Senator Wiener introduces bill to confront meth crisis using contingency management intervention

By Kerry Slater

Senator Scott Wiener (D-San Francisco) has introduced a bill to address the increase in meth usage and overdose deaths, a crisis that has impacted LGBTQ communities, particularly for gay, bi and trans men.

This legislation, SB 888, expands substance use disorder treatment options covered under Medi-Cal, requiring Medi-Cal to pay for contingency management. Contingency management has proven to be the most effective method of treatment for methamphetamine addiction. Contingency management describes the practice of giving those struggling with drug addiction financial rewards if they test clean. There is currently no form of Medication-Assisted Treatment (MAT) for meth use, unlike with opioids where treatment options such as methadone are available.

Meth use has spiked all over California and is having an outsized impact on the LGBTQ and black communities. Meth use is on the rise in LGBTQ communities, particularly for gay, bi and trans men, as a party drug known to enhance sexual experiences. The SFDPH also reports that the mortality rate is highest among African American men.

“We need to employ every possible tool to help people recover from this powerful addiction. Contingency management is an effective and essential tool in treating meth addiction – particularly given the lack of effective medical interventions – and we must expand access to it. This is a science-based approach to treating meth addiction, and it’s time for California to embrace it,” Wiener said.

According to the San Francisco AIDS Foundation, in one year of the PROP program, 63% of participants stopped using meth entirely and another 19% reduced their use. This approach, coupled with community support meetings, proves time and time again to be an effective method of treating meth addiction. This bill intends to make these programs accessible on a wider scale by authorizing them to be reimbursable by Medi-Cal.

The bill would also require the California Department of Health Care Services (DHCS) to issue guidance and training on the use of contingency management programs for Medi-Cal patients.