18-07-2025
Unhinged reason Democrat-run cities riddled with crime are now PAYING the meth addicts blighting their streets
Liberal cities are using cash and gift cards as an incentive for meth addicts to maintain their sobriety - but these programs may be in jeopardy under the Trump administration.
Addiction treatment facilities in cities including San Francisco and Portland, Maine, have been implementing contingency management (CM) techniques to keep patients clean and on the path to recovery.
Contingency management is a decades-old strategy that positively enforces sobriety by rewarding negative drug tests with prizes such as vouchers, gift cards and debit card cash valued.
The longer someone is able to stay on the straight and narrow, the heftier the pay - though maximum payouts vary from clinic to clinic.
The Substance Abuse and Mental Health Services Administration (SAMHSA), which is funded by taxpayers, allows patients to be awarded up to $750 each year through its vouchers.
Other programs, such as ones in Pennsylvania 's Allegheny County, reward participants up to $1,000 annually.
Treatment plans generally span anywhere from eight weeks to a year in duration and are most commonly used for treating stimulant addictions.
While experts have praised the method as an effective way to combat drug dependencies, it has sparked fierce criticism for its transactional nature - with skeptics saying unhealthy habits re-emerge once the money stops coming.
Researcher and clinicians have slammed the practice as 'bribery' and called it 'unethical to pay people for what they should be doing anyway,' according to the National Library of Medicine (NLM).
But for Jamie Mains, who is addicted to meth, CM programs have helped completely turn her life around.
'I was getting paid not to use and that was nice and that was the beginning,' Mains, of Portland, Maine, told The New York Times.
'But now I feel like being sober is payment enough, not waking up sick is payment enough, being trusted is payment enough.'
Mains had been binge-drinking since she was nine-years-old and her mother shot her up with heroin when she was just 12. She had been battling addiction ever since.
While she traded her fentanyl cravings for meth, she had no luck becoming totally sober until entering a CM program last year.
The program had just launched at Portland's Spurwink clinic, and Mains enrolled because the 'money was a good enough reason to try.'
Sixteen months later, Mains is totally sober. She told the NY Times that even when her step-mother started smoking crack in her car while they were on their way to a relative's funeral, she had no urge to cave.
'Most people recoil at paying people to do the right thing,' Dr. Sally Satel, a medical director of a methadone clinic in Washington DC and a senior fellow at the American Enterprise Institute told the NY Times.
'But we've got plenty of data that shows this works. So I think we just have to bite the utilitarian bullet.'
Over the past few years, Maine has seen a surge in meth addicts. From 2018 to 2024, the number of meth overdoses skyrocketed from seven percent to 37 percent, according to Maine's director of opioid response.
California, Montana, Washington and West Virginia have sought out Medicaid coverage for CM programs, according to the Legislative Analysis and Public Policy Association (LAPPA).
Most insurance plans do not cover CM treatments.
The recovery method first caught traction in 2011, when the Department of Veterans Affairs (VA) launched an initiative to broaden patient access to CM.
From 2011 to 2016, the method was implemented in 116 out of the 129 VA programs in collaboration with the Center of Excellence in Substance Addiction Treatment and Education (CESATE).
More than 8,000 veterans have been treated through these programs.
Beyond the VA, California has been spearheading efforts to implement CM programs.
Last year, Democratic Governor Gavin Newsom proposed using hundreds of thousands of tax payer dollars to implement such programs throughout the Golden State.
According to California's Department of Health Care Services website, 23 out of the state's 58 counties participate in the incentive programs.
One of those counties, San Francisco - which has one of the worst overdose rates in the nation - proposed a 'Cash Not Drugs' program last year.
The San Francisco Board of Supervisors approved the measure in order to combat the city's raging drug problem.
Under this program, people could receive up to $100 a week for steering clear of illicit substances, CBS reported.
Under the Biden administration, increased federal support and allowed more states to apply for Medicaid grants to fund the patient rewards.
Before raising the maximum SAMHSA voucher limit to $750, it was just $75.
But proponents of CM are worried for its future, as Donald Trump's health secretary, Robert F. Kennedy - a recovered heroin addict himself - may not be on board with expanding or sustaining these programs.
The Department of Health and Human Services did not respond to the NY Times' question specifically about CM,
Instead this agency issued the following statement: 'HHS must return to common-sense public health approaches focused on prevention, treatment, and long-term recovery.'
