This brief summarizes the results of recent research examining substance abuse among welfare recipients and addresses the need to balance work requirements for recipients of public aid with the necessity of making substance abuse treatment options available to those who need them. In 1996, when the Temporary Assistance to Needy Families (TANF) act was passed, replacing the Aid to Families with Dependent Children program, advocates and administrators feared that substance abuse disorders would prevent recipients from complying with TANF requirements. Although such disorders are not as widespread among TANF recipients as was initially feared, treatment of recipients with these disorders continues to raise challenging issues for policy-makers.
Traditionally, work requirements and treatment needs have been viewed as being in opposition to each other; however, treatment interventions that help clients succeed in job roles are likely important for TANF recipients, and the development of work skills is one goal of many treatment programs. The need for TANF programs to effectively screen and identify welfare recipients for substance use disorders is pressing and some models to achieve this task are emerging. In addition, states and localities must find ways to strengthen outreach and treatment referral services by identifying substance users who are not enrolled in TANF programs.
- Approximately 20 percent of TANF recipients report having used an illicit drug at least once in the past year. Prevalence of self-reported drug use among welfare recipients has remained stable post-welfare reform.
- Approximately 5 percent of TANF recipients report substance abuse or dependence and 6.5 percent report alcohol abuse; comorbidity with psychiatric disorders is commonly reported.
- Substance abusers report sharply increased incidences of domestic violence.
- Substance abuse is associated with increased duration of TANF receipt.
- Specialized screening and case management appear to be promising tools in identifying and treating substance use disorders.
- TANF recipients who satisfied abuse or dependence criteria were more likely to have been in substance abuse treatment compared with non-TANF recipients who satisfied substance abuse or dependence criteria.
A new program called CASAWORKS for Families provides an example of a "multi-faceted intervention for substance-using TANF recipients. The program combines substance abuse treatment, work-related services (including work readiness and vocational training), mental health, parenting services, and case management to integrate services." CASAWORKS and similar programs are designed to address multiple barriers to employment and job retention faced by substance abusers trying to fit into time-limited public aid programs.