that enter into a program will have to do it more than once for it to have long-lasting success.