Disability payments and chemical dependence: conflicting values and uncertain effects

Receipt of public support payments by people with substance abuse disorders has been a subject of intense controversy in recent years. Observing that such funds are often used to purchase addictive substances, many critics have questioned whether people with chemical dependencies are entitled to such payments and whether they should be allowed to spend these funds unsupervised. This discussion introduces a special section of five data-based papers on the relation of disability payments to chemical dependence. The papers address five questions: Do public support payments worsen substance abuse in vulnerable populations? Does assignment of a representative payee reduce substance abuse among such beneficiaries? What money management procedures are most likely to yield positive outcomes for clients? How can clients who need payees be fairly identified? And how should skilled, responsible payees or guardians be recruited, trained, and retained? In the absence of scientific data, both clinical practice and social policy are vulnerable to the whims of public opinion. These papers shed new light on a heated area of policy debate.