Is it worth spending $330 to avoid spending $10,000 plus?
If it is, you might want to consider wrapping your head around something that might sound a bit repulsive at first — paying meth addicts to stay clean.
California is moving closer to doing just that via Senate Bill 110 sponsored by State Senator Scott Weiner of San Francisco.
That $330 would go to addicts in the form of gift cards for groceries and such over a 12-week period they are involved in a drug detox program. Each time their urine is tested and it is clean of meth and other addictive drugs, they would receive a gift card with a $30 value.
If your first reaction is outrage to the notion, consider your pocketbook for a moment.
When a meth user is taken to a hospital emergency room suffering from an overdose, they can rack up a huge bill in excess of $10,000. It is a bill either picked up directly by taxpayers via MediCal or indirectly via higher insurance premiums and hospitalization costs.
Hospitals don’t simply eat what isn’t paid for. They pass it along in the form of higher costs for other services. Ultimately that pushes insurance premiums up.
A 2016 report by the Rand Corporation — a research organization that vets potential solutions to various public challenges — put the annual treatment for meth overdoses at $546 million and meth caused health problems at $351 million.
Overall some think tanks, non-profits and government agencies put the annual negative economic impact of meth use at $26 billion plus. That economic impact includes the costs of societal problems ranging from child abuse and endangerment to lost work productivity.
Weiner, who clearly has progressive tendencies, is taking a rather pragmatic approach. It is an approach that earned the unanimous support of the California State Senate that has a lot of folks on the left side of the political spectrum, some on the right and a few brave souls in the middle.
Weiner did not pull the idea out of thin air of using positive re-enforcement to try and increase the success rates of detox programs deal with meth.
First, unlike opioids, there isn’t a methadone style of medical aided treatment to combat meth addiction. The only way to kick the destructive habit is to get clean.
San Francisco, the city Weiner represents, has seen a 500 percent increase in meth overdose deaths since 2008. That is a huge cost not just to emergency rooms but police, fire and ambulance services. The cost borne by hospitals and public safety is an expense we all shoulder either directly through tax dollars or indirectly in the higher costs for medical care and health insurance.
Someone dying of an overdose in its self may not be a heavy burden. But most people who die that way usually have a fair amount of previous overdoes under their belt of which virtually all impact emergency rooms, public safety services and insurance plans.
There is also the fact more than half of all psychiatric emergency room admissions at San Francisco General Hospital involve meth users.
This is clearly not a San Francisco only thing. Meth is an issue everywhere including Turlock, Ceres and Manteca.
The American Journal of Hospital Pharmacy studied the ER patients over a four-month period at a 517-bed hospital. They found 2.5 percent of the patients were there due to overdoses from illegal drugs such as meth.
The meth patients admitted via the ER room stayed hospitalized for 5.8 days. Rest assured the bill for such a stay exceeded the $330 that would be used to buy 11 gift cards as sober incentives for a 12-week long detox program.
What Weiner is proposing is not an untested theory.
For almost 10 years the San Francisco AIDS Foundation through its Positive Reinforcement Opportunity Project (PROP) dealing with meth addicts has seen significant positive results. Those in the organization’s treatment programs that use the gift card incentive for staying sober as well as encompassing community support meetings have seen 63 percent of participants stop using meth and another 19 percent reduce their meth use.
Weiner’s bill would make such a gift card incentive program MediCal reimbursable to medical institutions and non-profits that employ it to treat meth addicts.
The concept at first glance likely comes across to most as being outrageous.
It is an incentive, after all, to simply follow the rules of a civilized society to stay sober and to regain one’s health and often economic stability given meth costs money.
Even if the success rate of those steered into such a treatment with positive reinforcement using gift cards when their urine stays clean is a 10th of that of the San Francisco AIDS Foundation effort with meth users, the cost savings taxpayers and society as a whole would still be significant.
Other such incentive programs across the country have also shown strong results with the “bribe” of gift cards.
It obviously won’t work in all cases. And it is also likely most of those staying clean weren’t long-term hardcore meth users.
But if it gets someone off heading farther down the meth highway to hell it means less costs foisted on the rest of society.
If we want to bring society back from a one-way trip to the abyss, we will need to put personal biases and our revolting reaction to endeavors that on the surface appear to be rewarding bad behavior, then we need to open our minds instead of our hearts.
While there is obviously a feel-good aspect about helping someone come clean it pales in comparison to the reduction of the destructive behavior that ruins people’s lives and the expensive burden meth use thrusts on society.
If tax dollars bankroll eleven $30 Safeway gift cards in exchange for avoiding tens of thousands of dollars in overdose treatments and the cost of treating health issues tied to meth use, how would that be a bad thing?
