> Average weekly mortality due to illicit drug overdose was 40% higher during weeks of income assistance payments compared to weeks without payments (P<0.001).

> Average weekly mortality due to illicit drug overdose was 40% higher during weeks of income assistance payments compared to weeks without payments (P<0.001). Consistent increases in mortality appeared the day after cheque disbursement and were significantly higher for two days, and marginally higher after 3 days, even when controlling for other temporal trends. Source: "Illicit drug overdose deaths resulting from income assistance payments: Analysis of the 'check effect' using daily mortality data", https://pubmed.ncbi.nlm.nih.gov/27402469/ https://pubmed.ncbi.nlm.nih.gov/27402469/ > The findings suggest that scheduling and staffing practices of various emergency service areas in Hennepin County reflect patient load variation associated with time of welfare check distribution. Systematic variation of time or amount of welfare could lead to improved distribution and reduction of emergency services demand. Source: "Correlation of emergency health care use, 911 volume, and jail activity with welfare check distribution", https://pubmed.ncbi.nlm.nih.gov/1648313/ https://pubmed.ncbi.nlm.nih.gov/1648313/ To be clear, these aren't arguments for removing or rejecting cash assistance altogether: > The implications are that there is a general check effect and that it was not reduced by ending benefits to persons with drug and alcohol related disabilities. Source: "Psychiatric emergencies: the check effect revisited", https://pubmed.ncbi.nlm.nih.gov/10331323/ https://pubmed.ncbi.nlm.nih.gov/10331323/ > Disability payments impact the timing of substance use, but receipt of disability payments is not associated with more overall substance use than unalleviated poverty. Money management-based clinical interventions, which may involve assignment of a representative payee, can minimize the purchase of substances with disability payments. Source: "The Check Effect Reconsidered", https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094507/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094507/ An example alternative model is California's In-Home Supportive Services (IHSS): https://www.payingforseniorcare.com/california/inhome-supportive https://www.payingforseniorcare.com/california/inhome-suppor... On the face of it, it's a voucher program for the disabled and elderly to obtain in-home assistance (cleaning, bathing, laundry, shopping, etc). But it's actually more of a jobs program for the unemployed or underemployed able-bodied. And in cities like San Francisco a significant fraction of recipients of the vouchers are older drug addicts, and a large number of those paid with the vouchers are able-bodied older adults. There's plenty of rules violations and cheating all around (because people will be people), but arguably the money is nonetheless more well spent--e.g. less of the public expenditure is diverted to drugs--than if the program simply provided cash directly to the recipients. Obviously, a single mother working two part-time jobs has much more to gain (as does the public) by no-strings-attached, direct cash assistance. Not all poverty looks the same, and not all of the impoverished have or even want the same incentives. That's the point being debated and that seems to chafe people the wrong way for some reason.