Voters in San Joaquin County, California, are about to decide if people on public benefits should be drug-tested under threat of losing their benefits. If approved, Measure R on the November ballot would require that anyone who receives cash or rent benefits from the county, and is suspected by officials of using drugs, submit to mandatory drug testing. Refusing to get tested would mean forfeiting benefits. If you test positive, you would have to agree to go into substance use treatment or lose benefits.
Measure R asks: “[Should we require] single adults age 65 and under, with no dependent children, who receive County funded public assistance benefits and whom the County reasonably suspects are dependent on illegal drugs, to participate in screening, evaluation, and treatment for drug dependency in order for those adults to be eligible for those benefits be adopted?”
It describes its goals as trying to help people dependent on drugs get into treatment: “Although reasonable participation in treatment programs will be required, sobriety of participants will not be … Perfection isn’t the goal; improved health and life outcomes is.”
Currently, the county pays a maximum of $75 a month to individuals on an EBT card, and a maximum of $367 in rental assistance, with $340 paid directly to a landlord. Under the measure, the county’s Human Services Agency would determine if there is “reasonable suspicion to believe that an individual is dependent upon illegal drugs.”
San Joaquin County’s proposal reflects a broader trend in California.
That person would have to submit to a “professional evaluation.” Anyone found to have a substance use disorder would then be compelled to enter a “treatment program determined to meet his or her rehabilitation needs.” The treatment would have to be made available at no cost to the individual, but refusal would mean loss of benefits.
There are some exceptions. The measure would not apply to recipients aged over 65, or to those with dependent families. And the county could choose to temporarily extend rental assistance if a person is at risk of eviction.
San Joaquin County’s proposal reflects a broader trend in California. Earlier in 2024, San Francisco voters approved Measure F, a similar law which also threatens to take away public benefits if people don’t submit to drug testing. That will take effect in January 2025.
San Joaquin County District 3 Supervisor Tom Patti wrote and sponsored Measure R. In comments reported by the local Stockton Record, Patti said he took San Francisco’s Measure F as a model.
“I think the biggest key is that we want to have regional continuity,” he said, adding that he had spoken to officials in other nearby counties. “And if there’s, again, that continuity, then I think we can really lead the way for the state to demonstrate how we can engage [in addressing drug-related issues].”
This also comes in the same year that California voters approved Proposition 1 to overhaul the state’s Mental Health Services Act. Prop 1 effectively cut public spending on community-based treatment and outreach to people with mental health and substance use issues, shifting county dollars to building new inpatient treatment beds. The measure was sold by Governor Gavin Newsom (D) and others as a necessary path to expanding treatment and housing units, but many harm reduction and homelessness advocates opposed it.
Forced or coerced treatment, which a number of these measures entail, is condemned by many experts as unethical, unhelpful and often harmful.
In this same election cycle, California voters are also deciding on Prop 36, which would essentially increase criminal penalties for certain drug charges, and create a new “treatment mandated felony” category—threatening people with prison or jail unless they agree to go to substance use treatment. This would reform Proposition 47, approved by the state’s voters in 2014, which reduced some drug and shoplifting charges to misdemeanors. Independent reviews have found no evidence that this led to any increase in crime, but that hasn’t stopped a backlash.
“Treatment should be voluntary and readily available and humane—not coercive.”
“California is in the middle of an identity crisis,” Denise Elerick, founder of the Harm Reduction Coalition of Santa Cruz County, told Filter of the recent developments. “We have been a leader in justice reform, but nobody’s had the courage to push back on these police unions and the far right wing who’s behind a lot of this, and to hold our so-called progressives accountable for buying into it.”
Elerick has experienced a related battle firsthand, having spent years fighting against efforts to shut down her organization’s syringe service program in Santa Cruz.
“The pressure is to get ‘tough on crime’ again all over,” she said. “It’s been 10 years since Prop 47 and the sky didn’t fall, crime didn’t shoot through the roof, we lived through a pandemic, the counties are saving millions of dollars directing people to programs for treatment and diversion.”
San Joaquin’s Measure R, if approved, might end up costing the county more money than it costs to distribute benefits, because of the need to hire additional staff to conduct assessments and screenings. “This is about more than just dollars. This is about making a statement,” County Supervisor Steve Ding told a Board of Supervisors meeting in August.
Elerick added that it’s all premised on there being adequate treatment available—which is frequently not the case.
“Let’s talk about what treatment is,” she said. “It’s a risky time for people that are forced into treatment. It should be voluntary and readily available and humane—not religious or faith-based, or coercive. There’s a myth that treatment will cure everything, and it’s nuanced for people … It’s not a ‘one and done’.”
Another major issue, she continued, is that for unhoused people who enter treatment, there is no safety net once they complete it, and many will end up back on the streets without a prospect of housing.
“How are they supposed to maintain any level of abstinence, when they’re going to go back to living outside with the same conditions?” Elerick asked. For people who use opioids, lowered tolerance after a period of abstinence increases vulnerability to overdose.
“Drug testing of welfare recipients is not ethically acceptable policy,” the researchers wrote.
Drug testing people on benefits has a long history in the United States. In 1996, President Bill Clinton’s “welfare reform” allowed states to require drug tests for public benefits.
In 2018, a ThinkProgress analysis found that states in 2017 spent nearly half a million dollars to drug-test over 2,500 people who had applied Temporary Assistance for Needy Families (TANF) benefits. At least 13 states actively drug-tested people on the TANF program, it estimated. All of this had resulted in just 301 positive tests.
The state of Florida has run into legal trouble over its drug-testing requirement for all people on TANF benefits; an appeals court in 2014 ruled that its blanket requirement was unconstitutional. Since then, jurisdictions have responded by requiring public agencies to show “reasonable suspicion” of drug use before ordering a test, just as San Joaquin County’s Measure R would do.
Researchers have also sought to evaluate these policies. In a 2018 paper, authors Mary Jean Walker and James Franklin looked at whether they are successful in getting people into treatment, whether or not they result in significant harms to people, and whether they save costs compared to alternatives. In all three areas, drug testing for benefits failed.
“Pursuing recreational drug users is not important in the light of costs incurred, while dependent users who may require referral are usually identifiable without testing and typically need a broader approach than one focusing on drugs,” they wrote. “Drug testing of welfare recipients is therefore not ethically acceptable policy.”
Photograph by Micah Baldwin via Flickr/Creative Commons 2.0