What does drug testing for welfare recipients really mean?

We look into the proposal, first introduced in the May budget, which the Coalition is hoping to roll out from 1 January 2018

The Government has begun to plan its establishment of a drug testing trial for welfare recipients, which is still subject to the passage of legislation.

The Social Services Legislation Amendment (Welfare Reform) Bill 2017 was first introduced in the House of Representatives on 22 June.

It is now before the Senate Community Affairs Legislation Committee, with a report due in less than two weeks.

Here’s what the Bill actually outlines:

  1. Starting 1 January 2018, the two-year trial in three regions will involve mandatory testing of 5,000 new recipients of Newstart Allowance and Youth Allowance.
  2. New recipients after 1 January 2018 will be randomly selected to undertake a drug test. Testable drugs will include methamphetamine, ecstasy, cannabis and opioids among others.
  3. Recipients who test positive to an initial drug test will be subject to income management for a 24-month period (including use of a cashless debit card). They will also be subject to further tests during the trial period.
  4. Recipients who test positive to more than one drug test in the 24-month period will be referred to a Department of Human Services’ contracted medical professional for assessment. If the medical professional recommends treatment, the recipient will be required to complete one or more treatment activities including rehabilitation, counselling or ongoing drug testing.
  5. Recipients who refuse to take either the first test or subsequent tests will have their payment cancelled with effect from the day on which the refusal occurred. If the person then makes a new claim, payment will not be payable for a four-week period following the cancellation.
  6. If a recipient tests positive to a second or any other subsequent test, they will be required to repay the cost of these tests through a percentage reduction of their fortnightly social security payment – a deduction capped at a maximum of 10%. It will be possible for a person to build up a drug test repayment deficit.
  7. Recipients who are part of the trial and fail to attend any scheduled appointments with the Department of Human Services will have their payment suspended until they attend a rescheduled appointment.
  8. It will be possible for the Department of Human Services to reduce the amount of the percentage of a person’s drug test repayment deduction if they are satisfied the person is in severe financial hardship, or in exceptional circumstances.
  9. If a person disagrees with results of a drug test and requests a second drug test, which results in a negative result or there is evidence the sample has been affected by a legal medication, the test will not be taken into account for drug test repayments.
  10. The Secretary will have the legislative power to extend the period of income management for longer than the 24-month trial period.
  11. Welfare recipients with mutual obligation requirements will no longer be granted a temporary exemption if they are sick or incapacitated due to drug or alcohol use.

Where are we now?

Canterbury-Bankstown in Sydney’s west has already been identified as the first trial site.

And on Wednesday the government announced Logan, Queensland, as the second location to trial drug testing of new jobseekers.

It also announced a “treatment fund” of up to $10 million.

Minister for Social Services, Christian Porter, says job seekers with drug abuse issues will benefit from the trial.

“This trial is focused entirely on helping job seekers overcome drug problems and to receive the help they need to get on a path towards securing a job and building a better future for themselves and their families,” says Minister Porter.

“Evidence shows that people who are unemployed can have higher rates of drug use, and we all know that using drugs is a barrier to gaining employment.

“It is not about penalising or stigmatising people who have a barrier to employment, which is as serious as drug abuse.  We want to help people in this situation.  Failure to do so simply leaves people at risk of a cycle of welfare dependency.”

However many disagree that the measure will not stigmatise people.

If I had to put a nasty star on the Government’s last Budget, it was this mean and non-evidence-based measure,” says Dr Michael Gannon, president of the Australian Medical Association (AMA), on Minister Porter’s announcement.

“It simply won’t work. The aspiration of Minister Porter, the aspiration of his Department, I’m sure the aspiration of everyone in this room is for people on welfare to, wherever possible, return to a productive life in the workforce.

“If you discriminate against them, if you impair their return to full functioning by labelling them as a drug user, then you impair their ability to get their life back on track,” says Dr Gannon.

AMA President Dr Michael Gannon

“That ultimately has to be the aspiration for welfare, to get people back to being productive members of either the workforce, or contributing to our community in some other way.

“This is not an evidence-based measure which will not help. We don’t expect people in most industries to have drug testing before they turn up to work. It’s simply unfair and it already picks on an impaired and marginalised group.

“It’s not evidence-based. It’s not fair. And we stand against it.”

St Vincent’s Health Australia, a major provider of alcohol and drug treatment and withdrawal services at its Sydney and Melbourne public hospitals, says the measures lack evidence and aren’t a cost-effective way of helping people with substance use disorders manage their health and stay in touch with the job market.

The healthcare provider says the Federal Government’s drug-testing trial will not work, and could see crucial income support taken away from vulnerable people placing them at even greater risk of harm.

“This is the key question: can the government point to a single piece of evidence – here or overseas – that shows the likelihood of this approach succeeding? They can’t because it doesn’t exist,” says Associate Professor Nadine Ezard, Clinical Director, St Vincent’s Hospital Sydney’s Alcohol and Drug Service.

