Following termination of the SSI Drug Addiction and Alcoholism (DA&A) program, a nine-site study followed 1,764 randomly selected SSI beneficiaries over two years. This paper examines how loss of SSI affected use of alcohol and illegal drugs. One-third of study respondents reported neither drinking nor using illegal drugs at baseline (just before the end of the program). Nevertheless, use of illegal drugs was 15 times more prevalent among the study sample (44%) than the general population, while use of alcohol was 1.3 times more prevalent (59%), and use of both alcohol and other drugs was significantly greater among those who would lose SSI than those who would retain it. During the follow-up period, prevalence of drinking and use of illegal drugs remained steady, but mean days of use declined for alcohol and illegal drugs other than marijuana. In three separate repeated measures ordinal regression models we examined the net effect of SSI retention on use of alcohol, marijuana and other illegal drugs over time, controlling for demographics, social and health status, and utilization of substance abuse treatment or self-help. Declines in use of alcohol and illegal drugs other than marijuana were similar for those who retained and those who lost SSI benefits, indicating that termination of the program had no effect on levels of substance use. Higher levels of substance use remained significantly and substantially associated with younger age (under 44 years), psychiatric and legal problems, and family or social conflicts, suggesting that subsets of the DA&A population need individualized services beyond income support.
BrillLeon (1972). The De-Addiction Process: Studies in the De-Addiction of Confirmed Heroin Addicts.Charles Thomas: Springfield, Illinois.
2.
CampbellKevin, BaumohlJim, and HuntSharon R. (2003). The bottom line: Employment and barriers to work among former SSI DA&A beneficiaries.Contemporary Drug Problems,30:195–240.
3.
ChoudhryG. Hussain and HelbaCynthia (2003). Rationale and procedures for weighting the SSI study data.Contemporary Drug Problems,30:137–146.
DaviesPaul, IamsHoward, and RuppKalman (2000). The effect of welfare reform on SSA's disability programs: Design of policy evaluation and early evidence.Social Security Bulletin,63(1):3–11.
6.
FlorentineRobert and AnglinM. Douglas (1994). Perceiving need for drug treatment: A look at eight hypotheses.International Journal of the Addictions,29(14): 1835–1854.
7.
FrismanLinda K. and RosenheckRobert (1997, June). The relationship of public support payments to substance abuse among homeless veterans with mental illness.Psychiatric Services,48(6):792–795.
8.
GrunwaldMichael (1996, December 7). SSI cutbacks hitting home in Mass.Boston Globe.
9.
GuydishJoseph, PonathClaudia, BostromAlan, CampbellKevin, and BarronNancy (2003). Effects of losing SSI benefits on standard drug and alcohol outcome measures.Contemporary Drug Problems,30:169–193.
10.
HanlonThomas E., NurcoDavid N., KinlockTimothy W., and DuszynskiKaren R. (1990). Trends in criminal activity and drug use over an addiction career.American Journal of Drug and Alcohol Abuse,16 (3&4):223–238.
11.
HedekerDonald and GibbonsRobert D. (1998). MIXOR software available by electronic mail at hedeker@uic.edu.
12.
HosmerDavid W. and LemeshowStanley (1989). Applied Logistic Regression.John Wiley and Sons: New York.
13.
HuntSharon R. and BaumohlJim (2003a), Drink, drugs and disability: An introduction to the controversy.Contemporary Drug Problems,30:9–76.
14.
HuntSharon R. and BaumohlJim (2003b). Now invited to testify: Former beneficiaries appraise the SSI Drug Addiction and Alcoholism Program.Contemporary Drug Problems,30:455–499.
15.
JensenPeter (1996, December 28). Addicts in state to lose benefits.Baltimore Sun.
16.
KaestnerRobert (1999). Does drug use cause poverty? In The Economic Analysis of Substance Use and Abuse: An Integration of Econometric and Behavioral Economic Research,ChaloupkaFrank J., GrossmanMichael, BickelWarren K., and SaferHarry, Editors. University of Chicago Press: Chicago, 327–355.
17.
Lewin Group, The (1998, July 21). Policy Evaluation of the Effect of Legislation Prohibiting the Payment of Disability Benefits to Individuals Whose Disability Is Based on Drug Addiction and Alcoholism. Interim Report Submitted to the Social Security Administration.The Lewin Group: Fairfax, Virginia.
18.
