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This drug addiction treatment works. Why is it so underused?

“In the drawings, I did very well,” said Eric Alick, 63, of Philadelphia, who completed an emergency management program for the addition of cocaine at Corporal Michael J. Crescenz VA Medical Center in Pennsylvania. “I could have three ‘good jobs’ in a row, but then bingo.”

Among the things he bought with his rewards were a new set of drills for his handyman job, perfume for his wife, and coffee and meals for the homeless veterans he had met in the cafeteria. of the hospital.

One problem with contingency management, the evidence shows, is that people are less successful in staying sober after treatment ends. For this reason, Richard Rawson, a researcher at the University of Vermont who has studied methamphetamine addiction for decades, believes that it should be used indefinitely, as drugs for opioid addiction often are.

“Unfortunately, drug addiction is a chronic brain disease and treatments must be designed to adapt to this reality,” he said.

For Ms. Waxler-Malloy, losing the debit card at the end of her four months of contingency management in early January was difficult, although her therapy sessions and 12-step meetings helped. Then, in May, she lost her job as a waitress due to the pandemic and relapsed, using methamphetamine and heroin “at full speed,” she said, for three weeks before s ‘stop with help from Brightview.

Yet the eight months she spent without using drugs was her longest period of abstinence in more than two decades. She thinks she may not have relapsed if contingency management, with its promise of rewards, was still part of her treatment regimen.

“It made me accountable,” she said recently. “Even just to stop by McDonald’s when you have that extra bit of money, to grab a burger and a fries when you’re hungry. It was really important to me.