{"id":110847,"date":"2024-10-05T23:30:49","date_gmt":"2024-10-05T16:30:49","guid":{"rendered":"https:\/\/hotvideos24.online\/?p=110847"},"modified":"2024-10-05T23:30:49","modified_gmt":"2024-10-05T16:30:49","slug":"a-meth-and-cocaine-addiction-treatment-trades-gift-cards-for-negative-drug-tests-shots","status":"publish","type":"post","link":"https:\/\/hotvideos24.online\/?p=110847","title":{"rendered":"A meth and cocaine addiction treatment trades gift cards for negative drug tests : Shots"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<\/p>\n<div id=\"storytext\">\n<div id=\"resg-s1-26506\" class=\"bucketwrap image large\">\n<div class=\"imagewrap has-source-dimensions\" data-crop-type=\"\" style=\"&#10;        --source-width: 2058;&#10;        --source-height: 1457;&#10;    \">\n        <picture><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/2058x1457+0+0\/resize\/1100\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F37%2Fef%2Fa1761b274ae1a3605d104e82de53%2Fgettyimages-179324691.jpg\" class=\"img\" type=\"image\/webp\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/2058x1457+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F37%2Fef%2Fa1761b274ae1a3605d104e82de53%2Fgettyimages-179324691.jpg\" data-format=\"webp\"\/><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/2058x1457+0+0\/resize\/1100\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F37%2Fef%2Fa1761b274ae1a3605d104e82de53%2Fgettyimages-179324691.jpg\" class=\"img\" type=\"image\/jpeg\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/2058x1457+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F37%2Fef%2Fa1761b274ae1a3605d104e82de53%2Fgettyimages-179324691.jpg\" data-format=\"jpeg\"\/><img decoding=\"async\" src=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/2058x1457+0+0\/resize\/1100\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F37%2Fef%2Fa1761b274ae1a3605d104e82de53%2Fgettyimages-179324691.jpg\" class=\"img\" alt=\"Gift cards given in exchange for negative drug tests help with meth and cocaine addiction.\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/2058x1457+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F37%2Fef%2Fa1761b274ae1a3605d104e82de53%2Fgettyimages-179324691.jpg\" data-format=\"jpeg\"\/>\n        <\/picture>\n<\/div>\n<div class=\"credit-caption\">\n<div class=\"caption-wrap\">\n<div class=\"caption\" aria-label=\"Image caption\">\n<p>\n                give ideas<br \/>\n                <b class=\"credit\" aria-label=\"Image credit\"><\/p>\n<p>                    kathathep\/iStockphoto\/Getty Images<\/p>\n<p>                <\/b><br \/>\n                <b class=\"hide-caption\"><b>hide caption<\/b><\/b>\n            <\/p>\n<\/p><\/div>\n<p>            <b class=\"toggle-caption\"><b>toggle caption<\/b><\/b>\n    <\/div>\n<p>    <span class=\"credit\" aria-label=\"Image credit\"><\/p>\n<p>        kathathep\/iStockphoto\/Getty Images<\/p>\n<p>    <\/span>\n<\/div>\n<\/p><\/div>\n<p>Bernard Groves has spent five years trying to quit methamphetamine.<\/p>\n<p>He lost his job. He lost his car. He nearly lost his apartment. Worse than that, he says, his addiction has hurt his family.<\/p>\n<p>\u201cI went [to lunch] with my auntie and I saw such sadness in her eyes,\u201d Groves said.<\/p>\n<p>The 35-year-old checked himself into several rehab programs in San Diego and San Francisco hoping &#8220;to be that Bernard I used to be for the people that I love.&#8221;<\/p>\n<p>But each time, Groves felt the progress he made in therapy morphed into people talking at him, telling him what to do. Eventually, he would always return to meth.