ManningWillard G., BlumbergLinda, and MoultonLawrence H. (1995). The demand for alcohol: The differential response to price.Journal of Health Economics,14:123–148.
19.
McKayJames R., RutherfordMegan J.. AltermanArthur I., CacciolaJohn S., and KaplanMara R. (1995). An examination of the cocaine relapse process.Drug and Alcohol Dependence,38(1):35–43.
20.
McLellanA. Thomas, KushnerHarvey, MetzgerDavid, PetersRoger. SmithIris, GrissomGrant, PettinatiHelen, and ArgeriouMilton (1992). The fifth edition of the addiction severity index.Journal of Substance Abuse Treatment,9:199–213.
21.
NorrisJean, ScottRichard, SpeiglmanRichard, and GreenRex (2003). Homelessness, hunger and material hardship among those who lost SSI.Contemporary Drug Problems,30:241–273.
22.
PetryNancy M. (2000). Effects of increasing income on polydrug use: A comparison of heroin, cocaine and alcohol abusers.Addiction,95(5):705–717.
23.
PetryNancy M. and BickelWarren K. (1998). Polydrug abuse in heroin addicts: A behavioral economic analysis.Addiction,93(3):321–335.
24.
PodusDeborah, ChangEunice, BrechtMary Lynn, SwartzJames, and AnglinM. Douglas, Drug use prevalence among former SSI DA&A recipients (2003). Contemporary Drug Problems,30:275–290.
25.
RosenheckRobert and FrismanLinda (1996). Do public support payments encourage substance abuse?Health Affairs,15(3): 192–200.
26.
ScottRichard and BaumohlJim (2003). Decisions to appeal, decisions to approve: Requalification for SSI by former DA&A beneficiaries.Contemporary Drug Problems,30:147–168.
27.
ShanerAndrew, EckmanThad A., RobertsLisa J., WilkensJeffery N., TuckerDouglas E., TsuangJohn W., and MintzJim (1995, September 21). Disability income, cocaine use, and repeated hospitalization among schizophrenic cocaine abusers—a government sponsored revolving door?New England Journal of Medicine,333(12):777–783.
28.
SnyderBill (1996, August 8). Counselors fear law punishing addicts, alcoholics will backfire.Nashville Banner.
29.
SPSS, Inc. (2000). Version 10.0.07.
30.
SwartzJames A., CampbellKevin, BaumohlJim, and TonkinPeggy (2003). Drug treatment participation and retention rates among former recipients of supplemental security income for drug addiction and alcoholism.Contemporary Drug Problems,30:335–364.
31.
SwartzJames, TonkinPeggy, and BaumohlJim (2003). The methodology of the multi-site study of the termination of Supplemental Security Income benefits for drug addicts and alcoholics.Contemporary Drug Problems,30:77–121.
32.
TabachnikBarbara G. and FidellLinda S. (1996). Using Multivariate Statistics (3rd ed.). HarperCollins: New York.
33.
TobarHector (1996, December 30). Aid is last hope for many recovering addicts.Los Angeles Times.
34.
United States Department of Health and Human Services (1997, July). Preliminary Results from the 1996 National Household Survey on Drug Abuse (National Household Survey on Drug Abuse Series: H-3). Substance Abuse and Mental Health Services Administration, Office of Applied Studies: Rockville, MD.
35.
United States Department of Health and Human Services (1999), 1998 National Household Survey on Drug Abuse.Substance Abuse and Mental Health Services Administration, Office of Applied Studies: Rockville, MD.
36.
WaldorfDan, ReinarmanCraig, and MurphySheigla (1991). Cocaine Changes: The Experiences of Using and Quitting.Temple University Press: Philadelphia.
37.
WillettJohn B. (1989). Some results on reliability for the longitudinal measurement of change: Implications for the design of studies of individual growth.Educational and Psychological Measurement,49(3):587–602.
38.
WinickCharles (1962). Maturing out of narcotic addiction.Bulletin on Narcotics,14:1–7.
39.
WittenburgDavid, StapletonDavid, TuckerAdam, and HarwoodRick (2003), An assessment of the representativeness of the SSI DA&A study panels.Contemporary Drug Problems,30:123–136.
40.
ZarkinGary A., FrenchMichael T., MrozThomas, and BrayJeremy W. (1998). Alcohol use and wages: New results from the National Household Survey on Drug Abuse.Journal of Health Economics17:53–68.
