Washington State Uses Gift Cards to Help People Quit Stimulants—And It’s Working

For 35 years, Seattle resident William Lester Jr. struggled with heroin addiction—and more recently, methamphetamine use. His weight had dropped to just 68 pounds when he was hospitalized for kidney failure, a turning point that led him to seek help.

"I wasn't ready to stop for years," Lester admitted. "Until one day, I said, 'I'm done, I can't do this anymore.'"

That decision brought him to a 12-week contingency management program, a treatment approach that rewards drug abstinence with gift cards—a system that is now proving highly effective in Washington and other states.

How the Program Works

Contingency management operates on a simple principle: incentivizing sobriety.

Participants provide a urine sample twice a week, testing for stimulant use.

• If the test is negative, they receive a gift card—starting at $12 per test and increasing with continued success.

• If the test is positive, they aren’t removed from the program, but their reward amount resets, requiring them to build back up.

• Participants can earn up to $599 per year in incentives, which can be used for groceries, clothing, or electronics.

"It's a bit unusual," said Michael McDonnell, a professor at Washington State University’s Elson S. Floyd College of Medicine. "But the person comes in, has a positive interaction with a clinician, and if they haven’t used in the last few days, there's a big celebration—and they get a gift card."

A Proven, Evidence-Based Approach

The program is backed by decades of research showing that rewards are highly effective in helping people reduce stimulant use, particularly among U.S. military veterans.

The U.S. Department of Veterans Affairs first implemented contingency management in 2011, but it faced resistance in the general public due to concerns that offering rewards could be seen as bribery.

However, as the opioid and stimulant overdose crisis worsened, attitudes began to shift.

• California became the first state to fund contingency management under Medicaid.

• Montana and Washington launched large-scale programs in 2021.

• Washington now has 24 clinics offering the 12-week program, with preliminary results showing 70% of participants have reduced stimulant use.

Bringing Treatment to Housing Programs

Unlike traditional clinic-based programs, Seattle’s Plymouth Housing—a supportive housing provider for formerly homeless individuals—has adapted the program for residents.

Instead of requiring participants to visit a clinic, peer-support workers come directly to residents' units for testing and check-ins.

"We actually have higher participation and completion rates than in clinical settings," said Aaliyah Bains, a behavioral health program manager at Plymouth Housing.

For Lester, that personal connection made all the difference.

"I've been to AA, treatment centers—none of it worked," he said. "But my peer-support worker had been where I was, and I could relate to them."

Though Lester initially thought he could cheat the system, he was surprised to find himself fully committing to the program.

"I stopped [using drugs] thanks to the program," he said.

Expanding the Model

With early success rates, contingency management is being looked at as a scalable approach to treating stimulant use disorder, which lacks the kind of medication-assisted treatments available for opioid addiction.

As more states explore funding the program, Washington's results could serve as a blueprint for addressing methamphetamine and cocaine addiction nationwide—offering a new path to recovery for those struggling with stimulant use.