The majority of submitters and witnesses acknowledged the benefits of providing medical and/or social assistance to people experiencing substance abuse issues. The Senate Community Affairs Legislation Committee (committee) also received evidence expressing a range of concerns about several aspects of the proposed drug testing trial, including:
the evidentiary basis for drug testing welfare recipients;
the methodology for the trial;
the processes involved in testing for illicit drugs;
the use of compulsory treatment and income management as consequences for a positive test in the trial; and
the increased demand on services providing treatment for substance abuse in the trial locations.
Evidence for the trial
Some submitters told the committee that there is a lack of academic evidence to support the view that drug testing welfare recipients and restricting their income would assist them to address their substance abuse issues. Several of these submitters referenced a 2013 report by the Australian National Council of Drugs which recommended that drug testing of welfare recipients not be considered in Australia and stated that:
There is no evidence that drug testing welfare beneficiaries will have any positive effects for those individuals or for society, and some evidence indicating such a practice could have high social and economic costs.
In response to concerns about the broader evidence base for drug testing welfare recipients, the Department of Social Services (department) submitted that the model proposed in the bill has not be studied before in Australia or internationally, which is why comparable evidence for this approach does not exist and why the program has been proposed as a trial. The department further stated:
The evaluation of this trial will help to establish an evidence base for this type of intervention by testing new ways of encouraging job seekers into treatment.
Some submitters observed that programs of drug testing welfare recipients in other countries had indicated that it is not a cost-effective method of identifying people with substance abuse issues, as there were a very low number of positive tests in those trial populations. For example, one trial in New Zealand of 8001 participants had only 22 positive test results, a total of 0.27 per cent of participants.
The committee received evidence from the department indicating that a higher proportion of drug tests are anticipated to be positive in the trial proposed by the bill, with an anticipated 420 to 450 of the 5000 participants, 8.4 to 9.0 per cent, expected to test positive to the initial test.
Other submitters commented that there is limited evidence that people who are receiving welfare payments use illicit drugs at higher levels than the general population or that drug use is the reason that they are unemployed.
However, the committee notes data that demonstrates drug and alcohol dependency currently affects the ability of jobseekers in Australia to participate in activities and seek employment. The Assistant Minister to the Prime Minister and Cabinet, the Hon Ben Morton MP, noted in his second reading speech that, in the 2018–19 financial year, there were 5247 occasions when a drug or alcohol dependency was used by a jobseeker as a reason for not meeting their mutual obligation requirements and, between 1 January 2018 and 31 July 2019, 8638 jobseekers already participated in a drug or alcohol treatment activity as part of their requirements.
Evidence from the Australian Institute of Health and Welfare's 2016 National Drug Strategy Household Survey demonstrated that unemployed people were more likely to use cannabis and meth/amphetamines than employed people (18.7 per cent and 4.6 per cent versus 12.2 per cent and 1.5 per cent, respectively), although they were less likely to use cocaine (2.4 per cent versus 3.8 per cent).
The Assistant Minister noted that the trial to be established by the bill will:
…assess the use of drug testing as a means of identifying jobseekers with substance abuse issues that may be preventing them from finding a job, and supporting them to address these barriers through interventions such as income management and referral to the appropriate treatment that they require.
Research methodology and evaluation
Some submitters raised concerns about the research methodology and evaluation process for the trial.
For example, the Network of Alcohol and other Drugs Agencies (NADA) questioned whether focusing the trial only in locations with high rates of illicit drug usage will result in data to accurately inform a future national roll-out of the program.
The City of Logan recommended that the evaluation include a number of measures to determine which aspects of the trial are successful, including success rates in terms of employment and treatment outcomes, as well as feedback from case managers and support providers, and the impact on those who refuse to participate in testing and therefore ‘drop out’ of the welfare system.
In its report into the Social Services Legislation Amendment (Drug Testing Trial) Bill 2018 (2018 bill), the committee acknowledged the importance of a rigorous methodology with clear metrics for evaluation being established before the commencement of the trial. In that report, the committee made two recommendations relating to the methodology of the trial:
The committee recommends that the Department of Social Services should establish and publish the evaluation strategy of the drug testing trial prior to the commencement of the trial.