<\/p>\n<aside id=\"ad-backstage-wrap\" class=\"ad-wrap backstage\" aria-label=\"advertisement\">\n<\/aside>\n<div id=\"resnx-s1-5140166-100\" class=\"bucketwrap internallink insettwocolumn inset2col \">\n<div class=\"bucket img\">\n                  <a class=\"imagewrap\" id=\"featuredStackSquareImagenx-s1-5124997\" href=\"https:\/\/www.npr.org\/2024\/09\/30\/nx-s1-5124997\/fentanyl-overdose-opioid-btmps-drug-cartel-xylazine-tranq-mexico-china\" data-metrics-ga4=\"{&quot;category&quot;:&quot;recirculation&quot;,&quot;action&quot;:&quot;story_recirculation_click&quot;,&quot;clickType&quot;:&quot;inset box&quot;,&quot;clickUrl&quot;:&quot;https:\\\/\\\/www.npr.org\\\/2024\\\/09\\\/30\\\/nx-s1-5124997\\\/fentanyl-overdose-opioid-btmps-drug-cartel-xylazine-tranq-mexico-china&quot;}\"><picture><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/100\/quality\/15\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-original=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/100\/quality\/100\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-format=\"webp\" class=\"img lazyOnLoad\" type=\"image\/webp\"\/><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/100\/quality\/15\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-original=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/100\/quality\/100\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-format=\"jpeg\" class=\"img lazyOnLoad\" type=\"image\/jpeg\"\/><img decoding=\"async\" src=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/100\/quality\/100\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3976x3976+1120+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F70%2F45%2F1524bf0f458fbe696f7b52f8f5e2%2Fgettyimages-1176414820.jpg\" data-format=\"jpeg\" class=\"img lazyOnLoad\" alt=\"A U.S. Customs and Border Protection agent checks pedestrians' documentation at the San Ysidro Port of Entry in San Ysidro, California.  A growing number of experts believe the flow of deadly street fentanyl from Mexico into the U.S. has been disrupted, contributing to a drop in fatal overdoses.\" loading=\"lazy\"\/><\/picture><\/a>         <\/p>\n<p><!-- END CLASS=\"BUCKETBLOCK\" -->\n      <\/div>\n<p><!-- END CLASS=\"BUCKET IMG\" -->\n   <\/div>\n<p><!-- END ID=\"RESNX-S1-5140166-100\" CLASS=\"BUCKETWRAP INTERNALLINK INSETTWOCOLUMN INSET2COL \" --><\/p>\n<p>\u201cMy best friend was like, \u2018I don&#8217;t get it, Bernard. You put your mind to something, you&#8217;ve always been able to achieve it. Why can&#8217;t you get over this meth?\u2019 \u201d Groves said. \u201cI don&#8217;t know why. And it feels awful.\u201d<\/p>\n<p>Unlike opioid addiction, there are <a href=\"https:\/\/www.axios.com\/2023\/10\/05\/fda-cocaine-stimulant-addiction-treatment\">no FDA-approved medications<\/a> for the <a href=\"https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt47095\/National%20Report\/National%20Report\/2023-nsduh-annual-national.pdf\">more than 3 million Americans<\/a> addicted to stimulants like meth and cocaine. Instead, the most effective treatment is low-tech \u2014 and more controversial: Give people retail gift cards usually worth less than $30 in exchange for negative drug tests. <a href=\"https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/72bda5309911c29cd1ba3202c9ee0e03\/contingency-management-sub-treatment.pdf\">Research shows<\/a> that it works, and after more than three decades of resistance, policymakers are finally giving that strategy a chance.<\/p>\n<div id=\"resg-s1-26509\" class=\"bucketwrap image large\">\n<div class=\"imagewrap has-source-dimensions\" data-crop-type=\"\" style=\"&#10;        --source-width: 3018;&#10;        --source-height: 2090;&#10;    \">\n        <picture><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/400\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 400w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/600\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 600w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/800\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 800w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/900\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 900w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/1200\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 1200w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/1600\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 1600w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/1800\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 1800w\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg\" sizes=\"(min-width: 1300px) 763px, (min-width: 1025px) calc(100vw - 496px), (min-width: 768px) calc(100vw - 171px), calc(100vw - 30px)\" class=\"img\" type=\"image\/webp\"\/><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/400\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 