SSI Receipt and Alcohol and Other Drug use among Former SSI DA&A Beneficiaries

Following termination of the SSI Drug Addiction and Alcoholism (DA&A) program, a nine-site study followed 1,764 randomly selected SSI beneficiaries over two years. This paper examines how loss of SSI affected use of alcohol and illegal drugs. One-third of study respondents reported neither drinking nor using illegal drugs at baseline (just before the end of the program). Nevertheless, use of illegal drugs was 15 times more prevalent among the study sample (44%) than the general population, while use of alcohol was 1.3 times more prevalent (59%), and use of both alcohol and other drugs was significantly greater among those who would lose SSI than those who would retain it. During the follow-up period, prevalence of drinking and use of illegal drugs remained steady, but mean days of use declined for alcohol and illegal drugs other than marijuana. In three separate repeated measures ordinal regression models we examined the net effect of SSl retention on use of alcohol, marijuana and other illegal drugs over time, controlling for demographics, social and health status, and utilization of substance abuse treatment or self-help. Declines in use of alcohol and illegal drugs other than marijuana were similar for those who retained and those who lost SSI benefits, indicating that termination of the program had no effect on levels of substance use. Higher levels of substance use remained significantly and substantially associated with younger age (under 44 years), psychiatric and legal problems, and family or social conflicts, suggesting that subsets of the DA&A population need individualized services beyond income support.