California Senator Scott Wiener's SB-110 Will Pay Meth Addicts to Stay Sober

JADED: Journalism with a Touch of Shade--Lashaun Turner-

Senator Scott Wiener (D) the author of several controversial bills, has introduced SB 110 which would allow the state’s Medicaid program to pay for Contingency Management, which would give incentives to people addicted to Methamphetamine (Meth) to stay in treatment.

Contingency management has proven to be the most effective method of treatment for methamphetamine addiction and is frequently used as a treatment program by the Veterans Affairs Administration,” Wiener’s office said in a news release.

Senator Scott Wiener Author of SB 110-Courtesy of the California Senate Website -sd11.senate.ca.gov-

What is Contingency Management?

According to the National Center for Biotechnology Information, Contingency Management refers to a type of behavioral therapy in which individuals are ‘reinforced’, or rewarded, for evidence of positive behavioral change. In the setting of drug misuse, Contingency Management most often involves provision of monetary-based reinforcers for submission of drug-negative urine specimens. The reinforcers typically consist of vouchers exchangeable for retail goods and services or the opportunity to win prizes. (Ncbi)

Though generally rejected due to concerns about potential harms to drug using participants, research suggests that cash may be a more effective reinforcer.

Research has shown that long-term drug abuse results in changes in the brain that persist long after a person stops using drugs. These drug-induced changes in brain function can have many behavioral consequences, including an inability to exert control over the impulse to use drugs despite adverse consequences—the defining characteristic of addiction. (National Institute on Drug Abuse)

Addiction and Contingency Management

The literature describes management of addiction as normalizing brain function as best as possible and teaching a person to find healthier ways to experience reward and pleasure. After leading a prolonged addictive lifestyle, it is difficult for a person newly in recovery to experience a sense of reward or pleasure while sober. Proponents say Contingency Management may be a useful incentive in fighting this state. Through a positive reward system, a person is taught to appreciate non-substance-related rewards.

Contingency Management Results

Various studies have reported that Contingency Management improved drug use outcomes, although the magnitude of effect decreases over time.

In another study individuals attending an outpatient substance use disorder treatment program were randomized to receive either cash or a gift-card incentive, with a variety of possible amounts (e.g., $10, $40, or $70) for attending a follow-up assessment 6 months later. Then they completed a urine toxicology screen three days after that, for which they received $40, with all participants receiving the same amount. While participants were more likely to attend the follow-up appointment if they received cash (rather than a gift card), and if they received a higher dollar value, their rates of negative toxicology screens 3 days after the follow-up assessment were similar. - Recovery Research Institute

Adding prize-based contingency management to other modalities including behavioral support for substance use disorders can increase short-term abstinence, but the effect does not appear to persist for the long term. There are numerous studies ongoing looking to correlate long term outcomes.

Jaded: In theory, and in the short-term, rewards and incentives can play a small role in addiction therapy. However, despite State and Federal governments efforts to increase spending on therapeutic modalities, there seems to be little evidence that these approaches have been more than a Band-Aid, with little in the way of long-term success.

Whether or not the effect of SB 110 will justify the expenditure of California taxpayer’s dollars is up for debate. Legislators keep allocating money for social programs that do not produce positive outcomes, under the the assumption that paying on the front end will be less than paying at the backend, thereby alledgedly reducing the human toll of the effects of drug addiction..

For instance, according to the San Francisco Chronicle, overdose deaths in San Francisco have increased and outpaced deaths by Covid 19 in that city, last year, despite having very progressive ideology, and treatment programs in place for addicts.

I think it is reasonable to examine the continued efforts of the same core of special interest State legislators who want to incentivize Meth addict’s abstinence under SB 110. Will it translate to outcomes such as lives saved, money saved on overdose management, relapse reduction etc., all this remains to be seen.

The bill is scheduled for consideration in the Assembly Health Committee on July 13, 2021. To voice your opinion, visit the California State Assembly.

I'm sure many Californians would like an incentive from our State government for healthy, sober living. This has been my Jaded Opinion. You are welcome to yours. What is your opinion on SB 110? Leave comments below. Like, Follow and Share.

• SAMHSA National Helpline-Confidential free help, from public health agencies, to find substance use treatment and information. 1-800-662-4357

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