Nationwide Stakeholders Urge Biden Administration to Lift Restriction on Contingency Management for Substance Use Disorders
Please see the attached letter from nationwide stakeholders, including the Addiction Policy Forum, American Academy of Addiction Psychiatry (AAAP), American Society of Addiction Medicine (ASAM), Behavioral Health Foundation, Center for Behavioral Health Integration, Drug Policy Alliance, DynamiCare Health, Faces and Voices of Recovery, Faith in Harm Reduction, Legal Action Center (LAC), National Association for Behavioral Healthcare (NABH), National Council on Mental Wellbeing, ReVIDA Recovery Centers, Shatterproof, Treatment Communities of America, and Young People in Recovery, calling on the Biden Administration to immediately end the $75 annual cap on Contingency Management (CM) incentives for individuals with substance use disorders (SUD). This issue is urgent. In 2022, the death rate from stimulant use surpassed that of opioids, underscoring the need for evidence-based, effective interventions.
The Evidence:
Contingency Management (CM), backed by over 60 years of research and over 100 peer-reviewed studies, has proven highly effective when incentives are set at at least $100 per patient per month for six months.
A recent White Paper analysis compared patients in New Jersey (limited to $75 annual incentives through SAMHSA grants) with patients in West Virginia (receiving up to $599 over six months via Medicaid). While retention rates and satisfaction were similar, New Jersey patients showed substantially less effort in treatment and far worse abstinence outcomes.
Despite this robust evidence, the federal $75 annual cap on CM incentives remains in place, contravening well-established clinical guidelines and undermining patient outcomes. In fact, CM was declared the "standard of care" for stimulant use disorder in 2023 by the joint Clinical Practice Guideline published by the American Society of Addiction Medicine (ASAM) and the American Academy of Addiction Psychiatry (AAAP).
The Paradox:
The $75 cap is arbitrary, ineffective, and rooted in outdated political fears of appearing "soft on drugs." However, with the Administration’s term winding down, such concerns are no longer relevant. What remains is the opportunity to correct a harmful, self-imposed policy that contradicts the President’s own National Drug Control Strategy, which called for removing barriers to evidence-based SUD treatments.
The Urgent Call to Action:
Patients, families, and healthcare providers are calling on the Administration to act. This does not require Congress, regulatory changes, or an Executive Order—just simple action to lift the cap. The attached letter, signed by numerous stakeholders and supported by real patient voices, highlights the need to resolve this policy paradox now.
Time is running out for the Biden Administration to deliver on its promise and align federal funding policies with the overwhelming scientific consensus. We hope this story will receive the coverage it deserves—before it's too late for meaningful change.