US Cities Use Cash Rewards to Reduce Meth Addiction

Methamphetamine addiction remains a critical and expanding public health challenge across the United States, characterized by its powerful stimulant effects and lack of effective medication treatments. In response, several cities, including Los Angeles, San Francisco, and Portland, have implemented contingency management (CM) programs that use small financial incentives such as gift cards or vouchers to encourage sobriety by rewarding negative drug tests. These CM approaches, although sometimes criticized as transactional or unethical, have shown effectiveness in improving outcomes for meth addiction by positively reinforcing abstinence over several months. The Trump administration's stance poses a potential threat to the continuation and funding of these programs, despite evidence supporting their success in helping individuals, including unhoused populations, reduce stimulant use. Experts emphasize that meth addiction involves complex biological, social, and economic factors, highlighting the limitations of viewing addiction solely through a pharmacological lens and underscoring the importance of innovative, multifaceted treatment strategies. Overall, contingency management is gaining traction as a crucial tool amid the absence of approved medical treatments for stimulant use disorders.