Imagine if an elderly loved one was thrown off Medicare because she tested positive for diabetes. Sound impossible? For the family and friends of Wisconsinites suffering from drug issues, a dreadful scenario such as this could become reality.
Governor Scott Walker’s proposal to drug test people receiving BadgerCare and other public programs flies into the teeth of the consensus among experts that substance misuse is a medical condition.
In the 19th Century diseases such as cancer and influenza were often blamed on the moral failings of the afflicted. Now we know better. Rather than heaping scorn upon the victims of serious illnesses, we treat them with modern medicine.
Over the last two decades, the scientific progress on how we treat physical diseases has been extended to drug and alcohol use. Doctors and other health care experts use the term “substance use disorder” when referring to drug and alcohol-related health issues. Decades of research have firmly established substance use disorders as medical conditions to be prevented and treated as early as possible.
Forced drug testing for people on public programs turns back the clock by reinforcing outdated images of those battling with substance use disorders. From a medical point of view, it would be like requiring tests for cancer or heart disease for BadgerCare applicants, and then throwing anyone off health coverage who tests positive.
To require low income people who rely on public programs for food, health care, and other necessities to undergo the humiliation of forced drug testing reinforces old and discredited stereotypes,especially the prejudice that people who are lower income are more likely to use drugs. Medical research establishes that people who rely on public assistance programs do not suffer from substance use disorders at levels substantially higher than the general population. In fact, when Florida implemented drug testing for public benefits recipients, only 2.6% of enrollees tested positive before it was thrown out in federal court.
Another argument might be that people relying on BadgerCare are receiving public money. But if it is justifiable to drug test people just because they receive public dollars, why not have forced drug tests for legislators, professors at are public colleges and universities, or Corporate CEOs who receive generous public economic development subsidies?
There are also racial overtones to the demand that people receiving BadgerCare and other public services submit to forced drug testing. Despite the fact that 61% of BadgerCare enrollees are white, the image of a typical enrollee that comes to the public mind is more likely to be an African American mother living in a city than a white farmer. Making the subtle exploitation of race stereotypes even more outrageous, research shows African Americans are less likely to use illegal drugs than whites.
Vilifying people of modest economic means through punitive drug testing programs diverts our focus from comprehensive solutions shown to help prevent substance use disorders in the first place. For anyone facing a serious illness like cancer, early preventative screenings can literally mean the difference between life and death. Applying this same level of urgency to substance use disorders through universal access to screening and treatment can ensure many never face the life-threatening tragedy of drug addiction.
Taking substance use disorders seriously begins by meeting the challenge where it often starts - with youth. A major study found that 9 in 10 Americans with addiction issues started using risky substances before age 18. In Wisconsin we rank higher than the national average in youth binge drinking and illicit drug use, and not a day goes by without another headline about the growing heroin crisis.
Proposals to drug test recipients on BadgerCare and other public assistance may score political points, but they actually divert us from applying modern medical research to the critical task of preventing and treating substance use disorders. The time is now to discard old prejudices which divide us based on economic status and race. Drug use touches every community and every walk of life. We need to pull together and make real public investments in evidence-based solutions which, beginning with our young people, tame the ravages of drug addiction and expand the freedom to live a fulfilling life.
Robert Kraig is the executive director and Erik Kirkstein is a health organizer for Citizen Action of Wisconsin, a statewide advocacy group working to address substance use disorders among youth and young adults in Wisconsin.
A version of this op-ed appeared in the Milwaukee Journal Sentinel on 2/10/15