Alcohol and Drug Behavior Among Welfare Recipients

DRUG USE TRENDS December 1996

One hotly contested aspect of the recent welfare debate is the unsubstantiated characterization of welfare recipients as having alcohol and drug problems, according to authors of a study published in the American Journal of Public Health. In their study, the authors present the most recent national estimates of alcohol and drug use, abuse and dependence among recipients in five social service programs. The primary objective was to identify high-risk groups within the welfare population in need of alcohol and drug prevention and treatment programs (Bridget F. Grant, PhD, and Deborah A. Dawson, PhD, "Alcohol and Drug Use, Abuse and Dependence among Welfare Recipients," American Journal of Public Health, October 1996, Vol. 86, No. 10, p. 1450; "Welfare and Drugs," USA Today, October 26, 1996, p. A3).

The data in the study were collected in the 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES) designed by the National Institute on Alcohol Abuse and Alcoholism. Data in the NLAES were collected in face-to-face interviews with one randomly selected respondent, 18 years of age or older, in each of 42,862 households in the United States. NLAES respondents were asked whether they received aid from any of five programs: Aid to Families with Dependent Children (AFDC); the Supplemental Food Program for Women, Infants, and Children (WIC); food stamps; supplemental security income (SSI); or Medicaid during the month before the interview.

Comparing rates between different races, gender and age groups helps define which subgroups within the welfare population are at greater risk of alcohol and drug abuse. Prevalence of heavy drinking and alcohol abuse/dependence was significantly greater for men than for women in each welfare program except AFDC. Drug use and abuse/dependence rates were about the same for each gender in all five programs. Rates for alcohol and drug use, abuse and dependence were not significantly different between non-Black and Black social service recipients. All alcohol and drug use and abuse rates were significantly higher for AFDC and food stamp recipients (but not WIC recipients) in the 18- to 34-year age group but not for the 35-years and older age group. For SSI and Medicaid recipients, alcohol and drug use and abuse rates were highest among 30- to 54-year olds.

TABLE 1:
PREVALENCE OF PAST YEAR DRUG
AND ALCOHOL USE AND ABUSE

			RECIPIENTS OF:
	National Estimates	Non-Welfare Recipients	WIC	Food Stamps	Medicaid	SSI	AFDC
Heavy Drinking	14.5%	14.8%	11.5%	13.8%	10.3%	6.4%	13.2%
Alcohol Abuse/Dependence	7.4%	7.5%	7.9%	8.2%	5.2%	4.3%	7.6%
Drug Use	5.0%	5.1%	7.2%	8.4%	6.0%	3.8%	9.8%
Drug Abuse/Dependence	1.5%	1.5%	2.5%	2.7%	2.0%	1.3%	3.6%

1. Heavy drinking was defined as an average daily consumption of more than two drinks per day or consumption of five or more drinks on at least 12 occasions during the previous year.
2. Alcohol or drug abuse and/or dependence was diagnosed using definitions appearing in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV). Respondents classified as abusers met at least one of the following criteria: continued use despite social or interpersonal problems, hazardous use, legal problems, and neglect of role obligations. A diagnosis of dependence required affirmitive responses to at least three of the following criteria: tolerance; withdrawal; unsuccessful attempts or persistent desire to stop use; use for longer or in larger amounts than intended; activities given up in favor of use; time spent in obtaining, using or recovering from substance effects; and continued use despite physical or pyschological problems.
3. Drug use was defined as taking sedatives, tranquilizers, opioids, heroin, amphetamines, cannabis, methadone, hallucinogens, inhalants or solvents without a prescription at least 12 times during the previous year.

Rates of alcohol and drug use and abuse among welfare recipients were similar to national estimates from the NLAES survey. These rates were also similar to rates from U.S. citizens not receiving these social service benefits. The study concluded that high-risk subgroups within the welfare population need more access to drug and alcohol prevention and treatment programs to facilitate the goals of proposed welfare reform -- work, responsibility and reduction of dependency.