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The Government’s drug-testing trial: costly and ineffective

August 2017

The Federal Government’s drug-testing trial of new income support recipients will not work and could see crucial income support taken away from vulnerable people placing them at even greater risk of harm, according to St Vincent’s Health Australia.

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

“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,” said A/Prof 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.

“The Australian National Council of Drugs said: ‘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.

“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, said 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.

"There will be more crime, more family violence and more distress within the community.”

In terms of the Government’s newly announced $10 million treatment fund for the drug-testing trial, St Vincent’s clinicians welcomed the additional funding but said the trial was a very expensive approach given it was unlikely to achieve the desired outcomes.

“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,” said 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.  

“Drug testing is helpful in monitoring treatment effectiveness, not in helping people towards treatment. We need prompt access to good quality treatment. 

“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,” said A/Prof Bonomo.

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