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Contingency Management Addiction Treatment in California

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Medically Reviewed By: Diana Vo, LMFT

December 30, 2022

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California leaders are looking at innovative ways to fight back against the growing number of drug overdose deaths blighting the nation.

According to CDC data, over 70,000 people died of a drug overdose in the United States in 2019. While over 70% of these deaths involved opioids, deaths involving psychostimulants like cocaine and meth are also increasing.

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In California, deaths from overdose involving stimulants almost quadrupled from 2010 to 2019. Since coronavirus added further pressure from all angles, preliminary data suggest an increase of 42% in overdose deaths linked to stimulants over 2019.

Now, while there are several FDA-approved medications proven effective for treating opioid use disorder, no approved pharmaceutical interventions exist for treating addiction to psychostimulants.

In an attempt to become the first state to pay residents to stay sober, Gov. Gavin Newsom has requested permission from the federal government to use tax dollars to fund this venture via Medicaid, a health insurance program covering almost 14 million Californians.

How would the program work, then?

Well, the process involves contingency management, a psychiatric intervention proven successful for treating substance use disorder. The California Health Benefits Review analyzed the available data and reports “clean and convincing evidence” for the effectiveness of contingency management in helping people stay sober during treatment, even if benefits don’t last for much more than six months.

With contingency management, healthy behaviors are incentivized – a negative drug test or a sobriety milestone, for instance. Small payments are made to a gift card, with the total amount of a few hundred dollars redeemable upon completion of treatment.

During active addiction, changes to the reward center in the brain occur. By rewarding positive, healthy behaviors monetarily, the brain begins to recalibrate. The incentives can also act as a small but powerful motivator to stay sober.

The total cost of this mooted program would be contingent on the number of participants. A small program covering 1000 people could cost less than $300,000, a drop in the ocean of California’s colossal $262 billion operating budget.

The director of California’s Medicaid program (Jaycee Cooper) stated that there is a “kind of hole” in the treatment services available with contingency management “the only thing people are pointing to that has been effective.”

The hope is that with California leading the way, others states will follow suit.

An integrated approach to treatment will yield the most favorable outcomes. Contingency management can play a valuable role in a comprehensive treatment plan. While there is a lack of medication available, psychotherapy like CBT and DBT can help those struggling with addiction to identify their triggers and formulate healthier coping strategies. Individual and group counseling sessions also play a crucial part in effective addiction treatment. When contingency management is interweaved, there is hope even for those with severe cocaine use disorder or meth use disorder.

If you’ve been grappling with substance abuse issues, especially if cocaine or meth are involved, we can help you here at Renaissance Recovery. Reach out to us at 866.330.9449 and we’ll help you fight back against substance use disorder using medication-assisted treatment, psychotherapy, and contingency management.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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