California gift cards for negative drug tests pilot program draws mixed reactions

Under a new pilot program approved by federal officials through the California Department of Healthcare Services (DHCS), 22 California counties are participating in the nation’s first statewide pilot program for “contingency management” drug addiction services.

Under this “contingency management” plan, program participants addicted to stimulants such as methamphetamines will receive cash or gift cards starting at just $10 and scaling up, with total payments up to $599, below the IRS threshold of $600 for reporting sources of income, in exchange for testing negative for stimulants such as methamphetamine.

The program was given the greenlight and allowed expansion in the first quarter of 2023.

While drug treatments such as methadone exist for helping ease addicts off opioids, no such medication exists for helping individuals addicted to stimulants. As a result, stimulant-related drug deaths in California stimulants accounted for 65% of drug-related deaths in California in 2021, up from 22% in 2011, according to the DHCS.

This new DHCS pilot program includes many of the state’s largest counties, such as Fresno, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, and San Diego Counties. It was authorized under 2021’s CalAIM program, which vastly increased the amount of services available under the state’s MediCal program and covers one-third of Californians with state-supported health services.

This contingency management program is designed to mirror a Department of Veterans Affairs program that has been in effect for over a decade and treated over 6,300 patients. With roughly half attending scheduled appointments, 92% of veterans participating in the program produced negative drug tests for their target drugs.

Dr. Brad Shapiro, medical director of the Opiate Treatment Outpatient Program at Zuckerberg San Francisco General Hospital and launching three DHCS-authorized contingency management programs, spoke to CalMatters about the success of the DVA program and stated, “It’s actually, in my opinion, really quite criminal that we’ve gone decades knowing this is an effective treatment and the powers that be have failed to make a pathway for treatment for people.”

However, results are not as clear-cut for individuals once they are out of the program and the financial incentives for positive behavior are exhausted, leading some to question the long-term efficacy of the program and whether or not the program can adequately address the root causes of stimulant addiction.

“Using gift cards as incentives distracts us from tackling the larger, more pervasive issue at hand,” said Los Angeles City Councilmember Traci Park, whose District 11 includes Venice, one of the state’s overdose epicenters. “These gestures, while well-intentioned, cannot genuinely address the root causes of the crisis we are facing. To achieve lasting and meaningful change, we must proactively address the underlying issues head-on.”