States waste hundreds of thousands on drug testing for welfare, but have little to show for it

In 2017, states spent more than $490,000 to drug-test 2,541 people who had applied for Temporary Assistance for Needy Families (TANF) benefits, which yielded just 301 positive tests.
While the costs for these programs has dropped somewhat over the past three years, the number of positive tests has also declined.
This year, ThinkProgress also asked states to provide the questionnaires used to determine whether there is “reasonable suspicion” that their applicants/recipients are abusing drugs. The five states that didn’t provide this information said they license a copyrighted questionnaire from a for-profit company that prohibits disclosure of the questions.
The screening method is deeply flawed. The questions typically ask people to volunteer information about their own illegal drug use, and the questions vary widely between states. The vast majority in all but one state still tested negative, even after they were given screening questions, raising serious questions about the efficacy of these screening processes.
“This is not an academic survey and it’s not a clinical tool that I’m doing for somebody at a treatment facility,” said University of Chicago professor, Dr. Harold Pollack, who’s studied drug testing in public assistance for more than a decade. “It’s a series of intrusive questions that I’m asking someone who is in economic need and has approached a public agency looking for assistance.”
The screening questions are asked arbitrarily and out of context, said Pollack. “I think there’s definitely an appropriate context in which I would ask someone these types of questions,” said Pollack. “If your children are showing up to school in dirty clothes and the school social worker starts looking into it, there’s a point where I would totally give someone a set of screening questions about substance use disorders… If someone shows up because don’t have enough money for food, it just strikes me as a real punitive moralistic thing that is not evidence-based.”
Five states use Substance Abuse Subtle Screening Inventory (SASSI) from the for-profit SASSI Institute, which has published screening tools since 1988. The screening results, the company said in a statement, “do not provide evidence that an individual is using or abusing a controlled substance… A diagnostic interview is necessary to determine for which substances, if any, the client has a substance use disorder.” The institute also said that “[t]o use the SASSI to discriminate against individuals, such as disqualifying job applicants or to deny public assistance, violates the purpose of the SASSI and is a violation of the Americans with Disabilities Act.” Still, the company licenses its questionnaire to states for precisely this purpose.
But even screeners like Wisconsin’s that have been well-studied and validated by the federal government, typically exclude alcohol so “the notion that this is being driven by concern about the recipients does not seem well-founded,” said Wendy Cervantes, senior policy analyst at the Center for Law and Social Policy. “If the goal is to actually identify addiction issues that are interfering with people’s life functioning, alcohol is [as] likely to be the problem as any other drug.”
Drug testing is one of those bad policy ideas that never seems to die. In fact, the Trump administration and Republican lawmakers are trying to mandate drug testing in other public programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP).
According to the National Conference of State Legislatures, no new states have added requirements in the past year, although bills have been introduced in Hawaii, Illinois, Iowa, Massachusetts, Minnesota, Nebraska, New York, Rhode Island, South Carolina, and Vermont in that time.
But data and expert testimony show lawmakers are wrong when they claim drug testing ensures no one’s taking advantage of government assistance or that it enables addiction treatment. It’s clear this policy only stigmatizes people who are in an already vulnerable situation.
“Substance use disorder is less common than people think in the welfare population,” Pollack told ThinkProgress. “If you wanted to really find someone with an alcohol disorder, you can go right outside a football stadium in Arizona, Saturday morning… But we don’t do that in large part because we treat people who are seeking public benefits different and in a less respectful way.”
Since a 2014 appeals court ruling struck down Florida’s unconstitutional universal drug testing requirement for all TANF applicants, states have implemented requirements that applicants and/or beneficiaries with a “reasonable suspicion” be tested. Thirteen states had such programs in operation in 2017. Those states are:


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