The committee recommends that the Department of Social Services publish the outcomes of the drug testing trial after it has been completed.
In the Government Response to the committee's report, the department supported these recommendations, noting that:
an independent consultancy will be commissioned to develop the evaluation strategy;
the evaluation strategy will be designed in conjunction with stakeholders through submissions and workshops in each trial location;
an Evaluation Steering Committee will be established to guide the work of the evaluation and will include representatives with drug and alcohol expertise;
an independent consultancy will be commissioned to conduct the evaluation in parallel with the trial; and
the findings of the evaluation will be published at the end of the trial.
The committee notes concerns of submitters and witnesses about the evidentiary basis for the drug testing trial.
However, the committee is mindful of evidence from the department that the model proposed in the bill has not been tested and that the results of the evaluation of the trial will help to determine the extent to which drug testing can assist jobseekers to overcome the barriers to their employment.
The committee is further encouraged by the department's commitment to ensure that the evaluation strategy is established before the commencement of the trial and to publish the results of the evaluation of the trial once it is completed.
Processes involved in drug testing
In total, 5000 participants across the three trial locations will be randomly selected from the drug test trial pool to undertake a drug test and will be notified to attend an appointment at their local Centrelink office. At that appointment, participants will be told that they are to undergo an immediate drug test, which will be conducted by a third-party provider either in the Centrelink office or at a nearby provider’s premises. The methods for testing proposed by the trial are based on the collection of saliva, urine and hair samples.
Some submitters have questioned the processes involved in testing participants, such as the methods of testing, the assessment of test results and the requirements for third-party providers.
Penington Institute, among others, submitted that the various methods of drug testing have significantly different sensitivity in detecting the recent use of different substances. For example, while heroin may remain detectable for three days after use, cannabis can remain detectable for as long as 14 days.
The City of Logan submitted that saliva testing should be used in the trial, rather than urine or hair testing, as this method is more likely to indicate a current and immediate influence of drugs on the individual, which would affect their job-readiness.
The Workplace Drug Testing Association (WDTA) clarified for the committee that saliva testing gives a better indication of current impairment, but that urine testing may be more suited to pre-employment screening as a broader historical test. These two methods are used equally in workplaces for the purpose of workplace-based drug screening. Hair testing can also be used to detect drug use or exposure in the months before the test, rather than days, and is less intrusive for the individual.
Some submitters have raised concerns about the role of third-party providers contracted to provide testing under the trial, particularly in relation to their expertise and the quality of the assessment of test samples. For example, the Australian Human Rights Commission submitted that appropriate measures should be put in place:
…to ensure that private contractors who are conducting the drug tests are adequately trained, and that robust procedures are put in place, to ensure the security and confidentiality of drug test result information.
The Department explained to the committee that contracted providers will be required to conform to Australian Standards in relation to drug testing, as well as the requirements set out for providers in the drug test rules, to be made under proposed section 38FA of the bill.
The WDTA explained that there are currently Australian Standards for drug testing using urine and saliva, and several laboratories have also been accredited in accordance with international guidelines for hair testing.
The department further noted that the drug test rules, which were provided in 2017 as an exposure draft relating to the Social Services Legislation Amendment (Welfare Reform) Bill 2017, will be updated after the current bill is passed and following consultation with drug testing experts. The Department of Human Services (Services Australia) also informed the committee that it had taken expert advice in drafting preliminary requirements as part of the procurement of a provider and 'will continue to take expert advice as required, including in the evaluation of tender responses'.
Some submitters raised concern regarding the impact of drug testing on participants' drug use. For example, the Royal Australasian College of Physicians noted that an unindented consequence of drug testing for certain substances may be that participants shift their drug use to those substances which are not tested for and which may be more dangerous, such as synthetic cannabis or opioids, or prescription drugs.
