Beeminder Forum

Paying drug addicts to stay sober

Really interesting article!

Steven Kelty had been addicted to crack cocaine for 32 years when he tried a different kind of treatment last year, one so basic in concept that he was skeptical.

He would come to a clinic twice a week to provide a urine sample, and if it was free of drugs, he would get to draw a slip of paper out of a fishbowl. Half contained encouraging messages — typically, “Good job!” — but the other half were vouchers for prizes worth between $1 and $100.

“I’ve been to a lot of rehabs, and there were no incentives except for the idea of being clean after you finished,” said Mr. Kelty, 61, of Winfield, Pa. “Some of us need something to motivate us — even if it’s a small thing — to live a better life.”


This is great! Reminds me of a podcast episode I listened to a long time ago on programs that encourage people to save more money by giving people tickets in a drawing for a pot containing the interest from all the savings in the program. The more you deposited, the more tickets you got in the drawing, if I recall correctly.

This is talked about in McGonigal’s “The Willpower Instinct”, too. I think there she said that paying people outright had a lower success rate than this lottery version, with the uncertainty of the reward playing a role.


Found what I was thinking of! It’s called a prize-linked savings account.

Prize-linked savings is the concept of using the chance to win a prize to incentivize personal savings. A prize-linked savings account or PLSA (also called a lottery-linked deposit account ) is a savings account where some of the interest payment on bank deposits or marketing dollars are distributed as prizes based on chance. They are attractive to consumers as they function both as a sweepstakes or game of chance (as there is a chance of a large prize) and as savings (the deposit is never lost, unlike normal lotteries) vehicle.


I’m not an expert in drug addiction or public policy, but if this is interesting to you, take a look at the pushback against harm reduction too.

1 Like

In the UK, government “premium bonds” that work this way have been popular since the 50s.


I loved this article! I’m also a big fan of randomness and how our brains only really pay attention when they’re surprised. And probability is a form of surprise.

I’m mulling over trying to set up a random reward system for myself. Days I meet some kind of stretch goal I get to generate a random number that corresponds to some possible reward? Where reward = baked treats? extra screen time? money to bank towards an indulgence? Still thinking it through.


Yes, you can make a long list of things that could function as rewards.

Doing things you’d love to give yourself but rarely feel like you can indulge – this would be a great chance to indulge

1 Like