CALIFORNIA FOCUS
1720 OAK STREET, SANTA MONICA,
CALIFORNIA 90405
FOR RELEASE: FRIDAY, NOVEMBER 3, 2023 OR THEREAFTER
BY THOMAS D. ELIAS
“CAN CASH PAYMENTS DENT DRUG
ADDICTION AND HOMELESSNESS?”
“The business of America is business,” President Calvin
Coolidge famously observed in 1925.
Plenty of other American cliches support his view: “Money
talks, (other stuff) walks,” goes one. “Show me the money,” says another.
California authorities have now begun testing this principle
on drug addiction, one of the state’s most obdurate problems. If it works there,
they also ought to try it on homelessness, where high percentages of the
unhoused either refuse temporary shelter or end up back on the streets after
getting thrown out of housing for various types of misbehavior.
The ongoing trial is a response to the failure of drug
addiction to respond to the many millions of state and federal dollars that
have been thrown at it. The idea is to toss some of that money toward documented
addicts of substances from heroin to cocaine, methamphetamines, fentanyl and
other opiates and stimulants.
Deaths from these and related drugs quadrupled between 2011
and 2020, reports the California Health Care Foundation. Emergency room visits
caused by amphetamine use rose 50 percent in just two years, from 2018 to 2020.
If
addicts get highs from the drugs, one still unproven theory goes, perhaps
they’ll be even more thrilled by receiving cash. Well, not exactly cash, but
gift cards from a variety of retail and grocery stores.
These
start with a $10 reward from Medi-Cal for the first clean urine test, rising
steadily over 24 weeks to a total of $599, just below the $600 level where
income sources must be reported to the Internal Revenue Service and the state
Franchise Tax Board.
This is definitely throwing money at a big problem, about $50
million in mostly federal funds, but in a much more direct way than via
psychotherapy and other current tactics.
Today’s main treatment methods will not be going away, nor will
prescribed medications and counseling.
The idea of the money is to provide positive reinforcement,
with material results from constructive behavior and exercise of will power.
Authorities see this as a tool that might somehow “rewire”
addicts’ brains to make them more interested in material well-being than
immediate highs.
No one thinks cash-for-clean-tests can end drug addiction
problems for everyone who suffers them. But if it works on a significant
percentage, letting them sober up and stay that way for as long as 24 weeks,
that would be progress and more than cover its costs by saving far more money
in the costs of street crime and treatment.
And here’s that other idea: If cash can work for addicts, could
it help the homeless?
Many of them refuse to enter shelters because they want to
remain free of rules and are not interested in counseling opportunities usually
provided in temporary shelters like hotels now being rented or bought by cities
and counties around the state.
But how about giving them a no-strings attached stipend for each
week they spend seven nights in temporary shelter? Maybe raise rewards a bit if
they seek counseling and are observed to be taking treatment seriously.
If their acquaintances still on the streets see some of the
unhoused getting food, shelter and money, some who now reject moving in may
become motivated to accept a temporary hotel room of their own, even if it
means controlling their behavior at least enough not to get kicked out.
If this works and some of those involved move on to permanent
housing or get jobs in today’s wide-open employment market, it would cost far
less than the hundreds of millions of tax dollars now being spent for hotels
and other temporary shelter.
There’s also the fact that drug addiction and homelessness
often involve the same individuals. Helping them through one problem might contribute
to solving the other.
The peer-reviewed Journal of the American Medical
Association has reported that 80 percent of studies of cash rewards for
giving up use of stimulants showed they reduced drug usage, at least somewhat.
In a way, this could be the ultimate test of the Coolidge observation
about America. For if money can’t dry out a significant portion of drug addicts
and move major numbers of the homeless to inside spaces, it’s hard to see what
else might.
-30-
Elias is author of the current book “The Burzynski Breakthrough: The Most
Promising Cancer Treatment and the Government's Campaign to Squelch It,” now
available in an updated third edition. His email address is tdelias@aol.com
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