Pubdate: Tue, 01 Oct 2002
Source: Washington Post (DC)
Copyright: 2002 The Washington Post Company
Contact:  http://www.washingtonpost.com/
Details: http://www.mapinc.org/media/491
Author: Harold Pollack, Peter Reuter
Note: Harold Pollack is associate professor of public health at the 
University of Michigan. Peter Reuter is a professor in the School of Public 
Affairs and the Department of Criminology at the University of Maryland.

TAKING EXCEPTION

Myths About Drugs And Welfare

The National Center on Addiction and Substance Abuse (CASA) at Columbia 
University employs many distinguished researchers and performs valuable 
work in drug abuse treatment and policy. Unfortunately, CASA researchers 
have their work cut out for them in dispelling the myths spread by their 
own director, former health, education and welfare secretary Joseph A. 
Califano Jr.

Califano claimed in a Sept. 18 op-ed in The Post: "Today the bulk of 
mothers on welfare -- perhaps most -- are drug and alcohol abusers and 
addicts, often suffering from serious mental illness and other ailments." 
This wildly overstated account reinforces false stereotypes about who is on 
welfare and makes it harder to address problems of drug abuse and 
psychiatric disorders among women who receive public aid.

Not surprisingly, welfare recipients are more likely than the general 
public to have problems with alcohol or illicit drugs.

But these problems appear to affect a small minority of welfare recipients. 
In recent nationally representative surveys, about 19 percent of welfare 
recipients reported the use of any illicit drug during the previous 12 
months, compared with about 7 percent of working-age women who do not 
receive public cash aid. A far smaller proportion appeared to satisfy 
screening criteria for dependence on these drugs.

Heavy drinking and alcohol dependence were similarly unusual in these data.

The number of problematic drug users receiving welfare declined during the 
1990s because of the sharp decline in welfare caseloads and because of a 
general decline in problematic drug use throughout the society. Moreover, 
the proportion of welfare recipients who reported recent illicit drug use 
was lower in the year 2000 than it was in 1990.

Of course, such surveys may understate the extent of the drug problem, 
because they are based on what welfare recipients report about themselves. 
Yet other kinds of data yield similar results.

For example, three Michigan welfare offices recently required applicants to 
undergo urine testing.

Eight percent of tested applicants, 21 out of 268, yielded positive results 
for recent illicit drug use. Eighteen of the 21 positive results were for 
marijuana use alone.

States that have targeted drug and alcohol abuse among welfare clients -- 
for example, by including substance-abuse professionals in the 
welfare-screening process -- have rarely found more than a few percent of 
recipients in need of services.

Drug abuse disorders appear more widespread within especially troubled 
segments of the welfare population, including mothers who have been 
sanctioned for breach of program rules, long-term recipients and women 
referred to the child protection system.

Screening and assessment of welfare recipients for substance abuse and 
psychiatric disorders are therefore essential, as is access to effective 
programs such as CASAWORKS, an intervention rightly touted by Califano. Yet 
there is no evidence that drug abuse and addiction affect a large 
proportion -- let alone the majority -- of the broader population of 
welfare recipients.

The fact is that if we stopped all drug and alcohol abuse among low- income 
mothers, we would accomplish a great social good, but we might not have 
done much to reduce the welfare rolls.

Poor job skills, family dislocation, depression and logistical barriers to 
combining paid work with family obligations are more widespread than 
substance abuse or chemical dependence.

Califano does a public service by bringing attention to the problems facing 
welfare recipients with substance abuse disorders.

Many policies he promotes -- such as adequate support for long-term 
treatment when this is medically required -- deserve public support. Yet he 
does a disservice with inflammatory rhetoric that overstates the problem.

Such rhetoric unavoidably, if unintentionally, reinforces widespread 
suspicions that welfare clients are beyond help and not worthy of our 
assistance.
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MAP posted-by: Larry Stevens