Contingency Management: A Better Approach to Substance Abuse?

We cannot police our way out of the mental health and substance abuse crises in our community. Criminalizing desperation and mental illness is costly: in human lives, in moral terms, and in actual dollars spent. Stigmatization and “tough love” aren’t the only or most effective ways to help people recover from substance abuse. Let’s follow the evidence, with compassion.

This article from the Washington Post presents an evidence-based approach to substance abuse called “contingency management.” In essence, it offers modest “rewards” — from public affirmations to small gifts of goods or money — to people in a program who maintain sobriety.

If your first response to this approach is outrage —”What?!? Pay people to stay off drugs?!?”— I implore you to read this article. It’s a cost-effective strategy (way cheaper than running them through the courts and jail) that is demonstrably better than other strategies, especially if paired with community reinforcement.

Addiction destroys connection. This approach can help restore connection — to a person’s sense of self-worth and to others.