400w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/600\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 600w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/800\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 800w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/900\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 900w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/1200\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 1200w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/1600\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 1600w,&#10;https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/1800\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg 1800w\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg\" sizes=\"(min-width: 1300px) 763px, (min-width: 1025px) calc(100vw - 496px), (min-width: 768px) calc(100vw - 171px), calc(100vw - 30px)\" class=\"img\" type=\"image\/jpeg\"\/><img decoding=\"async\" src=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/1100\/quality\/50\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/3018x2090+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7f%2Ff5%2F39d88eca458a919569de46249cb5%2Fbernard-img-5922-lusen-mendel.jpg\" class=\"img\" alt=\"Bernard Groves (left) has been going to contingency management sessions with his counselor Andrew Dertien (right) since June to try to kick his meth addiction. (Photo by Lusen Mendel for Tradeoffs)\" loading=\"lazy\"\/>\n        <\/picture>\n<\/div>\n<div class=\"credit-caption\">\n<div class=\"caption-wrap\">\n<div class=\"caption\" aria-label=\"Image caption\">\n<p>\n                Bernard Groves (left) has been going to contingency management sessions with his counselor Andrew Dertien (right) since June to try to kick his meth addiction.<br \/>\n                <b class=\"credit\" aria-label=\"Image credit\"><\/p>\n<p>                    Lusen Mendel for Tradeoffs<\/p>\n<p>                <\/b><br \/>\n                <b class=\"hide-caption\"><b>hide caption<\/b><\/b>\n            <\/p>\n<\/p><\/div>\n<p>            <b class=\"toggle-caption\"><b>toggle caption<\/b><\/b>\n    <\/div>\n<p>    <span class=\"credit\" aria-label=\"Image credit\"><\/p>\n<p>        Lusen Mendel for Tradeoffs<\/p>\n<p>    <\/span>\n<\/div>\n<\/p><\/div>\n<h3 class=\"edTag\">\u2018This isn\u2019t treatment\u2019<\/h3>\n<p>Offering people small rewards for not using drugs \u2014 known as <a href=\"https:\/\/aspe.hhs.gov\/reports\/contingency-management-treatment-suds\">contingency management<\/a> \u2014 dates back to the 1980s. Patients are tested for drugs regularly over several months. They receive a gift card for every negative result, and payouts grow with each test.<\/p>\n<p>The treatment is based on a well-established concept that positive reinforcement is an effective motivator. Animals pull levers when rewarded <a href=\"https:\/\/www.verywellmind.com\/what-is-a-skinner-box-2795875\">with food<\/a>. Students\u2019 <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1901\/jaba.1970.3-223\">behavior improves<\/a> by letting them watch TV after class. Compared to traditional counseling, researchers have found people are <a href=\"https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/72bda5309911c29cd1ba3202c9ee0e03\/contingency-management-sub-treatment.pdf\">twice as likely<\/a> to stop using meth or cocaine if they receive gift cards.<\/p>\n<aside id=\"ad-secondary-wrap\" class=\"ad-wrap secondary\" aria-label=\"advertisement\">\n<\/aside>\n<p>Studies suggest the immediate excitement of getting a gift card after a negative test replaces the dopamine rush people get from using drugs. Scientists hypothesize this activity effectively rewires our brains.<\/p>\n<p>But the approach has failed to catch on in spite of the evidence.<\/p>\n<p><a href=\"https:\/\/www.uclaisap.org\/profiles\/rawson.html\">Rick Rawson<\/a>, a professor emeritus of psychology at UCLA and early proponent of contingency management, says many addiction care providers historically dismissed the treatment as a form of bribery.<\/p>\n<p>\u201cYou would hear things like, this isn&#8217;t treatment, this is just paying people not to use drugs,\u201d Rawson said. \u201cIt wasn&#8217;t a medicine. It wasn&#8217;t talk therapy. It was this sort of transactional thing.