In case you hadn’t notice, the United States has been in the grip of a long battle with opioids and drug addiction as a whole. The nation has become one of the most challenging in the world to move away from a dependency on prescription drugs, and addiction has become rife across the country. Most professionals and analysts suggest that it comes down to a lack of treatment options. But with one addiction program making a huge difference for many Americans, why is it so often ignored as a viable treatment option?

Contingency management has become a premium form of adjustment and addiction treatment across the USA. Many people have been using this system as it gives the addict an incentive through money and other prizes. It gives them something to look for other than a clean body and mind; for many addicts, that simply is not enough. When a program offers them an incentive to stay ‘clean’, though, they are far more likely to stick to it. So, why is contingency management such an underused concept?

The majority of those who are against it disregard the project on moral grounds.

What is immoral about contingency management?

Some see it as a service that is simply being used to try and give people an out through financial means. But if those means were to dry up and the program was to suspend or end entirely, would the addicts not simply fall back into addiction?

That is the fear. When an addict is given a treatment program to help them get clean, it often revolves making tough choices and concessions. It forces them to sacrifice their addiction in return for the potential of anything else they wish. However, if the sole incentive to keep working hard is financial, are they likely to stick to it when the money dries up?

However, it isn’t simply giving someone a wage to try and help them overcome addiction. Instead, many contingency management programs use a big bowl of cards and on each card is something. It could be a simply feel-good message to encourage them, or it could be a monetary voucher – sometimes for as much as $100.

That motivation is, for some, all that they need to keep them going. They can get their life back on track and receive a little reward for their continued commitment to betterment. The problem is that many see it as problematic to ‘reward’ someone for simply staying off their addiction. But is that right?

It is a tough subject, and one that is almost impossible to skirt around for most people without finding they have a position. Many treat addicts with disdain, and see the idea of them being ‘rewarded’ for simply not being an addict as ridiculous.

But think about the immense human, financial and societal cost of addiction. If giving addicts a little something to keep them focused on the path to recovery helps to reduce the energy, time, and resources used combating addiction elsewhere, is that not ‘worth’ the cost of the reward?

 

Citation

https://www.nytimes.com/2020/10/27/health/meth-addiction-treatment.html