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.
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.
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.
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.”