There?s been a dramatic spike in substance use disorders in the US, driven by the pandemic and the increasing availability of highly potent drugs such as fentanyl and methamphetamine. The rarely used, but evidence-based practice of contingency management to treat substance use disorders is showing promise to help this crisis. Further, smartphone technology and gamification can be effectively applied to help reward healthy behaviors and drive better outcomes. Substance misuse is estimated to cost the US almost a half trillion dollars annually in healthcare costs, lost productivity, and criminal justice spend. Further, overdose deaths have reached record levels, with over 100,000 lives lost in the last twelve months. Innovation and investment are desperately needed to reverse these trends.