Treating Drug Addiction

 I have been at many positions on this topic, There’s an Effective Way to Treat Drug Addiction—but You May Not Like It , but I will say that I have liked Sally Satel's reasoning in general, and I agree that reward systems tend to be effective.

There are at least two questions here, what is good for the individual and what works. I am mostly interested in the latter when it comes to public policy. This spiritual condition of an individual is the most important consideration, but that doesn't mean that the government should have anything to do with it. There is a difference between a government allowing virtue to flourish and trying to make it happen.

I have no need to punish or avoid punishing the offender. I think advocates in both directions overestimate how much effect it has. Punishing does not do half the good nor half the harm people think it does. This is why we have coaches, teachers, and leaders, because some people need to be treated gently and others need to be kicked in the butt - general rules have too many exceptions.

The answer may come from a proven nonmedical remedy. A Stanford team’s examination of 157 clinical trials of treatments for cocaine, including both psychotherapy and medications, found little clinical benefit with one notable exception: contingency management, a program that leverages motivational incentives, or “carrots,” to help shift an addict’s behavior. According to the Stanford analysis, these methods more than doubled the odds of someone testing negative for cocaine.

Methamphetamine — despite its reputation as being more addictive than cocaine and certainly more damaging to the brain — was shown to be similarly responsive to contingency management.

 Nothing works all the time, some things work more often than others.