When William Lester Jr. He decided to get into a 12 -week program to address the use of drugs, he says he weighed only 68 pounds. The Seattle resident, Washington, has been using heroin for 35 years, and recently methamphetamine.
He knew something had to change when he was admitted to the hospital for kidney failure.
“I wasn’t ready to stop for years until one day I said,” I’m almost, I can’t do it anymore, “said Lester, who lives in a supporting accommodation in Seattl.
He called on his worker that he had put him on the path of managing program in unforeseen situations – which rewards abstinence from stimulus drugs, such as methamphetamine or cocaine, with gift cards.
Gift cards twice a week
A program that operates in countries, including California, Montana and Washington, asks participants to give a urine pattern and make a quick test to see if they use drugs or not in the last few days.
For each negative test, the patient receives a reward. In the State of Washington, IU Plymouth Housing in Seattl, where Lester lives, that prize comes in the form of a gift card.
“It’s a little unusual because the way is the procedure, where a person enters and usually have a really positive, fun interaction with the clinic,” said Michael McDonnell, a professor at the Community and Health Department at the Elson S. Floyd Medical Faculty at the University Washington.
“If he shows that a person has not used [stimulants] In recent days, they have a really big celebration and give that person a gift card, “McDonnell explained.
For each sample of negative urine, which occurs twice a week, the patient receives a $ 12 gift card. And the amount gradually increases with each negative test. Participants can get a maximum of $ 599 per calendar year.
If the patient tests the drug positively, it is not expelled from the program. Instead, their gift card is reduced and they must upgrade their path.
Gift cards can be used to buy foods, clothing or even electronics.
Managing in unforeseen situations Decades of evidence that support his success To help people stop or reduce their stimulating drugs, McDonnell states.
The program is implemented outside the clinic, except in Seattl, where it operates outside Plymouth Housing, permanent supporting non-profit organization for people who are struggling with long-term homelessness. There, 40 people have followed the program for more than a year.
In Plymouth, the goal is to bring a program to people, instead of going to an outpatient clinic.
According to Aaliyah Bains, head of behavior program at Plymouth Housing, this is big.
“It was not easy to remove from the clinical environment and push it into accommodation,” she remembers. But it works.
“We actually have higher rates of participation and larger rates of completion than in clinical environments,” Bains said, referring to preliminary data.
Another difference lies in the fact that in Plymouth, a worker’s peer assistant who comes to a population unit means that someone who has experienced addiction sees them.
“I was in AA, in many such things, but see, I can’t treat anyone I wasn’t where I was,” Lester said, adding that it was support in his residential unit who got him to join him to the program.
Participation in this was not always easy. Lester says he thought he could deceive the system, but that he was surprised to hold on it.
“I stopped [using drugs] Thanks to the program. ”
With the increasing discussion of inadvertent drug treatment in Canada, CBC Julia Wong goes to Washington to find out about Ricky’s law and challenges of forcing people to rehab.
Evidence -based approach
Most evidence for the management of unforeseen situations comes from decades of veterans research.
The United States Veterans’ Department has implemented the program In 2011. But attitudes – like viewing awards as a myth – slowed its use for the general public.
Things moved when an overdose epidemic became a public health crisis.
California was the first country to cover the management of unp
In 2021, the states of Montana and Washington began to use the program to a large extent for stimulant use disorder.
In Washington, 24 clinics offer a 12-week program. Preliminary results show that out of more than 200 participants, about 70 percent have been engaged and recorded a decrease in their stimulus of use, according to McDonnell.
Information Morning – Frederickon14:40Clinical examination meth
This is the largest clinical trial so far in the world about the use of methamphetamine, and will participate in the River Stone recovery center in Fredericton. J Eanne Armstrong spoke with Dr. Sarah Davidson. https://www.cbc.ca/news/canada/new-runswick/frederickon-river-stone-centre-trial-mesh-7.7230339 [https://www.cbc.ca/news/canada/new-brunswick/fredericton-river-stone-centre-trial-meth-1.7230339]
British Columbia also has several programs to manage unforeseen situations, although very limited.
“It is an important part of the continuity of care for the use of substances,” a spokesman for the Ministry of Health said in a statement.
BC programs are operated by Vancouver Coastal Health and Fraser Health, including a 12-week group consultation program delivered by AIDS Vancouver. Most of them are focused on the use of stimulants.
The need for effective treatment programs has become more urgent in recent years as the crisis of toxic drugs has been deteriorating.
Although Fentanil and other opioids have made titles since 2016 in Canada and North America as a whole, stimulants are also present in the increasing share of the death of an overdose. In Canada, stimulants were found together with Opioids in 64 percent of the death of toxic drugs in 2024.
During the same year, cocaine was detected in 52 percent of toxicological reports on overdose, and methamphetamine was found in 43 percent.
The new report reveals that after the pandemic of Covid-19, the overdose of death in Ontario of multiple substances has surpassed death from one substance.
Bains says that the management of unforeseen situations provides the opportunity to succeed.
“So many programs are all or nothing, you have to be 100 percent sober or you are not successful. This is simply not what is managing in unforeseen situations.”
Bains has also witnessed the pride of some of the 40 participants in the one -year Pilot Plymouth Pilot project.
“I saw him change people. Giving them the opportunity to have $ 20 a week for someone who has no income changes life.”
Trucks are more likely to end
Although it can be thought that financial prizes would not be able to succeed as well as for more voluntary patients, McDonnell says they have proven to be a strong stimulus regardless of income.
“I have doctors, lawyers and other people who are financially well -made, but they really desperately want to stop using their substances … And they are motivated by the idea that they have been rewarded,” the researcher explained.
If nothing else, people who do badly manage to manage unforeseen situations.
“The likelihood is that they will end the program because they have so many other things they deal with,” McDonnell said. And, he added, they can rely on stimulants to be awake for security.
“It’s dangerous to be homeless: someone could come and steal your things, you might be attacked,” McDonnell said.
According to Lester, for six years located in Plymouth, it is more likely to say that the program.
Despite its low income, he says that incentives were less important than the process of responsibility and that someone believes in his success.
“I could tell you that I feel better now than I have ever felt in my life,” he said proudly.