“We could have told the government, if addiction medicine specialists had been consulted in this process, but we weren’t. There’s been no clinical input in putting this policy together despite its potential impact on the health and well-being of people with substance use issues.”

She cites the Australian National Council of Drugs, which has stated that there is no evidence that drug testing welfare beneficiaries will have any positive effects for those individuals or for society, and some evidence indicating such a practice could have high social and economic costs.

“This bill does more than simply introduce drug testing. It also seeks to introduce a range of harsh measures which could see crucial income support taken away from people who are very vulnerable,” says A/Prof Ezard.

Associate Professor Nadine Ezard, Clinical Director, St Vincent’s Hospital Sydney’s Alcohol and Drug Service

“Currently, welfare recipients with mutual obligation requirements can be granted a temporary exemption if they have a doctor’s certificate saying they’re incapacitated due to sickness or injury, or if in a personal crisis. This policy removes that exemption if a person is sick or incapacitated due to drug or alcohol use.

“These changes would include secondary health problems associated with drug use. For example, someone receiving hospital treatment for cirrhosis of the liver because of alcohol use would not be able to receive a temporary exemption from their job search requirements.

“By definition, people with severe substance use disorders are unable to modify their behaviour, even in the face of known negative consequences.

“In fact, an increase in stigma and anxiety for people with substance use disorders will exacerbate addiction issues rather than address them. We are concerned that drug users – even those outside the trial locations – will fear their welfare payments may be affected if they seek help.”

Associate Professor Yvonne Bonomo, Director, Department of Addiction Medicine, St Vincent’s Hospital Melbourne, says the disincentives in the policy would not persuade people with substance use disorders from using drugs.

“These disincentives won’t work to help people off drugs,” said A/Prof Bonomo.

“In 2015, the NZ government spent NZD$1m testing 8,000 people, with only 22 testing positive – it was not a cost-effective use of precious resources,” says A/Prof Bonomo.

“A much less expensive and more effective approach would be to use the already existing flags within the welfare payments system – which indicate when someone is struggling with their drug and alcohol use – and support these people to access health services in a timely way. 

“For example, when there is a pattern of a number of temporary exemptions from mutual obligations attributable to drug and alcohol misuse, a jobseeker could be referred to a drug and alcohol treatment service provider.

“If the government is serious about developing evidence-based policies to help people with substance abuse disorders find a job then we stand ready to help – but this policy is not the way to go,” says A/Prof Bonomo.

Pharmacist and harm minimisation advocate Angelo Pricolo agrees that the measures won’t work.

“Addiction cannot be cured by a punitive measure, certainly not one as simplistic as this,” he tells AJP.

Angelo Pricolo.

“Addiction means you continue to use your drug of choice even though it is doing harm, even though you know it and can see it. Smokers are a prime example. They have become the modern day lepers with almost no public places left to smoke, crazy prices to purchase cigarettes and all the health warnings, but they still smoke.

“We are setting people up for failure with the second strike or third strike philosophy. Addiction is not a game of baseball. Addiction needs support for the patient, the right setting and often pharmacotherapy. It takes a long time to treat addiction, it doesn’t just go away with the threat of punishment,” says Mr Pricolo.

He says it’s important to think about the broader context of drug dependence and approach the situation with empathy.

“The majority of the people targeted are already struggling with finance so creating more debt for them may drive them to riskier behaviour. Many will have come from deprived circumstances or unthinkable violations in their youth that have driven them to drugs. Before we judge let’s strive to be a circumspect and understanding community with a mature solution,” says Mr Pricolo.

“Each step of the [proposed] process creates more cost for the taxpayer for very little return. Other jurisdictions that have adopted similar restrictions to benefits (like in the UK and Canada) have abandoned the plan. The money could be more wisely invested in improving access to real treatment options, shorter waiting lists for patients and more training for the resource-starved drug and alcohol sector.

“The only salvageable idea is creating pathways to treatment. Unfortunately though the route the government is proposing is full of potholes and roadblocks that will create more havoc than already exists.”

Dr Alex Wodak, president of the Australian Drug Law Reform Foundation, says if the government had consulted experts before unveiling their plan to drug test welfare recipients, they would have been advised to drop it immediately.

“First up, alcohol and drug use plays a minuscule role in unemployment and underemployment,” says Dr Wodak, who played a huge role in getting needle syringe programs started in Australia in the 1980s.

“People are locked out of paid work because there is only one job available for every 17 job seekers in this country, according to the Australian Unemployed Workers Union. It’s even worse than that for our young people and those living in regional centres.

“And for the small number of people who are unable to hold down work due to alcohol and drug problems (unemployed Australians use drugs at a much lower rate than employed Australians), stripping away their income support will do nothing but push them even further into the margins of society,” says Dr Wodak.

“We have tried punishing people struggling with severe drug problems for half a century and it hasn’t worked. When people are down, don’t push them down even further: help them to get up. These proposals are exactly the opposite of what we should be doing.”

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