Contingency management (CM), which involves paying people to use less meth or engage in treatment, is the most effective treatment tool for methamphetamine use disorder. Compared to CM, other treatments (like medications, counseling, detox, and rehab) do not work well for meth use.

Despite this, CM is not widely available due to legal, political, and operational barriers. To address this in California, DHCS is implementing a CM pilot in some counties through the Drug Medi-Cal Organized Delivery System (DMC-ODS). However, not all individuals needing CM services are able to access the DMC-ODS. This is especially true for people experiencing homelessness, for whom transportation, social, stigma, lack of insight, and other barriers prevent them from accessing DMC ODS services.

Meth use is especially problematic as people experience homelessness enter permanent supportive housing (PSH). Housing First models mean that individuals entering PSH are not expected to be in recovery. Continued meth us in PSH can cause major behavioral disturbances that can put the individual, their neighbors, staff, and the building in harm's way.