- - Monday, February 23, 2015

ANALYSIS/OPINION:

Proposals to drug test welfare recipients have received harsh criticism in recent days, including charges that they are unconstitutional. Critics have been particularly tough on the plan contained in Wisconsin Governor Scott Walker’s latest budget proposal.

Though several states are pursuing slightly differing plans, the main idea is that if a person is using illegal drugs, benefits could be withheld unless they enter treatment to overcome their drug abuse.

In the Milwaukee Journal-Sentinel, the idea was compared to throwing an elderly person off of Medicare because of diabetes, when “decades of research have firmly established substance use disorders as medical conditions to be prevented and treated as early as possible.”

Meanwhile, the Washington Post attacked the suggestion that welfare recipients use drugs at higher rates than the general population, charging the proposal merely introduces stigma. Nearly every critic cites a Florida study where, according to the New York Times, only 2.6 percent of applicants tested positive (108 of 4,086, with 40 applicants refusing the test).

Critics question whether these programs, in any meaningful sense, “work.”

An obvious goal of these efforts would be to reduce the prevalence of illicit drug use in this population, since it is a behavioral disorder that does great harm to themselves and their families.

Yet another goal could be to ensure that public funds, taken from those who labor (some who themselves struggle economically), are spent constructively and not on drug use. Otherwise, these funds only worsen the problems of the poor, and threaten their neighbors by attracting the drug trade.

What are the facts about rates of drug use? While studies are mixed concerning exact numbers, the Department of Health and Human Services reviewed the evidence, and the data indicate that welfare beneficiaries do suffer abuse at higher rates, with harsher consequences.

A good proxy for drug use in this population can be found in the annual National Household Survey of Drug Use and Health (NSDUH). It found that drug use afflicted about 9 percent of the U.S employed population 18 and older, but that rates among the unemployed were above 18 percent.

Even staunch critics such as Professor Harold Pollack of the University of Chicago report that, according his analysis of the 2011 NSDUH, “some 22.3 percent of welfare recipients reported illicit substance use in the previous year.”

So is the Florida report finding only 2.6 percent drug use among applicants a measure of the failure of the program? Only if the rationale for the program is punitive, trying to “catch” drug users so as to disqualify them.

If the goal is deterrence, then these figures could signal that the testing program reduced prevalence and helped recipients become drug free.

But such studies miss a larger point—whether the drug use of welfare recipients is higher or not, they are likely to suffer more from it. They are more vulnerable, lacking the resources for interventions and support, while their children, already at a disadvantage economically, likely suffer even greater harm.

As for constitutionality, a central issue is “unreasonable search,” if there is no suspicion of drug use. Yet it is a commonplace for employment, including at the White House and many businesses, to be conditional on a drug test. Mr. Walker’s goal, he says, is to make people employable, and their drug use is a “barrier.”

Finally, drug users, whether receiving welfare assistance or not, are people who need help, not acquiescence in their continued addiction. Those who accept that drug use is a “medical condition,” should also realize that early intervention is essential, and this can be the outcome of a positive drug test. Further, studies of treatment outcomes have shown that people who have an incentive are more likely to succeed at recovery.

These last points, surely humane ones, may be the best reasons to give such programs a chance at proving themselves.

John P. Walters and David W. Murray direct the Hudson Institute’s Center for Substance Abuse Policy Research. They both served in the Office of National Drug Control Policy during the George W. Bush administration.


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