Reviews | Paying people not to use drugs works. So let’s keep doing it.


A welcome addition to the widespread drug treatment problem is the concept of using a paid inducement to encourage abstention from drug use, as Emefa Addo Agawu’s opinion essay from 3 April: “She was paid not to use drugs. Here’s why this approach could help many others. The main tool of this prevention program is frequent drug testing to verify that the addict has stopped using drugs.

This new strategy called “contingency management” is similar to several other successful drug prevention programs that use drug testing to confirm qualification to receive valuable incentives, such as continued employment or continued participation in a privileged activity, such as school sports. It is also used in drug courts to obtain an official expungement from a permanent record of illegal drug activity. Although often challenged under the influence of the lucrative addictive substance industries, drug testing has been court-approved and widely used for decades. The technology has improved to the point where a simple, inexpensive oral swab drug test can detect up to a dozen different drugs, from tobacco to opioids, including fentanyl, in about 10 minutes.

Thus, the direct cash incentive revealed in this valuable article is a welcome addition to the national drug prevention arsenal to help reverse the current tragic rates of drug addiction, disability and overdose death that are a scourge for today’s society. As the essay states, “With so many people in the United States struggling with addiction, why is an effective, tested treatment still barely used?”

DeForest Rathbone, Leonardtown, Maryland

The writer is an activist for the prevention of drug consumption.

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