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Cracking down on "taxpayer-subsidized" drug addiction
After declaring that it was “unfair for Florida taxpayers to subsidize drug addiction," Florida Governor Rick Scott (pictured) this week signed legislation that will require adults who apply for Temporary Assistance for Needy Families (TANF) in the state to undergo drug tests, administered by the Florida Department of Children and Families but paid by the applicant, to qualify for benefits.
Those who pass will, presumably, get the benefits—along with a reimbursement for the state for the cost of the required testing, which is to begin July 1.
But adults who don’ t pass are the key concern for behavioral health providers in the state, explains Bob Sharpe, CEO and president of the Florida Council for Community Mental Health (FCCMH) in Tallahassee. This group represents 65 large community behavioral health organizations that provide safety-net services to more than 250,000 Florida residents.
Although Sharpe says that the FCCMH did not take position on the drug-test legislation, he stated that “we are concerned if people are denied benefits, even if some of those benefits are used inappropriately. The most important thing for these people,” he stresses, “ is access to treatment.”
Sharpe says that much of FCCMH’s attention this year centered on defeating the threat of major budget cuts for public behavioral health services during the state’s recent budget process. Because the latest budget maintained funding at current levels for these services, he believes that the state’s providers will be able to provide services for those adults who fail tests and are denied welfare benefits.
However, he noted that “they’ll have to be fit in like any other consumer, based on existing agency capacity and existing funding.”
His statement is based on two assumptions: that individuals will respond to what’s available, namely available outpatient or intensive outpatient treatment; and that demand generated by TANF applications who fail tests won’t exceed that predicted in a pilot study, which found levels of positive drug tests results roughly equal between TANF applicants and the general population.
“If we get a large swell of test-positive adults, capacity could be overwhelmed,” he acknowledges.
Sharpe adds that those whose substance-use disorders require more intensive residential treatment, as well as those seeking sober/supportive housing services in early recovery, will face much sharper resource limitations.
While Sharpe says that losing welfare benefits “is a very difficult lesson for those involved in drug abuse, in the end, it can be a good thing if it gets them into treatment.”
Judge: Big differences between employer, government drug tests
The concept of government-mandated drug testing, as a condition for government benefits, doesn’t strike many Americans as a big problem, given that virtually all working adults are subject to drug tests as a condition of employment.
But there are major legal differences, says attorney William Judge, counsel to Park-Dickens Group (Chicago), a former panelist to the Office of National Drug Control Policy in the Bush Administration, counsel to the American Society of Addiction Medicine (ASAM), and a expert on employment-related drug testing. He draws a bright legal line between drug testing mandated at work and that mandated by government.
“When I’m dealing with employers and the workplace, the presence of substances is a primary safety issue. The Constitution doesn’t apply,” says Judge, who regularly advises employers about how to implement employee testing programs and strongly recommends they offer comprehensive counseling and treatment programs, rather than termination, for those who fail. But government-sponsored drug tests “are a search, so anytime that government does them, they become a Fourth Amendment issue,” he says. “Is it reasonable that government require people to be tested—searched—in order to obtain a benefit that they are already entitled to under law?” An even bigger concern, he says, is “what happens when there’s a positive test? Judge, who is 29 years sober, asserts that “cutting off benefits is not going to get people into treatment. Losing benefits for six months or a year is an eternity if you’re addicted. They’re going to continue to medicate unless the fundamental issue—the pain that drives their addiction—is addressed. The alternative that is left to them is crime—to get money to medicate that pain.”
“When I see legal and policy actions like these taken, I just shake my head,” he continues. “This is such an easy issue for a politician. Among people who are working the thinking often is ‘if you’re not working, then you must be lazy or on drugs.' But in this economy, all of that is crap.”
During his work as a legal panelist on the topic of drug testing for the ONDCP, Judge says that he offered a consistent piece of advice: “I’m an absolute advocate for treatment. If you’re going to set up a drug testing program, do it right by setting up a counseling and support system for those who test positive.” Otherwise, he says, “we’re essentially saying that we’re going to ‘throw these people away.’”
While at least one state—Michigan—passed a testing requirement, which was later overturned on appeal, and at least one more—Kentucky—is considering such a measure, the fate of Florida’s drug-testing-for-welfare measure will ultimately be decided in the courts.
