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.