Welfare drug test plan passes Lower House


Pharmacist politician Emma McBride has taken aim at plans to drug test welfare recipients, citing her experience helping people with substance dependency

The Social Services Legislation Amendment (Drug Testing Trial) Bill 2018 was read in the House of Representatives for the second time on Monday, and passed 76-67.

If it passes the Senate, the Bill would require 5000 recipients of Newstart and Youth Allowance in three areas – Canterbury Bankstown in NSW, Logan in Queensland and Mandurah in Western Australia – to participate in a two-year trial of drug testing.

Jobseekers who refuse to take a drug test will have their payments cancelled. They will not be able to reapply for four weeks.

Those who test positive will be placed on income management to limit their ability to access drugs, and will be subjected to a second test within 25 working days. Those identified as requiring treatment will be required to undertake it.

Calling the measure “cruel and mean-spirited,” Ms McBride, hospital pharmacist and member for Dobell on NSW’s Central Coast, said that she had 20 years’ worth of first-hand experience working with people with substance dependency.

She has been working in this space since her second year as a pharmacy student in the mid-90s, she said.

“While I was training as a pharmacist, I worked in a community pharmacy—one of the first in NSW to provide an opioid treatment program,” she told the Lower House.

“This program, underpinned by the principles of harm minimisation, has led to many people being able to rebuild their lives and their relationships and to gain employment, and it has been provided by community pharmacies since the late 1970s.

“I met teachers, chefs and executives all turning their lives around, with the support of GPs, pharmacists and addiction specialists.

“More recently, I worked as a mental health pharmacist, providing clinical support to an OTP clinic and a withdrawal management clinic in Wyong Hospital. This in-patient unit provides withdrawal management from an evidence based, clinically-proven harm minimisation approach. It works.”

Unfortunately, there are only 15 beds at Wyong Hospital for this purpose, for the entire Central Coast, she said.

“This unit is also part of the state-wide referral process receiving clients from all across NSW, particularly from areas where there are no local services.

“If the government is genuine in its claim to help those burdened by dependence, a good first step would be to properly fund units like this one and not attack welfare recipients.”

Ms McBride highlighted uncertainty about the actual workings of the proposal and the evidence to support it.

A drug and alcohol clinician and former colleague of Ms McBride had spoken to her with a number of concerns, including that vulnerable people would be punished by removing their only means of financial support, and force them further into disadvantage, homelessness and potentially crime.

“As she sees it, this is the government using drug testing as a punitive measure,” Ms McBride said.

“She is also concerned about technical aspects of the proposal. She asked: ‘We know the drug testing will be contracted out to a third party, but will they have the right expertise? Will they be skilled drug and alcohol clinicians who can thoroughly assess the extent of substance use? Will people who are quite legitimately enrolled in opioid treatment programs be caught up in this trial?’”

Ms McBride said that she had also spoken to addiction medicine specialists who were concerns about technical aspects of the trial – for example, it has not yet been confirmed what tests will be used, whether they involve urine, hair or saliva.

“With lower-cost tests there is a risk of false positives,” she said. “Reliable tests can be extremely costly and likely unaffordable.”

“For example, according to the Royal Australasian College of Physicians, a gold standard urine tests costs been $550 and $950 to administer.

“The testing could potentially encourage people to use less-traceable but more-harmful drugs or increase alcohol consumption, which is not being tested as part of the trial.”

The international experience has not produced evidence that this approach has been effective, she warned.

“In 2013, the New Zealand government instituted a drug-testing program amongst welfare recipients.

“In 2015, only 22 of 8,001 recipients tested returned a positive result for illicit drug use. This detection rate was much lower than the proportion of the general New Zealand population estimated to be using illicit drugs.

“Similar results were found in the United States. In Missouri’s 2014 testing program, of the state’s 38,970 welfare applicants, 446 were tested with 48 testing positive.

“In Utah, 838 of the state’s 9,552 applicants were screened with 29 returning a positive result. These were costly initiatives—costly initiatives that drive people into poverty and potentially crime.

“We don’t know the full cost of the government’s measures yet, and we haven’t seen evidence to support it.

“The Department of Social Services’ own figures show that very few jobseekers are likely to test positive. A recent Senate estimates hearing heard that overall the department expects only 100 to 120 people to test positive a second time across the three trial sites.

“That’s $1 million committed for an evaluation of a trial that is likely to impact up to 120 people, before we know how much the contract to the private provider will cost.”

A number of members criticised the Bill, saying it was not clinically appropriate and that the measure will push people into poverty, was aimed at demeaning and denigrating vulnerable people, and would put Centrelink staff at risk of abuse.

Ben Morton, member for Tangney in WA, said however that the trial was “compassionate”.

“One of the worst barriers to a productive life and to getting a job is drug addiction itself,” he told the House.

“Doing nothing isn’t an option. Doing nothing isn’t helping Australians to address their drug addiction and to get off welfare and into work.

“Newstart and Youth Allowance are designed to help people while they look for work, but, if you are bombed out of your brain on drugs or booze, you can’t search for work. Even if you get the interview, you’re not going to get the job. That’s the sad reality.

“People with substance abuse issues deserve government support and intervention to help them get clean, into work and back to a productive life, not just for them but also for their family.”

The bill was passed 73-67 and will now need to pass the Senate.

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