San Francisco Paying Drug Addicts up to $600 to Get Clean

A pilot program in San Francisco will give gift cards worth up to $599 to people who successfully kick their cocaine and meth addictions, part of a new attempt to slow the city's scourge of overdoses.

Twenty-two patients have signed on to participate in the program, which awards weekly payouts to participants who successfully stay off drugs during a 24-week period, KTVU reported.

After the first week with a negative drug test, patients are eligible for a $10 gift card. The reward gradually scales up from there.

Those who test positive for drugs one week aren't banned from the program altogether. Instead, they're encouraged to return the next week with a negative test and will continue to be rewarded accordingly.

Although fentanyl is responsible for a significant portion of overdoses in the city, the pilot program instead seeks to treat people with addictions to stimulants, including cocaine and methamphetamine.

While there are medications that can cut cravings for opioids, no analog exists for stimulants, John Dunham, contingency management supervisor at Zuckerberg San Francisco General Hospital, told KTVU.

"So, in order to [address] that, we're looking at psychological approaches," Dunham said.

Researchers believe money can be a powerful incentive that helps rewire the brain's craving and reward system, overriding long-held habits and addictions.

Dana, a participant who has been homeless for three years, told KTVU that she was motivated to enter the recovery program after learning that she was pregnant.

"I didn't really have a reason to change before, or at least in my mind I didn't think I had a reason to change," she said.

So far, the program has worked for Dana, along with approximately half of the other patients.

That figure is notable, Dunham explained, because cocaine and meth addictions are known to be especially difficult to kick.

"Some of those participants have been using stimulants for greater than 20 years and have changed that behavior," he said.

The city's Office of the Chief Medical Examiner reported 647 fatal overdoses in 2022. But this year is on track to be far deadlier, with more than 560 overdoses recorded so far. August alone saw 84 overdose deaths — or close to three deaths each day.

Overdoses have been steadily rising across the country, with 2021 seeing roughly 106,700 drug fatalities, more than double the rate in 2015, according to the National Institute on Drug Abuse.

There are currently two similar cash incentive programs operating in the city, per KTVU.

California's "contingency management" programs, funded through Medicaid, are reportedly the first of their kind in the nation. Advocates say they're backed by decades of research into the underlying motivations that fuel drug addiction.