For an increasing number of Americans, addiction treatment involves not only hard work, but also earning rewards — sometimes totaling $500— for negative drug tests or showing up for counseling or group meetings. There's brain science behind the method, which is known as contingency management. And barriers to wider adoption of reward programs, such as government concerns about fraud, are starting to crumble. U.S. overdose deaths climbed to a record high during the pandemic. While opioids are mostly to blame, deaths involving stimulants such as methamphetamines also are climbing. Often, people die with multiple drugs in their system. Medication can help people quit opioids, but stimulant addiction has no effective medicine. Rewards programs — especially when the dollar value increases with consistent performance — are widely recognized as the most effective treatment for people addicted to stimulants. More than 150 studies over 30 years have shown rewards work better than counseling alone for addictions including cocaine, alcohol, tobacco and, when used alongside medications, opioids.