\u201d<\/p>\n<div id=\"resnx-s1-5140166-101\" class=\"bucketwrap internallink insettwocolumn inset2col \">\n<div class=\"bucket img\">\n                  <a class=\"imagewrap\" id=\"featuredStackSquareImage1192423154\" href=\"https:\/\/www.npr.org\/sections\/health-shots\/2023\/08\/07\/1192423154\/only-1-in-5-people-with-opioid-addiction-get-the-medications-to-treat-it-study-f\" data-metrics-ga4=\"{&quot;category&quot;:&quot;recirculation&quot;,&quot;action&quot;:&quot;story_recirculation_click&quot;,&quot;clickType&quot;:&quot;inset box&quot;,&quot;clickUrl&quot;:&quot;https:\\\/\\\/www.npr.org\\\/sections\\\/health-shots\\\/2023\\\/08\\\/07\\\/1192423154\\\/only-1-in-5-people-with-opioid-addiction-get-the-medications-to-treat-it-study-f&quot;}\"><picture><source srcset=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s=100&amp;c=15&amp;f=jpeg\" data-original=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s=100&amp;c=100&amp;f=jpeg\" data-template=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s={width}&amp;c={quality}&amp;f={format}\" data-format=\"webp\" class=\"img lazyOnLoad\" type=\"image\/webp\"\/><source srcset=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s=100&amp;c=15&amp;f=jpeg\" data-original=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s=100&amp;c=100&amp;f=jpeg\" data-template=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s={width}&amp;c={quality}&amp;f={format}\" data-format=\"jpeg\" class=\"img lazyOnLoad\" type=\"image\/jpeg\"\/><img decoding=\"async\" src=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s=100&amp;c=100&amp;f=jpeg\" data-template=\"https:\/\/media.npr.org\/assets\/img\/2023\/08\/08\/ap19352597373596_sq-0b07a36982d75001d324507d35668836b2867323.jpg?s={width}&amp;c={quality}&amp;f={format}\" data-format=\"jpeg\" class=\"img lazyOnLoad\" alt=\"Only 1 in 5 people with opioid addiction get the medications to treat it, study finds\" loading=\"lazy\"\/><\/picture><\/a>         <\/p>\n<p><!-- END CLASS=\"BUCKETBLOCK\" -->\n      <\/div>\n<p><!-- END CLASS=\"BUCKET IMG\" -->\n   <\/div>\n<p><!-- END ID=\"RESNX-S1-5140166-101\" CLASS=\"BUCKETWRAP INTERNALLINK INSETTWOCOLUMN INSET2COL \" --><\/p>\n<p>Concerns of fraud have also stymied contingency management&#8217;s growth. Rawson persuaded California health officials to fund a pilot program in 2005. But the work stopped abruptly after federal health officials warned participating clinics that the project ran afoul of rules designed to prevent doctors from luring patients into their offices and then charging Medicaid for care they never provided.<\/p>\n<p>\u201cI&#8217;d pretty much given up,\u201d Rawson said after Medicaid shut down the pilot. \u201cI figured this just isn&#8217;t going to happen.\u201d<\/p>\n<h3 class=\"edTag\">Contingency management gets second chance<\/h3>\n<p>Outside of the Department of Veterans Affairs, which has offered contingency management since <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2949875924001127\">2011<\/a>, the treatment lay dormant for nearly a decade. But attitudes began to shift after the synthetic opioid fentanyl fueled a rise in overdose deaths in the U.S., Rawson said.<\/p>\n<p>\u201cPeople started to recognize that a lot of these people are buying cocaine or methamphetamine and dying of fentanyl overdoses because fentanyl is mixed into the drug supply,\u201d said Rawson.<\/p>\n<p>In the last four years, some states have relied on federal grants or court rulings against opioid manufacturers to fund their contingency management programs. In California \u2014 where overdose deaths involving meth have <a href=\"https:\/\/skylab.cdph.ca.gov\/ODdash\/?tab=CA\">skyrocketed<\/a> \u2014 health officials asked the federal government to allow the state to become the first in the nation to pay for contingency management with Medicaid dollars.