To the editor: The authors provide an excellent description of contingency management as an evidence-based treatment for some people addicted to stimulants such as cocaine and methamphetamine (“There is an effective way to treat drug addiction, but you may not like it.” July 15).
What is not mentioned is that contingency management is derived of a basic science of behavior discovered by psychologist BF Skinner called operant conditioning. The discovery of operant conditioning has generated numerous evidence-based treatments for various disorders, including but not limited to the behavior of people diagnosed with autism and related disorders.
The fundamental principle of operant conditioning is reinforcement, which simply states that the outcome of some behavior increases the future probability of that behavior. For substance users, the desired behavior is to be substance-free.
According to the authors, some may not like that people with substance abuse disorders earn money by not using substances. They say some call this bribery.
But reinforcement is not a bribe. Bribery is defined as offering someone gifts or money to engage in behavior that is often illegal or dishonest. Bribery often occurs before the behavior, while reinforcement always follows the behavior.
There is nothing about reinforcing appropriate behavior that can be called bribery. When you receive a salary for working, we do not call it bribery.
Henry D. Schlinger, Glendale
This writer is professor emeritus of psychology at Cal State Los Angeles.
..
to the editor: I enjoyed the recent op-ed by Sally Satel and David Farabee.
Addiction has an enormous cost to society in the loss of workers in the economy, the loss of family members in our communities, and in the dollars spent on hospitals, prisons, and other institutions to try to come to terms with this problem. the data He says things are likely to get worse as powerful designer drugs ensnare new users and send them to emergency rooms with overdoses.
The good news is that treatment programs work. Barely 40% of people who undergo drug treatment achieve lasting abstinence, and many of those people return to paid employment. According to the International Narcotics Control BoardEvery dollar spent on drug addiction prevention and treatment can save governments up to $10 in future costs.
The real question is not, “Can we afford to treat drug addiction?” The question is, “Are we willing to continue wasting money by not treating addiction adequately in every community in America?”
Stuart Gallant, Belmont, Ma.
