WELFARE REFORM

DRUG TESTING PLAN ILL-CONCEIVED

The Ontario government plans to implement mandatory drug testing for all
welfare recipients as part of the government's social assistance reforms.

The government will require those recipients who test positive to undergo
treatment as a condition of receiving welfare benefits.

The government's proposal is by far the most radical application of drug
testing in the public or private sector. It ignores the medical definition
of addictions and contradicts current welfare legislation, which does not
recognize addiction as a disorder.

Mandatory drug testing has never been legislated in any Canadian province or
federally.

Certain Canadian employers require drug testing for employees whose
performance could place others at risk.

One premise of these programs is that prospective employees have a choice of
whether to accept a job with attached terms and conditions, including drug
testing. Prospective employees are not compelled to work for employers who
require drug testing.

Welfare is the only option for unemployed or sick individuals without
resources and is a matter of survival, rather than choice. They have no
option to refuse drug testing.

Other groups for whom drug testing is required include prisoners and persons
involved in motor vehicle accidents.

The authority for testing both groups arises from the criminal justice
system.

In 1991, the Nova Scotia government established a drug-testing program for
parents of children being followed by child protection agencies. Parents
with an established history of addiction can be subject to mandatory drug
testing for up to 12 months, upon order by the Family Courts of Nova Scotia.

In all these circumstances, drug tests occur within a criminal or
quasi-criminal context where individual safety or the safety of others may
be at risk. Further, strict protocols are enforced for the collection,
preservation and integrity of specimens for testing.

In contrast, the Ontario plan as thus far enunciated by the government is
open-ended, with no accountability or safeguards similar to those provided
by the legal system. Being on welfare is not a criminal act and has never
meant relinquishing the protection from state intrusion, including drug
testing, enjoyed by other citizens.

The Ontario government's intention to interpret a positive drug test as an
indication of a medical disorder is not in accordance with current standards
in medicine.

Physicians use a diagnostic manual to diagnose persons as having a
substance-related disorder, the technical term for addictions.

Specific criteria must be met for determining the type of disorder,
including substance dependence and substance abuse, the most relevant to the
Ontario plan.

The manual's authors emphasize that a positive test for drugs does not by
itself meet the criteria for a substance-related disorder and, similarly, a
negative test does not rule out such a diagnosis.

Under the Ontario plan, a positive drug test will be considered presumptive
evidence of a disorder that requires treatment. The government has not
indicated yet what sort of treatment it will provide to welfare recipients
who, according to legitimate medical criteria, have never been diagnosed
with a disorder.

The government's problem of diagnosis and definition is compounded by the
Ontario Disability Support Program Act, 1997 and the accompanying Ontario
Works Act, 1997.

In the legislation, persons are not recognized as having a disability if
they are addicted and "the only substantial reduction in activities of daily
living" is due to the use of the addictive substance.

A diagnosis of a substance-related disorder by a medical practitioner does
not constitute a "substantial mental or physical impairment" under either
act.

According to the new plan, the government will be mandating treatment for
persons who, under current welfare legislation, are not recognized as having
a disability.

Finally, the Ontario government has not explained to whom it will send
welfare recipients for treatment.

Ontario's drug rehabilitation programs already are woefully inadequate for
the demand.

Ontario is home to thousands of addicts who cannot get treatment for their
addiction.

The government recently aggravated the situation by stopping transportation
subsidies for addicted recipients receiving care from services that are not
composed of regulated health professionals, including Alcoholics Anonymous
and Narcotics Anonymous.

Who will pay for and provide treatment for those welfare recipients who test
positive?

The Ontario government's drug testing plan is without merit.

It represents a massive and unwarranted intrusion into the lives of welfare
recipients.

The plan will lump those on welfare in the same category as criminals.

It is humiliating, punitive and unhelpful to a group already struggling to
cope with the stresses of day-to-day living.

Philip B. Berger is medical director of the Inner City Health Program and
Chief of the Department of Family & Community Medicine at St. Michael's
Hospital in Toronto.