SAN FRANCISCO — For more than two decades, Robert Bowers stole money, jewelry, identities, even silverware, to feed his methamphetamine addiction. He landed in prison, rehab and skid row hotels.
Until earlier this year, when the government paid Bowers to quit.
A little-heralded program run by San Francisco's Public Health Department over the last year has given meth users rewards worth up to $40 per week to stay off drugs. And, in a break from traditional approaches, participants receive no counseling or lectures, even if they test positive for meth use.
Their end of the bargain is simple: Show up at a clinic three times a week, urinate in a cup and collect their reward -- a voucher, not cash -- if they test drug-free.
"Here I am getting clean, I feel better and I'm getting something for it," said Bowers, 42, who says he hasn't used meth since early February and has put more than 45 pounds on his formerly ravaged 128-pound frame. "That means something."
Though just a pilot program, the San Francisco venture is the latest in a string of experiments and studies over the years to point in the same intriguing, if controversial, direction: Addicts respond remarkably well to material rewards, even little ones.
"You're using the exact same technique that parents use with their children every day," said Nancy Petry, a researcher at the University of Connecticut School of Medicine who is studying this approach. "It's behavior modification and behavior shaping."
The findings could be especially significant in California, where methamphetamine use continues to surge. It has surpassed alcohol and heroin as the drug of choice among those seeking treatment. The drug increases arousal and reduces inhibitions, sometimes leading to violence, child neglect and serious health problems such as malnutrition and heart failure among chronic users.
In essence, the voucher approach replaces one reward with another -- the high of drugs such as meth with the mental boost of grocery money, a gift certificate or a rent subsidy. Given the power of addiction, as shown by many addicts' desperate and self-destructive acts, the trade-off might seem woefully insufficient. But for some reason, researchers say, it works.
