Senator Wiener’s Recovery Incentives Act, Confronting the Growing Meth and Overdose Crisis, Passes Senate Unanimously

SACRAMENTO – Senator Scott Wiener’s (D-San Francisco) legislation, Senate Bill 110, passed the Senate by a unanimous, bipartisan vote. This legislation will address the worsening methamphetamine addiction crisis facing our state. The Recovery Incentives Act legalizes the substance use disorder treatment known as “contingency management,” and authorizes Medi-Cal to cover it. Contingency management has proven to be the most effective method of treatment for methamphetamine addiction, and is frequently used as a treatment program by the Veterans Affairs Administration. This intervention program gives those struggling with substance use disorder financial rewards if they enter substance use treatment programs, stay in the program, and get and remain sober. This positive reinforcement helps people reduce and even fully stop substance use.

In the Biden-Harris administration’s new drug policy platform, increasing access to evidence-based treatment was slated as the number one priority. This includes contingency management. The platform cites the need to end “policy barriers related to contingency management interventions (motivational incentives) for stimulant use disorder” as part of its effort to expand evidence-based treatment.

There is currently no form of Medication-Assisted Treatment (MAT) for meth, unlike with opioids where treatment options such as methadone are available. Contingency management is thus a critical tool in addressing the meth addiction crisis. According to the San Francisco Department of Public Health (SFDPH), since 2008, meth overdose deaths in San Francisco have increased by 500%. Additionally, 50% of psychiatric emergency room admissions at San Francisco General Hospital are now meth-related. These disturbing statistics demonstrate the urgency with which San Francisco and other communities must address this epidemic. 

With drug overdose deaths on the rise across the country, the state, and in San Francisco — San Francisco had a record number of overdose deaths in 2020 — effective substance use intervention programs are more important than ever. In San Francisco, according to data collected in 2019, roughly 60% of all overdose deaths were meth-related. 

Meth use has spiked all over California and in San Francisco, and worsened through the COVID-19 pandemic. With social isolation, mental health issues like depression, and economic suffering all worse for many than in prior years, meth use has also increased significantly. Since COVID-19 was declared a national emergency on March 12th, The Hill reports that patients across the country “tested positive for methamphetamines at a roughly 20 percent higher rate between March and May than previous samples.”

Stimulant use has also grown rapidly in the LGBTQ and Black communities, which were already deeply impacted by the meth crisis. The LGBTQ community — particularly gay, bi and trans men — have seen a rapid increase in meth use as a party drug taken to enhance sexual experiences. SFDPH also reports that the mortality rate is highest among African American men. 

Programs like the San Francisco AIDS Foundation’s PROP (Positive Reinforcement Opportunity Project) program – in which LGBTQ men who used meth are given gift cards for staying sober – are found to be highly effective. 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 again to be an effective method of treating meth addiction. Veterans Affairs hospitals throughout the state also use contingency management programs with success. 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. 

The bill is sponsored by the San Francisco AIDS Foundation, APLA Health, Equality California, the City and County of San Francisco, and the California Association of Alcohol and Drug Program Executives (CAADPE).

“The Recovery Incentives Act makes it possible for so many more people to access lifesaving meth addiction treatment,” said Senator Wiener. “Meth is causing deep harm to every community across the state, and the LGTBQ community has also been especially impacted. We must expand access to science-based treatments for substance use disorder.”

“San Francisco AIDS Foundation applauds the unanimous, bipartisan passage of SB 110 through the Senate today,” said Laura Thomas, Director of Harm Reduction Policy at the SF AIDS Foundation. “As a provider of contingency management services, we are acutely aware of its potential to change lives. It gives people with methamphetamine use disorder an effective tool to achieve their health goals. Contingency management is a well-researched, evidence-based treatment and should be accessible across California. This legislation is one step towards that goal. We are grateful to Senator Wiener for his leadership on this issue.”

“Behind the rise in opioid overdose deaths in California lurks a rise in deaths by stimulant overdose,” stated Vitka Eisen, President and CEO of HealthRIGHT 360. “We must use every available evidence-based intervention in order to address this challenge. Contingency management has a strong body of research supporting its effectiveness in treating methamphetamine addiction. The passage of SB 110 will give us an additional tool that can immediately save lives.”

“CAADPE applauds the California State Senate for its approval of SB 110, and Senator Weiner for his leadership on this important substance use disorder treatment strategy to address the substance use disorder crisis plaguing our state and our country,” said Al Senella, President, CAADPE, CEO, Tarzana Treatment Centers. “Contingency management is a proven, evidence based therapy to address the crisis of stimulant drugs (methamphetamine) and to help people find a path to healthy lives. In this time of the need for public health safeguards, California should be using all known and effective strategies to address the growing need for substance use disorder services.” 

“It’s time to end meth’s devastating impact on the LGBTQ+ community,” said Equality California Legislative Director Tami A. Martin. “With today’s passage of SB 110 by the California Senate, the Golden State is one step closer to ensuring that folks who are struggling with substance use disorders can get the help they need. We are proud to cosponsor this legislation and thankful to Senator Wiener for his leadership.”

“APLA Health applauds the Senate for today’s unanimous, bipartisan vote in support of SB 110,” said APLA Health Chief Executive Officer Craig E. Thompson. “In LA County alone, meth-related deaths increased over 900% from 2008 to 2018 and meth is now linked to more deaths than any other drug. The COVID-19 pandemic only exacerbated the crisis and communities of color continue to be hit especially hard. SB 110 is a critical step toward ensuring that all Californians have access to one of the most effective, evidence-based treatments for meth addiction at our disposal.”