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Tradeoffs
The Best Way to Fight Meth Addiction? Gift Cards
For decades, the most effective treatment for addiction to methamphetamine or cocaine has been mired in stigma and mostly limited to small research studies. But with deaths involving meth and cocaine on the rise, policymakers across the country are turning to gift cards to fight drug use.
This story has been updated to clarify the research on long-term effects of contingency management and the eligibility requirements to deliver contingency management through CalAIM.
Credits:
Stephen Higgins, PhD, Professor of Psychology and Psychiatry, University of Vermont
Richard Rawson, PhD, Professor Emeritus, UCLA Department of Psychology
Andrew Dertien, Contingency Management Coordinator, HealthRIGHT 360
Bernard Groves
Ayesha Appa, MD, Assistant Professor of Medicine, UCSF and San Francisco General Hospital
Tyler Sadwith, Medicaid Director, California Department of Health Care Services
Learn more and read a full transcript on our website.
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309. As Trump Targets USAID, What’s at Stake for U.S. and Global Health?
17:44||Season 1, Ep. 309The Trump administration’s swift and sweeping efforts to dismantle the U.S. Agency for International Development is creating chaos across global public health efforts. One doctor working to halt an Ebola outbreak in Uganda reflects on consequences, now and long-term, of America’s abrupt change in policy.Guest:Dr. James Lawler, Director of International Programs and Innovation, Global Center for Health Security at the University of Nebraska Medical CenterLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.308. RFK Jr. Wants to Change What Americans Eat. He's Not The First
26:04||Season 1, Ep. 308The fight to improve Americans’ nutrition could get new momentum from Robert F. Kennedy Jr., but he will face practical and political limits to changing U.S. food supply if he’s confirmed to lead the Health and Human Services Department.Guests:Laura Schmidt, professor at the University of California at San Francisco Philip R. Lee Institute for Health Policy Studies; Department of Humanities and Social Sciences; and School of Medicine. Susan Mayne, former director of the Food and Drug Administration Center for Food Safety and Applied Nutrition 2015-2023; Yale University adjunct professor of epidemiology.Christina Roberto, director of the Center for Food and Nutrition Policy at the University of PennsylvaniaLearn more and read a full transcript on our NEW website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.307. The Powerful Vaccine Committee RFK Jr. Could Soon Control
19:47||Season 1, Ep. 307If the Senate confirms Robert F. Kennedy Jr. — a vaccine skeptic — to lead the Department of Health and Human Services, he would control a powerful group of federal vaccine advisors.Guests:Ron Balajadia, Hawaii Department of Health immunization branch chiefDorit Reiss, University of California, San Francisco, professor of public health law Dr. Sarah Long, former member of the Advisory Committee on Immunization Practices and Drexel University, professor of pediatric infectious diseaseDr. Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia.Richard Hughes IV, attorney with Epstein Becker Green Per Fischer, CEO, MinervaXLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.306. RFK Jr. Is Headed to Capitol Hill. A Former HHS Secretary Lays Out the Stakes
23:07||Season 1, Ep. 306Former HHS Secretary Kathleen Sebelius shares what the country’s top health official can and can’t do, and what she wants senators to consider ahead of RFK’s confirmation hearings.Read our new story about an obscure but extremely influential vaccine committee that Kennedy, if confirmed. would control.Guest:Kathleen Sebelius, Former U.S. Secretary of Health and Human Services SecretaryLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.305. Why Many Republicans Think Shrinking Medicaid Will Make it Better
25:01||Season 1, Ep. 305Many Republicans have singled out Medicaid as a policy that could see big changes under the new administration and Congress. We take a closer look at why many conservatives think less Medicaid will mean better Medicaid.Guests:Josh Archambault, Senior Fellow, Cicero InstituteBrian Blase, President, Paragon Health InstituteMichael Cannon, Director of Health Policy Studies, Cato InstituteElizabeth Matney, Iowa Medicaid Director (2021-2024)Barbara Sears Roshon, Ohio Medicaid Director (2016-2019)Tom Scully, CMS Administrator (2001-2004)Learn more on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.304. Biden’s Medicaid Director Reflects on Lessons Learned and Worries for the Future
25:50||Season 1, Ep. 304With Medicaid poised for potential cuts from Republicans in Washington, Dan Tsai reflects on what he's learned running Medicaid for the Biden administration — and his hopes and concerns for the program's future.Guest:Dan Tsai, Deputy Administrator and Director of Center for Medicaid and CHIP Services, CMSLearn more on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.303. The Fifth Branch: The Last Line of Care
42:13||Season 1, Ep. 303Alternative response teams are being asked to tackle vexing problems: mental illness, homelessness, addiction. How much can they actually do? We explore how Durham grapples with connecting people to long-term care and support, and where the city draws the line between crisis response and social services.Guests:Ryan Smith, Director, Durham Community Safety DepartmentSammetta Cutler, Peer Support Specialist, Durham Community Safety DepartmentSarah Hall, Durham residentDavid Prater, Peer Support Specialist, Durham Community Safety DepartmentJohn Warasila, Real estate developer and architect, Alliance ArchitectureBo Ferguson, Deputy City Manager, DurhamPatrice Andrews, Police Chief, Durham Police DepartmentChristie Thompson, Staff Writer, The Marshall ProjectAllison Casey, EMT, Durham Community Safety DepartmentEMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness. To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.Learn more on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.302. The Fifth Branch: Keeping People Safe
40:02||Season 1, Ep. 302How do you keep everyone safe? We look at HEART’s impact on the safety of Durham residents in crisis, the mental health workers responding, and the police.Guests:David Prater, Peer Support Specialist, Durham Department of Community SafetyRyan Smith, Director, Durham Department of Community SafetyYolanda, Durham residentSgt. Dan Leeder, Durham Police DepartmentPatrice Andrews, Police Chief, Durham Police DepartmentChristie Thompson, Staff Writer, The Marshall ProjectEMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness. To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.The Marshall Project's Christie Thompson reports on the state of alternative crisis response across the country.Learn more about this series, which first ran in July, 2024 on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.301. The Fifth Branch: Convincing the Cops
35:27||Season 1, Ep. 301How do you convince police officers that it makes sense to send unarmed mental health workers to some 911 calls?Guests:Patrice Andrews, Police Chief, Durham Police DepartmentRyan Smith, Director, Durham Department of Community SafetySgt. Dan Leeder, Durham Police DepartmentAbena Bediako, Clinical Manager, Durham Department of Community SafetyChristie Thompson, Staff Writer, The Marshall ProjectEMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch. Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness. To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.Learn more about this series, which first ran in July, 2024, on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.