How To Help Someone Quit Meth – California may be first state to try treatment that will pay meth users if they don’t use it: SHOT – Health News Overdoses of deadly drugs, including meth, are on the rise. California is preparing to introduce a controversial but proven treatment that would pay meth users less money if they don’t use it.

At the AIDS Foundation of San Francisco, staffers Tyrone Clifford (left) and Rick Andrews (right) demonstrate how to begin an emergency response visit, where participants take specimen cups for urine samples. If the sample is negative for stimulant or cocaine use, participants will receive an amount of stimulant added to their “bank” that can later be redeemed for gift cards. Christopher Altalejo-Price/San Francisco AIDS Foundation Hide caption

How To Help Someone Quit Meth

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When Billy Lemon was trying to beat his methamphetamine addiction, he went to the San Francisco AIDS Foundation’s drug treatment program three times a week and peed in a glass. If they tested negative for meth, they were paid about $7.

“It seemed like a really good thing for someone who didn’t have legitimate money without committing a crime,” says Lemon, who was arrested three times for selling meth before entering rehab.

The payments were part of a routine addiction treatment called contingency management, using cash or gift cards to encourage drug users to quit. At the end of week 12, after all drug tests came back negative for stimulants, Lemon earned $330. But to him, it was more than money. I was told I did a good job.

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“It was the first time I thought, ‘I’m still buried in my self-esteem. This guy is going to see that and give me seven dollars to take care of myself,'” he said.

As overdoses and the public health costs associated with meth and cocaine continue to rise in California, state officials are desperate for more effective treatment and legislation to make emergency treatment more accessible. Controllers. Washington, Montana and West Virginia are exploring similar strategies.

Because studies show that responding to unexpected situations works. Therapeutic principles, mainly positive reinforcement methods, are widely used in weight loss, fitness programs, and in families to persuade parents to behave well instead of punishing their children’s bad behavior.

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Billy Lemon, 50, kicked his meth habit nine years ago after participating in the San Francisco AIDS Foundation’s “crisis management” program for methamphetamine and cocaine users. Every time the drug test came back negative, he got a little money. Lemon currently operates a rehab center in San Francisco at the Castro Country Club. Beth Laberge/KQED Hide caption

Research shows that emergency treatment is the most effective treatment for meth or cocaine addiction, especially when combined with other behavioral treatments. At the San Francisco AIDS Foundation in 2011, In 2019, 63% of people who entered the program stopped using stimulants altogether, and an additional 19% reduced their use.

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The Department of Veterans Affairs has used this therapy to treat 5,600 veterans over the past 10 years. About 92% of the 73,000 urine samples collected by the VA program tested negative for drugs.

“Patients often come to treatment confused about change. Why? Because drug use is so illusory. Drug use provides powerful and immediate reinforcement,” DeFilippis says. “On the other hand, recovery and its immediate consequences are often unpleasant: signs of withdrawal, a clear view of the desolate landscape that is one’s life.”

Contingency plans address this challenge head-on by providing immediate rewards and reinforcement for abstinence, he added. Small rewards and rewards are meant to rewire the brain’s reward system, so instead of meth or coke, people reach for cash or a gift card to release dopamine.

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“Like, ‘Ah! Ah! I don’t have to use that ingredient every day and I feel great. Let’s do it for another week,” says Lemon. “Then all of a sudden it’s day 90, and things are really changing.”

Despite its effectiveness, this treatment is controversial. Critics have derided paying drug users to stop using drugs as unethical or bribery. Most insurance companies won’t cover it. The same is true for state Medicaid programs. Federal authorities generally prohibit financial incentives to protect patients from fraud and waste, and state authorities interpret the laws to prohibit fraudulent payments.

But as the drug epidemic worsens in California and across the country, with the use of stimulants like methamphetamine tripling in recent years, state officials are calling for changes to these policies. Critics are softening their stance. The bill currently on the governor’s desk — SB 110 — would allow the state’s Medicaid program to pay for emergency management services, with the goal of encouraging more drug treatment centers to offer them.

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“We’re taking this proven and effective approach to methamphetamine addiction, unequivocally legalizing it and starting to pay for it,” said state Sen. Scott Wiener (D-San Francisco), the bill’s sponsor. Coping with this health epidemic”.

Wiener said he was surprised to see the bill pass the California state legislature with bipartisan and unanimous support.

“Republicans love it,” he says. “We didn’t expect them to like it, but they like it because there’s an element of abstinence to it. We pay, so they don’t use it.”

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The California Department of Health Services, which administers the state’s Medicaid program, is also getting involved. Department leaders have asked federal regulators for express permission to offer emergency management through a statewide pilot project, and federal officials appear poised to grant it.

Until recently, the federal government had been unwilling to relax rules preventing public health programs from providing emergency response. In the year In 2020, under the Trump administration, medical professionals asked the US Department of Health and Human Services to waive the rule for two years, but the department refused.

“It’s clear that the [Trump] administration has had little interest in looking at the evidence and the science on the various topics that helped propel the bill, so to speak,” said Laura Thomas, director of harm reduction policy at the San Francisco AIDS Foundation.

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Meanwhile, the Biden administration has specifically stated that one of the top priorities of its 2021 drug control policy is to “identify and address policy bottlenecks related to emergency management.”

Dr. Kelly Pfeiffer, deputy director of behavioral health at the California Department of Health Services, says the need is urgent. In the year In 2020, more Californians died from meth and cocaine overdoses than from fentanyl overdoses, and meth abuse continues to wreak havoc on California’s prisons, courthouses, foster care facilities and hospitals. .

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The director added that the lack of effective and available treatment has increased the desperation of stimulant drug users. There are currently three drug treatments approved by the FDA for opioid addiction: methadone, buprenorphine, and naltrexone. Stimulants and colas do not have such drugs.

“People see success stories,” she says. “They see their friends and family get treatment, get help and get better.”

One disadvantage of emergency treatment is that the benefits may diminish after active treatment ends. As a result, some doctors believe that stimulant treatment should be given on an ongoing basis, just as drug treatment for opioid use disorder can be prescribed indefinitely. But a new study shows that the effect may last longer than previously thought. In a review of 23 previously published trials, researchers at the University of Connecticut found that people who participated in an emergency response were 22% more likely to be abstinent six months after completing treatment than people who received other treatments. to the.

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For Billy Lemon, resolving the emergency situation was all he needed to speed up his recovery and stay on track for residential recovery. After spending all incentive payments, he used $330 to buy a new cell phone.

Because up until that point there were Breaking Bad’s style burner phones,” he said, referring to the prepaid and disposable phones used by drug dealers to avoid police detection and then thrown away. “My number will never be there. It wasn’t. “

Nine years later, he’s still running sober.

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