Metsch Lisa R, Pollack Harold A
University of Miami School of Medicine, Miami, FL 3316, USA.
Milbank Q. 2005;83(1):65-99. doi: 10.1111/j.0887-378X.2005.00336.x.
The 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) changed the nature, purpose, and financing of public aid. Researchers, administrators, and policymakers expressed special concern about the act's impact on low-income mothers with substance use disorders. Before PRWORA's passage, however, little was known about the true prevalence of these disorders among welfare recipients or about the likely effectiveness of substance abuse treatment interventions for welfare recipients. Subsequent research documented that substance abuse disorders are less widespread among welfare recipients than was originally thought and are less common than other serious barriers to self-sufficiency. This research also showed significant administrative barriers to the screening, assessment, and referral of drug-dependent welfare recipients. This article summarizes current research findings and examines implications for welfare reform reauthorization.
1996年的《个人责任与工作机会协调法案》(PRWORA)改变了公共援助的性质、目的和资金来源。研究人员、管理人员和政策制定者对该法案对患有物质使用障碍的低收入母亲的影响表示特别关注。然而,在PRWORA通过之前,对于这些障碍在福利领取者中的真实患病率以及针对福利领取者的药物滥用治疗干预措施的可能效果知之甚少。后续研究表明,物质滥用障碍在福利领取者中的传播程度低于最初的设想,且比其他严重的自给自足障碍更为少见。这项研究还显示,在对依赖药物的福利领取者进行筛查、评估和转诊方面存在重大行政障碍。本文总结了当前的研究结果,并探讨了对福利改革重新授权的影响。