Bribing People Not to Take Meth Works

Santa Barbara County’s experiment with a pay-to-stay-away program for heavy meth users appears to be paying off even though the total numbers are not that staggering. To date, 48 serious methamphetamine users have signed up for a novel program run by the county’s Department of Behavioral Wellness in which users are given gift cards every time they test negative for meth in urine tests.

The total amount any one person can be paid is $600 in a year. Payments start off small — $10 per test — but escalate over time to nearly three times that amount. Of the 48, program director Melissa Wilkins said 18 have successfully graduated. 

Unlike other drugs, there is no FDA-approved medication to wean people afflicted with “Stimulant Use Disorder” or SUD — a new acronym for people addicted to meth. As a result, other more experimental approaches are being pursued. 

According to Wilkins, the payment system manages to engage people recovering from meth. “We’ve seen more people maintain abstinence from methamphetamines in this program than in traditional outpatient programs,” she wrote.

Santa Barbara is one of 19 California’s 58 counties to opt into this federally funded program. Statewide, the Los Angeles Times reports that 2,700 individuals are enrolled in such programs. It’s part of a $61 million experiment in which federal MediCal dollars are funneled through a relatively new program called CalAIM, which covers the costs of many maintenance and recovery programs associated with addiction, mental health, and homelessness that were previously not reimbursed.

While the high death rates triggered by fentanyl have commandeered most of the public attention, Wilkins noted that meth remains a potent and deadly drug. Deaths from meth and other stimulants had quadrupled since 2010, she wrote, and since 2017, about half of all the people dying from stimulant overdoses also involved opioids. 

Those in the rehab field are discovering that the meth brain responds positively to the lure of rewards. “The immediate delivery of the incentive helps tip the decision-making toward avoiding stimulant use to avoid difficult periods,” she wrote.