Some submitters have concerns about the risks relating to false positive results for certain substances in the trial given the consequences for participants. The Queensland Network of Alcohol and other Drug Agencies told the committee that this concern may be higher for saliva testing than other methods.
The Royal Australasian College of Physicians submitted that many psychiatric drugs may return false positive results for amphetamines and that it would be unfair to subject a participant with a prescription for a psychiatric drug to income management for such a result.
For these reasons, the WDTA has recommended that the trial include a medical review of some results, such as for testing relating to opioids, due to the complexities around illicit opioids such as heroin and similar test results for prescription opioids like codeine.
In relation to this matter, the department's submission clarifies that the trial is focussed on the use of illicit drugs by jobseekers and is not intended to capture those who are taking legal medications, including medicinal cannabis. Any participants who undergo drug testing will be asked to provide information about any legal medications they are taking which may cause false positive results, and this will be taken into account in recording the test result.
In addition, trial participants who believe that they have received a false positive test are able to request a second test, for which they will not be required to pay the cost unless that test also provides a positive result.
The committee notes the concerns raised by submitters about the processes involved in drug testing under the trial and that limited specific detail is currently available in relation to these processes, noting that additional details will be included in the drug testing rules.
The committee agrees that any drug testing processes used for the purposes of the trial should meet Australian and international standards for collection and assessment, and should be conducted in a manner that takes into account any legitimate reasons that an individual may have for testing positive for a particular substance.
The committee is satisfied that both the Department of Social Services and the Department of Human Services (Services Australia) are undertaking all necessary consultation to ensure that drug testing carried out under the trial will meet these requirements.
Consequences of a positive test
As outlined in Chapter 1, drug test trial participants who test positive to a testable drug will be placed on income management for two years and be required to undergo further random drug tests. If a second test is also positive, the participant will be referred to a health professional for assessment and may be recommended drug treatment appropriate to their circumstances. If treatment is recommended, the participant will need to complete the recommended treatment as part of their Job Plan.
Some submitters questioned whether the compulsory drug treatment and income management aspects of the trial will have the desired outcome of reducing substance abuse. St Vincent's Health Australia noted that:
Part of the clinical definition of substance use disorder is that people continue to misuse drugs or alcohol despite knowing there will be negative consequences.
However, the Kirby Institute submitted that, while some models of compulsory treatment do not achieve their stated goals, compulsory treatment has been proven effective when used to divert individuals away from the criminal justice system.
Some submitters noted that income management and restricted access to discretionary funds may not prevent people from continuing to use illicit substances, particularly if their use is limited and infrequent. Uniting Communities submitted that in one of the trial sites for the cashless debit card program, an alcohol and other drugs treatment centre reported that there had not been a decrease in the number of people seeking help so far.
The department told the committee that income management for the drug testing trial will be provided through an adaptation of the existing Supporting People at Risk measure using the BasicsCard, and participants will have access to the various supports which are available to all individuals currently on income management through the BasicsCard. The Supporting People at Risk measure is currently used in the Northern Territory for the support of people with alcohol abuse issues who have been placed on the Banned Drinker Register.
In the second reading speech for the 2018 bill, the then Minister for Social Services, The Hon Dan Tehan MP, explained why he considered that income management was an important part of the drug testing trial:
This is designed to restrict their access to cash and limit their ability to use their payments to fund further harmful drug use, while not reducing the amount of payment they receive.
The submission from Brisbane South PHN supported this view, noting that a positive aspect of income management under this program is that it does not impose a financial penalty that would reduce an individual’s welfare payment overall.
Some submitters also raised concerns that by not offering drug treatment after a first test, the trial may not meet the program’s aim of improving ‘a recipient’s capacity to find employment or participate in education or training by identifying people with drug use issues and assisting them to undertake treatment’.
For this reason, some submitters proposed ways in which the drug testing trial could be enhanced to address some of the concerns raised by stakeholders and communities, including:
allowing individuals to volunteer for drug treatment or income management either before undergoing a test, or providing for voluntary instead of mandatory participation following a positive drug test;
introducing an option for drug treatment following a first positive test, either in conjunction with or instead of income management; and
implementing income management only on the advice of a health professional, including ceasing income management once the individual completed a drug treatment program, or if it is deemed no longer necessary to support their treatment.
