Contingency Management As a Treatment Protocol

In July of 2000, I wrote this to my son on the back of a photo of the two of us:

“My sunshine, I’ve been blessed with having you. You are my soulmate. The happiest times of my life were shared with you. You have been my friend and support through hard times. And through you I found myself. Love life. Don’t be scared. Remember, ‘That shall also pass.’ God bless you, my love. Mom”

I lost him, my only son and the father of my 3-year-old grandson, to fentanyl poisoning on November 9, 2020.

He suffered on and off from stimulant use disorder, anxiety, and depression for 23 years. Last fall when he relapsed and was looking for treatment, most of the providers required cash only — up to $38,000 per month — and one treatment program told him that his private insurance would only cover three days. It would have been a joke, if it didn’t result in tragedy. 

I’ve since learned that contingency management is the most effective treatment protocol for stimulant use disorder, but my son never received it.

It was never offered. Contingency management incentivizes patients through tangible rewards, which has been shown to significantly improve retention in treatment and abstinence. 

There is a current bill that just passed in the California legislature, SB 110, which would allow for the inclusion of contingency management within substance use disorder services under the state’s Medicaid program. I will be urging the Governor to enact SB 110 swiftly so that this treatment protocol can be offered to patients and save lives.

Unfortunately, stimulant-involved deaths are escalating.

In 2020, California had a 45% statewide increase in fatal overdose deaths. My son became a statistic, one of 93,000 sons, daughters, fathers, mothers, sisters, brothers, friends. Besides the loss of the 93,000 lives, no one is talking about the families that are left behind and the generation we are losing. 

Nothing can return my soulmate to me. And my grandson will never see his beloved daddy again. So, this is what I live for: the hope that my grandson’s generation will not be cast away like his father’s generation was, and that the antiquated stigma surrounding addiction will cease to exist. My hope is that my efforts may save another mother from the unimaginable loss of a child and that we will see more treatment options, like contingency management, which help people thrive in recovery. 

I am one of the countless mothers that would like to see SB 110 signed into law, so that this science-based therapy can be utilized by treatment providers and help increase those entering treatment, ultimately saving lives. 

Irene Filimonoff-Haney is a Shatterproof Ambassador who lives in California.