<\/p>\n<aside id=\"ad-third-wrap\" class=\"ad-wrap third\" aria-label=\"advertisement\">\n<\/aside>\n<p>The Biden administration greenlit the <a href=\"https:\/\/www.dhcs.ca.gov\/Pages\/DMC-ODS-Contingency-Management.aspx\">plan<\/a> along with a broader package of non-traditional health care services California is testing called <a href=\"https:\/\/www.chcf.org\/resource\/calaim-in-focus\/calaim-explained\/\">CalAIM<\/a>. Under the state\u2019s contingency management program, which launched last year, gift cards after each stimulant-free urine test start at $10 and climb up to $26.50. A patient who tests negative every time over six months can earn up to $599, which can be paid out individually or in a lump sum.<\/p>\n<p>It&#8217;s unclear if that is <a href=\"https:\/\/www.statnews.com\/2024\/08\/05\/meth-addiction-contingency-management-incentives\/\">enough money<\/a> to persuade people to quit. Most studies show contingency management works best when patients can make <a href=\"https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/72bda5309911c29cd1ba3202c9ee0e03\/contingency-management-sub-treatment.pdf\">upward of $1,000<\/a>. California picked a lower amount to avoid triggering tax problems for patients or compromising their eligibility for other public benefits like food assistance.<\/p>\n<p>The value of the gift cards have worked for Bernard Groves. He&#8217;s been off meth since the first week of July, one of his longest stretches since he started trying to shake the habit.<\/p>\n<p>He&#8217;s used the gift cards to buy exercise weights at Walmart and food for his pet bird London at Petco. He&#8217;s also used the money to pick up donuts or a movie night with his mom, sister and grandma.<\/p>\n<p>\u201cBeing able to treat my family and do things for them is special,\u201d Groves said. \u201cIt brought some joy back in my life.\u201d<\/p>\n<p>He\u2019s surprised at how much pleasure he\u2019s gotten from the program.<\/p>\n<p>\u201cLike, how could you say you&#8217;re excited to pee in a cup? But I was, every week.\u201d<\/p>\n<p>Groves hopes this approach will help him finally kick his meth use. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8034391\/\">Recent studies<\/a> have found people are more likely to stay off stimulants for up to a year after these programs, compared to counseling and 12-step programs.<\/p>\n<h3 class=\"edTag\">California\u2019s approach leaves some patients out<\/h3>\n<p>Nearly 4,000 people have participated in California\u2019s new program as of September 2024. Researchers at UCLA say at least 75% of urine samples submitted by patients in the program have been negative for stimulants, and clinics say many of their patients have gotten into housing, gone back to work and reconnected with their families.<\/p>\n<aside id=\"ad-overflow-3-wrap\" class=\"ad-wrap overflow\" aria-label=\"advertisement\">\n<\/aside>\n<p>But California has an <a href=\"https:\/\/www.kff.org\/mental-health\/issue-brief\/a-look-at-substance-use-disorders-sud-among-medicaid-enrollees\/\">estimated 210,000<\/a> people on Medicaid who are addicted to meth or cocaine. Medicaid in California generally only covers addiction treatment through specialty addiction clinics, so most people who get their treatment from primary care doctors, community health clinics or hospitals are unable to access contingency management.<\/p>\n<p>Ayesha Appa is an addiction specialist who runs an HIV clinic at San Francisco General Hospital, where most of her patients are homeless, using meth and on Medicaid. She offered contingency management through a private grant until funding ran out in June, and she\u2019s ineligible to offer it through CalAIM.<\/p>\n<p>\u201cIt feels both incredibly frustrating and just heartbreaking as a provider,\u201d Appa said, to know a powerful treatment exists that she can\u2019t offer. \u201cIt feels like I have a patient living with diabetes, and instead of being able to offer them insulin, all I can do is talk with them about diet and exercise, even though I know there\u2019s a better option out there.\u201d<\/p>\n<p>She thinks often of one patient, a 45-year-old woman, who \u201cdesperately wanted to stop using\u201d meth, but who struggled to quit. Appa urged her to visit a CalAIM clinic to get contingency management treatment, but the woman didn\u2019t trust other doctors. Ultimately, the woman overdosed and died.<\/p>\n<p>\u201cWhat if we could have offered her contingency management in the clinic that she was coming into already?