Pubdate: Mon, 18 Jul 2016
Source: Vancouver Sun (CN BC)
Copyright: 2016 Postmedia Network Inc.
Contact:  http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Tom Blackwell

STUDY LINKS WELFARE PAY TO OVERDOSES

'Cheque Effect'

Staggered Payments Under Consideration

Researchers in British Columbia are urging authorities to explore new 
ways to dispense welfare cheques, after concluding the current, 
once-a-month payments trigger more than 15 preventable drug-overdose 
deaths a year - in just one province.

The deaths are striking evidence of the so-called "cheque effect," 
dangerous bingeing among drug abusers and alcoholics believed to 
occur after the monthly dump of social-assistance money, say the 
scientists' new study.

They urge provinces to consider distributing smaller amounts more 
frequently, or staggering payments so not everyone gets paid at the same time.

"These are preventable deaths ... what ends up being more than a 
death a day following each cheque issue," said Michael Otterstatter, 
the B.C. Centre for Disease Control epidemiologist who spearheaded 
the research. "It would be warranted to look at methods ... to try to 
reduce this avoidable mortality."

Although his work in the International Journal of Drug Policy 
examined only illicit drug use, Otterstatter said it's possible the 
same issue is exacerbating the current epidemic of Fentanyl abuse and death.

Meanwhile, a study released earlier this year by Toronto scientists 
suggests the phenomenon extends to other people who get paid once a 
month, and to alcohol as well as illicit-drug use.

One advocate for the poor said the issue is not the timing of welfare 
hand-outs, but their size, noting that single recipients in B.C. 
receive just $610 a month - when even a room in Vancouver's depressed 
Downtown Eastside averages over $500 monthly.

Evidence indicates that improving income and housing quality tends to 
lessen rates of addiction and mental illness, said Trish Garner of 
the B.C. Poverty Reduction Coalition.

"You've been in a state of stress and survival and hunger and cold 
for the whole month and you get this (welfare payment)," added 
Garner. "I think anyone's reaction would be to spend a little on what 
gives you enjoyment."

B.C.'s Ministry of Social Development and Social Innovation said in 
an emailed response to questions that it will review the study, and 
is awaiting other research on the issue, too.

It notes that most provinces and the federal government also send 
assistance once a month on the same day, reflecting the need to pay 
rent and other monthly bills. It said it tries to ensure the money is 
used properly by, for instance, urging recipients to set up direct 
deposits into bank accounts, which "helps keep cash off the street."

Regardless, researchers in Canada, the U.S. and elsewhere have for 
several years been citing evidence of the cheque phenomenon, 
including increased emergency-department visits, overdoses and mortality.

The theory is not just that individual drug abusers receive a small 
windfall, but that money flows into whole communities of users, said 
Otterstatter.

Still, past studies have tended to be less-than rigorous in 
establishing the link, he said.

Seeking more clarity, he and colleagues obtained data on illicit-drug 
overdose deaths - an unambiguous, "hard" event - and exactly when 
they happened from the provincial coroner's office, then overlayed 
the dates of social-assistance payments.

The coroner's data did not actually specify whether the victims were 
on welfare. But statistical analysis showed an unwavering trend over 
the 2009 to 2013 period studied: versus other weeks, there were 
nearly twice as many fatal overdoses on the Thursday and Friday after 
Wednesday cheque days.

"You see this cheque-week after cheque-week, month after month, year 
after year," said Otterstatter. "The pattern is so consistent."

Overall, 77 out of the 1,343 deaths - an average of 15 a year - 
appeared to occur because of the timing of payments, he said.

The Ontario study published in May looked at ambulance calls related 
to licensed establishments in the Toronto-area's Peel region between 
2005 and 2014.

It found four times as many drunkenness-related calls to a bar and 
almost three times as many assaults on the last day of the month - 
cheque day - or the next day, compared to the previous week.

Dr. Joel Ray, the internal-medicine specialist at St. Michael's 
Hospital who led that research, cautioned that the new B.C. study 
could not definitively link the extra 77 deaths to welfare recipients.

But he agreed there is enough evidence of a cheque effect now that 
governments should consider changes.

"Most Canadians would argue that their investment in social 
assistance programs should be for the assistance of that individual's 
well-being, rather than harming them," said Ray. "And alcohol ... and 
illicit drugs harm people."
- ---
MAP posted-by: Jay Bergstrom