Effects of Losing SSI Benefits on Standard Drug and Alcohol Outcome Measures

Abstract

P.L. 104–121 eliminated drug addiction and alcoholism (DA&A) as an impairment category for Supplemental Security Income (SSI), allowing a six-month period for DA&A recipients to request an eligibility redetermination, and terminating all SSI DA&A benefits on January 1, 1997, In a multi-site cohort study of persons affected by this change, participants were interviewed prior to the benefits termination date and reinterviewed over a two-year follow-up period. We assessed the impact of loss of SSI DA&A benefits on Addiction Severity Index (ASI) composite scores, which are often used to reflect treatment outcomes in seven areas (psychological, social, alcohol, drug, legal, employment, and medical). We classified participants as either on SSI or off SSI (n=1,670) during follow-up and analyzed ASI composite scores treating time as a linear effect, including baseline composite scores as covariates. The dependent variable in each analysis was the ASI composite score, dichotomized into high and low categories. We hypothesized that those who lost SSI benefits would experience poorer outcomes than those who requalified for benefits. In the context of the limitations discussed, the results do not support this hypothesis. Participants in both groups showed either improvement or no change over time, and patterns of change did not differ by SSI status.