Fentanyl overdoses are down in the United States, but deaths from stimulants like cocaine and methamphetamines (“Meth”) are up. Why? Because there is no medication to suppress cravings for “Meth” and other stimulants.
More Relief for Opioid Addiction, not Stimulants
Naloxone (Narcan) has revived those who abuse opioids. Suboxone is a combination of naloxone and buprenorphine It can stop cravings for those afflicted with Opioid Use Disorder. Methadone can also be used on its own to treat OUD. It is the oldest and most proven opioid addiction treatment medication. However, it can be addictive and is highly regulated. Vivitrol is a once-a-month injection or available as a pill and can stop cravings for alcohol and opioids.
It is estimated that 3 million Americans are addicted to stimulants. More thoroughly than any other type of drug, stimulants hijack the brain. The stimulants cause a flood of dopamine (the “feel good” transmitter) to be released in the nucleus accumbens of the brain. Those dopamine levels skyrocket to 1,000 and can remain there for hours. For that reason alone, it is very challenging to stay away from meth.
Contingency Management
New studies have found that stimulant abusers are finding success in a rewards program that dates back to the 1980’s. Veterans have been using it since 2011. You’re basically paying stimulant abusers to stop their habit and for their efforts, they receive gift cards and resources.
Here’s how it works:
- It’s out-patient and for Medicaid recipients only.
- At a clinic, with a contingency management coordinator, those with a history of substance abuse have to urinate in a cup. If the cup does not contain traces of illicit drugs, then the patient is rewarded with a gift card or debit cash of $10.00. The reward increases as the weeks go on if the urine is clean. For completing a 24-week program, it is possible to earn up to $599.
- After 12 weeks, the patients concentrate on stabilization and attend once a week.
- At the program, patients learn about other supportive resources: counseling, medications for other drugs, housing, Bible Study, for example.
Drawbacks:
- It’s possible to trade your gift cards for money to buy drugs.
- Scams happen and clean urine tests can be taken by non-addicts and passed off as the addict’s urine. Some clinics are switching to mouth swabs which a therapist can witness.
- It is regarded as bribery by some who think addicts should get sober by themselves.
- As relapse is so common in drug addiction, patients can go to meetings and earn gift cards just for showing up despite a “dirty” urine analysis.
Despite the drawbacks, recent studies have found people are more likely to stay off stimulants for up to a year after these programs. Just ask Jamie Mains who wanted to get sober so she could be allowed to see her young grandson. She has been sober for a year. Or Quinn Coburn who was tired of abusing drugs and had been in prison for 5 years. He, too, has remained sober.
These contingency management programs are gaining ground as stimulant abuse has soared. Compared to counseling, cognitive behavior therapy and 12-step programs, these programs are doing well. The average time of relapse for the traditional approaches is usually three months.
Source: Upended by Meth, Some Communities Are Paying Users to Quit, The New York Times, 7/17/25.
Wesley Cullen Davidson
Wesley Cullen Davidson is an award-winning freelance writer and journalist specializing in parenting. Currently, she is targeting her writing about recovery to parents whose children have substance abuse disorders.