The Impact of Welfare Reform on Methadone Treatment: Policy Lessons from Service Providers in New York City

Abstract

This article explores the impact of recent changes in welfare policy on public assistance recipients who are in methadone maintenance treatment, from the perspective of methadone service providers. Data were collected between late 2000 and early 2002, and included in-depth interviews with 11 providers from three methadone treatment programs in New York city, contextual interviews with three welfare agency personnel and three patient advocates, and participant-observation in trainings and clinical meetings related to vocational services and public assistance for methadone patients. Because service providers are front-line implementers of new welfare regulations, their experiences, and insights should be consulted by policymakers as welfare policy continues to evolve.

• Welfare reform
• Methadone treatment
• New York City
• Policy analysis
• Addiction
• Entitlement

Notes

^aThus, the first 5-year time limits were reached on January 1, 2002.

^bIn fact, unions have taken a strong position in opposition to New York City's WEP policies, though their objections are directed at the program generally, rather than at the role that substances users play as potential or actual WEP employees. For example, District council 37, the union representing municipal employees, sued the Giuliani administration over a variety of WEP-related issues, including the allegedly illegal replacement of more than 2000 unionized positions with WEP employees (Anderson, 2000).

Additional information

Notes on contributors

Ellen Benoit

Ellen Benoit, Ph.D., is an Assistant Project Director in the Institute for Special Populations Research at NDRI. Her research focuses on inequality and social policies related to public health and social control, particularly from a comparative, historical perspective. She has articles published and in progress on poverty and the illegal drug trade, and on social welfare and criminal justice policies in the United States and Canada.

Rebecca Young

Rebecca Young, Ph.D., is an Assistant Professor of Women's Studies at Barnard College. She has conducted behavioral research on HIV/AIDS, substance use, sexuality, and urban health for 15 years. Dr. Young has an interest in philosophy of science, and is involved in several interconnected studies of measurement issues and investigators' beliefs in scientific research on sexuality, gender, and race.

Stephen Magura

Stephen Magura, Ph.D., C.S.W., is Acting Executive Director of NDRI and has been the Principal Investigator of many studies sponsored by the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Child Health and Development. These studies have included drug abuse clinical trials, treatment outcome evaluations, health services research, social epidemiology studies, HIV prevention research, and policy analysis. Dr. Magura has authored or edited several books and special journal issues, including Outcome Measures for Child Welfare Services (1986), Experimental Therapeutics in Addiction Medicine (1994), a special issue of Health and Social Work on “Chemical Dependency” (1994), and a special issue of Substance Use & Misuse on “Program Quality in Substance Dependency Treatment” (2000). He serves on the Editorial Boards of five professional journals, is an elected member of the College on Problems of Drug Dependence (CPDD) and the Research Society on Alcoholism (RSA), serves on federal advisory committees, and is a faculty member of the Middle Eastern-Mediterranean Summer Institute on Drug Use.

Graham L. Staines

Graham L. Staines, Ph.D., was, until recently, a Senior Project Director at NDRI where he directed projects on modified therapeutic communities for both methadone patients and mentally ill chemical abusers (MICAs), treatment matching on levels of care among alcoholics, and new models of vocational rehabilitation for methadone clients. Prior to coming to NDRI, he was a Study Director at the Institute for Social Research at the University of Michigan. Funded by the Department of Labor, his research, which focused on the quality of work life, included three national Quality of Employment Surveys of representative samples of workers. In addition to journal articles, his publications on the relationship between work and family life include The Impact of Work Schedules on the Family (co-authored with Joseph H. Pleck in 1983).