Charles R. Schuster, professor in Wayne State's School of Medicine and former director of the National Institute on Drug Abuse under Presidents Ronald Reagan and George H.W. Bush, commented about how incentives can influence adult behavior. The idea of offering incentives such as gift cards and bus tokens, CD players and rent subsidies, is slowly catching on in drug and alcohol treatment. "Many of us recognize this as one of the most important and effective tools we have," said Schuster. "But we've done a lousy job of selling it." More than 60 studies here and in Europe show that rewarding substance abusers for staying clean helps keep them enrolled in the critical early weeks of outpatient rehab, when dropout rates can hit 40 percent or more.