The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66199

Daniel Dohan, PhD¹, Laura Schmidt, PhD², and Stuart Henderson, PhD¹. (1) Institute for Health Policy Studies, University of California, San Francisco, 3333 California St. Suite 265, San Francisco, CA 94118, 415.476.0751, dohan@itsa.ucsf.edu, (2) Public Health Institute, Alcohol Research Group, 2000 Hearst Ave., Suite 300, Berkeley, CA 94079

Welfare reform has instituted policy changes that now empower welfare workers to explicitly address substance abuse problems among aid recipients. This represents a philosophical shift in the welfare system from a culture of entitlement to one focused on self-sufficiency. Studies of welfare workers in the pre-reform era showed that the old entitlement culture fostered negative views of substance abusers, and that while these negative views often went unstated by workers, they could result in administrative actions terminating substance-abusing clients from aid. This study investigates changes in workers’ views of substance abuse and their use of new policies directed towards substance abusers in the post-reform system. We examined how three welfare reform policies—formal screening for substance abuse, time limits and work requirements—affected workers’ self-reported views and behaviors towards substance-abusing clients using data from in-depth interviews with welfare workers in a large Northern California county. We found that generally, workers had positive views of these policy changes. Pre-reform, workers were frustrated with welfare policies that seemed to “enable” substance abuse while allowing workers very few means for addressing self-destructive behaviors among their clients. New reform policies mitigate these concerns by allowing workers to directly address and sanction substance abuse, thereby increasing job satisfaction. Although welfare reform has made discussions of substance abuse more explicit, the reformed system still provides workers with limited resources for responding to it as a barrier to work. In addition, welfare reform may have improved day-to-day life for welfare workers, but it may not be having equally positive effects on substance-abusing clients.

Learning Objectives:

• Evaluate changes in workers’ views of substance abuse and their use of new policies directed towards substance abusers in the post-reform welfare system.

Keywords: Welfare Reform, Substance Abuse

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.