\u201d Appa said.<strong> \u201c<\/strong>When I think about her, it&#8217;s an equal mix of guilt and regret because it truly felt like we could have done more.\u201d<\/p>\n<h3 class=\"edTag\">&#8216;People get better&#8217;<\/h3>\n<p>California Medicaid Director Tyler Sadwith believes in the power of this treatment, but has taken a careful approach as the state attempts to scale this work because of the stigma contingency management still has among some health providers and lawmakers.<\/p>\n<aside id=\"ad-overflow-4-wrap\" class=\"ad-wrap overflow\" aria-label=\"advertisement\">\n<\/aside>\n<p>Sadwith said he appreciates that more people could benefit right now, but starting small gives proponents their best chance of convincing state and federal leaders to extend and expand the program beyond its current end date of 2026.<\/p>\n<p>\u201cWe need to prove that this works and that this works well,\u201d Sadwith said. \u201cWe feel the importance and the weight of getting this right\u201d as the first state in the nation to cover this sort of treatment under Medicaid.<\/p>\n<p>To make sure programs deliver the treatment effectively and minimize the chance of fraud, California requires clinics go through extra training and inspections, and makes clinicians enter their results into a central database. Clinics also have to dedicate three staffers to the program, a workforce requirement that has forced some providers to delay starting the treatment or not participate at all.<\/p>\n<p>So far, state officials have set aside $5.6 million to help clinics stand up their programs, and Sadwith is eager to reach more patients.<\/p>\n<p>\u201cWe want to use this opportunity to prove to the public, to the field, to our federal partners, and to other states that this works,\u201d Sadwith said. \u201cPeople get better, and there is a role for contingency management in Medicaid.\u201d<\/p>\n<p>At least three other states \u2014 Montana, Washington and Delaware \u2014 are now running their own programs through Medicaid, and four others are seeking federal approval.<\/p>\n<p><em>This story comes from the health policy news organization Tradeoffs. Ryan Levi is a reporter\/producer for the show, where a <\/em><a href=\"https:\/\/tradeoffs.org\/2024\/10\/03\/contingency-management-methamphetamine-cocaine-california\/\"><em>version of this story<\/em><\/a><em> first appeared. Listen to the story here:<\/em><\/p>\n<p>\n            <iframe loading=\"lazy\" width=\"100%\" height=\"80\" src=\"https:\/\/embed.acast.com\/tradeoffs\/contingency-management-methamphetamine-cocaine-california\/?brandColor=e65a4b\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;overflow:hidden;\"><\/iframe>\n   <\/p>\n<p><!-- END ID=\"RESNX-S1-5140166-102\" CLASS=\"BUCKETWRAP STATICHTML\" -->\n<\/div>\n<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<br \/><div data-type=\"_mgwidget\" data-widget-id=\"1660802\">\r\n<\/div>\r\n<script>(function(w,q){w[q]=w[q]||[];w[q].push([\"_mgc.load\"])})(window,\"_mgq\");\r\n<\/script>\r\n<br \/>\n<br \/><a href=\"https:\/\/www.npr.org\/sections\/shots-health-news\/2024\/10\/05\/nx-s1-5140166\/meth-cocaine-addiction-treatment-contingency-management\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>give ideas kathathep\/iStockphoto\/Getty Images hide caption toggle caption kathathep\/iStockphoto\/Getty Images Bernard Groves has spent five years trying to quit methamphetamine. He lost his job. He lost his car. He nearly &hellip; <a href=\"https:\/\/hotvideos24.online\/?p=110847\" class=\"more-link\">Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-110847","post","type-post","status-publish","format-standard","hentry","category-health","entry"],"_links":{"self":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/110847","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=110847"}],"version-history":[{"count":0,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/110847\/revisions"}],"wp:attachment":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=110847"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=110847"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=110847"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}