Some witnesses and submitters also raised concerns that both income management and drug treatment may be seen by jobseekers as a punishment for their substance abuse, rather than a positive step towards treatment and rehabilitation.
The Assistant Minister stated in his second reading speech for the bill:
This is not about penalising jobseekers. This is not about penalising those with drug abuse issues. It is about finding new and better ways of supporting those jobseekers with drug abuse issues to overcome the barriers to work.
The committee recognises that some submitters and witnesses are concerned about the use of income management and compulsory drug treatment as part of the drug testing trial.
While the committee acknowledges these concerns, it also notes that an objective of the trial is to assess the extent to which these measures will assist trial participants with substance abuse issues to overcome barriers to work.
Increased demand on services
Throughout this and previous inquiries, peak alcohol and other drug services bodies, as well as other social service providers and academics with expertise in this area, told the committee that the referral of participants through a drug testing trial will place an additional burden on services already at capacity in the trial locations.
A $10 million treatment fund to support the drug testing trial was announced with the introduction of the 2018 bill. During the hearing for this inquiry, the department clarified that this $10 million fund would be divided as follows:
$3 million to boost the capacity of drug treatment services in trial locations, to be delivered through Primary Health Networks;
$6 million for individualised support to meet the needs of a participant, such as for residential rehabilitation or counselling; and
$1 million for case management services.
Some submitters told the committee that $10 million may not be sufficient to address the unmet need for drug treatment services in trial locations. Submitters noted that health experts have estimated that an extra $1.2 billion in annual funding is needed nationally to manage people with addiction.
The committee received evidence that current waiting lists for public drug (including alcohol) treatment facilities can be up to six months long and that unmet demand may be over 200 000 patients per year nationally.
Other submitters raised concerns that the mandatory placement of trial participants into treatment may displace members of the community who are seeking voluntary treatment for their substance abuse issues.
The Explanatory Memorandum notes that, should treatment not be immediately available, trial participants placed on a waiting list will satisfy their mutual obligation requirements for drug treatment.
Furthermore, in his second reading speech, the Assistant Minister noted that the $10 million treatment fund is in addition to over $780 million in Commonwealth funding, for the four years from July 2018, to reduce the impact of drug and alcohol abuse on individuals, families and communities, including funding for National Ice Action Strategy to tackle the use of methamphetamine in regional Australia.
The committee acknowledges that some submitters are concerned about whether the $10 million drug treatment fund will be sufficient to cover the increase in expected demand for drug treatment services in the trial locations.
However, the committee notes that this fund is not intended to cover all drug treatment services in a trial location. Rather, it will provide support to services and specific, individualised funding to meet the needs of the small number of participants who test positive to illicit substances more than once.
In addition to the matters discussed above, submitters and witnesses also raised concerns about:
the nature of consultation undertaken with communities and other stakeholders before and after the drug testing policy announcement;
privacy implications of the program;
the potential for an increase in stigma, poverty and crime in the trial regions; and
whether the program has a disproportionate effect on particular communities, such as Aboriginal and Torres Strait Islander peoples.
Concluding committee view
The committee notes the support of submitters and witnesses for programs which help people with substance abuse issues to receive treatment.
However, the committee recognises the ongoing concerns raised by some submitters and witnesses about the proposed drug testing trial, particularly in relation to the research and evaluation methodology for the trial and the processes for conducting a drug test.
The committee understands that these aspects of the trial are still being confirmed by the Department of Social Service and the Department of Human Services (Services Australia), in consultation with experts and other key stakeholders. The committee looks forward to the evaluation strategy and the drug test rules being made available ahead of the commencement of the trial.
The committee is confident, based on evidence received in this and previous inquiries, that the proposed trial will allow the Commonwealth Government to assess the extent to which drug testing assists welfare recipients to overcome substance abuse issues and find employment.
The committee recommends that the bill be passed.
Senator Wendy Askew