1 A.G. Sulzberger, States Adding Drug Test as Hurdle for Welfare, N.Y. TIMES (Oct. 11, 2011), http://www.nytimes.com/2011/10/11/us/states-adding-drug-test-as-hurdle-for-welfare.html?pagewanted=all&_r=0; see also Drug Testing and Public Assistance, NAT’L CONF. ST. LEGISLATURES, http://www.ncsl.org/issues-research/human-services/drug-testing-and-public-assistance.aspx (last updated Apr. 17, 2013) (providing a comprehensive survey of enacted or proposed drug testing legislation in the states).

2 See, e.g., H.B. 208, 2011 Gen. Assemb., Reg. Sess. (Ky. 2011) (establishing a substance screening program for adults who receive monetary public assistance, food stamps, or state medical assistance); S. 69, 129th Gen. Assemb., Reg. Sess. (Ohio 2011) (establishing a drug-testing requirement for adults who apply for need-based programs that provide cash assistance, medical assistance, housing assistance, food assistance, or energy assistance); H.R. 1174, 2012 Leg. Assemb., 87th Sess. (S.D. 2012) (directing the South Dakota Department of Social Services to screen and test any adult recipient who is otherwise eligible for TANF or food stamps).

3 ARIZ. REV. STAT. ANN. § 46-294 (Supp. 2013) (West); FLA. STAT. ANN. § 414.0652 (West 2013); GA. CODE ANN. § 49-4-193 (West 2012); MICH. COMP. LAWS ANN. § 400.57e (West 2008); MO. ANN. STAT. § 208.027 (West Supp. 2013); H.R. 2388, 53rd Leg., 2d Reg. Sess. (Okla. 2012) (to be codified at OKLA. STAT. tit. 230, § 52); S. 2580, 107th Gen. Assemb., Reg. Sess. (Tenn. 2012) (to be codified at TENN. CODE ANN. § 71-5-2); H.R. 155, 59th Leg., Gen. Sess. (Utah 2012) (to be codified at UTAH CODE ANN. § 35A-3-304.5).

4 Middle Class Tax Relief and Job Creation Act of 2012, Pub. L. No. 112-96, § 2105, 2012 U.S.C.C.A.N. (126 Stat.) 156, 162-63 (to be codified at 42 U.S.C. § 305).

5 Drug Free Families Act of 2011, S. 83, 112th Cong. § 2.

6 FLA. STAT. ANN. § 414.0652 (West 2013); GA. CODE ANN. § 49-4-193 (West 2012).

7 Press Release, Rick Scott, Governor of Fla., Governor Scott Fulfills Campaign Promise to Require Drug Screening for Welfare Recipients (May 31, 2011), available at http://www.flgov.com/2011/06/03/governor-scott-fulfills-campaign-promise-to-require-drug-screening-for-welfare-recipients/.

8 Martin Karamra, Drug Testing Welfare Recipients, CBS (Apr. 13, 2011), http://stlouis.cbslocal.com/2011/04/13/drug-testing-welfare-recipients/.

9 Sulzberger, supra note 1.

10 GA. CODE ANN. § 49-4-193 (West 2012).

11 Marchwinski v. Howard (Marchwinski II), 309 F.3d 330, 333 (6th Cir. 2002); Brief of the States of Alabama, Kansas, Michigan & Oklahoma as Amicus Curiae in Support of Appellant & Reversal at 18, Lebron v. Sec’y, Fla. Dep't of Children & Families, 710 F.3d 1202 (11th Cir. 2013) (No. 11-15258).

12 FLA. STAT. ANN. § 414.0652 (West 2013); S.B. 292, 158th Gen. Assemb., 2011-2012 Reg. Sess. (Ga. 2012).

13 See, e.g., Press Release, Alcee L. Hastings, Fla. Representative, Gov. Scott's Targeting of Welfare Recipients for Drug Screening Misguided (May 31, 2011), available at http://alceehastings.house.gov/news/documentsingle.aspx?DocumentID=327803 (quoting Congresswoman Corrine Brown who argues that drug tests for welfare recipients amount to “strip searching our state's most vulnerable residents merely because they rely on the government for financial support during these difficult economic times”).

14 U.S. CONST. amend. IV; Skinner v. Ry. Labor Execs.’ Ass’n, 489 U.S. 602, 616-17 (1989) (“We have long recognized that a compelled intrusio[n] into the body for blood to be analyzed for alcohol content must be deemed a Fourth Amendment search.” (internal quotation marks omitted)); Mapp v. Ohio, 367 U.S. 643, 646-47 (1961) (applying the prohibition against unreasonable searches and seizures to the states).

15 Suspicionless drug tests implicate other constitutional rights, aside from the Fourth Amendment, including the right to privacy. However, courts have largely addressed suspicionless drug testing as a Fourth Amendment problem, and at times, an unconstitutional conditions doctrine problem. Therefore this Article will focus on the Fourth Amendment problems and unconstitutional conditions problems that arise when governments attempt to condition public assistance benefits on passing a drug test.

16 Skinner, 489 U.S. at 620 (citing Griffin v. Wisconsin, 483 U.S. 385, 390 (1978)).

17 Chandler v. Miller, 520 U.S. 305, 323 (1997).

18 See discussion infra Part IV.

19 WENDY E. PARMET, POPULATIONS, PUBLIC HEALTH, AND THE LAW 6 (2009).

20 Id.

21 See, e.g., RECONSIDERING LAW AND POLICY DEBATES: A PUBLIC HEALTH PERSPECTIVE (John G. Culhane ed., 2011); Parmet, Wendy E. & Robbins, Anthony, A Rightful Place for Public Health in American Law, 30 J.L. MED. & ETHICS 302 (2002)Google ScholarPubMed; Robbins, Anthony, Public Health Literacy for Lawyers: Teaching Population-Based Legal Analysis, 111 ENVTL. HEALTH PERSP. 744 (2003)Google ScholarPubMed; Selkowitz, Jonathan E., Comment, Guns, Public Nuisance, and the PLCAA: A Public Health-Inspired Legal Analysis of the Predicate Exception, 83 TEMP. L. REV. 793 (2011)Google Scholar.

22 42 U.S.C. §§ 601-619 (2006).

23 Id. § 602(a)(1)(ii).

24 Id. §§ 607(c)(2)(B), 608(a)(7).

25 Id. § 601(a).

26 Id. § 608(a)(1).

27 Id. § 604(3); 76 Fed. Reg. 3637, 3638 (Jan. 20, 2011).

28 IFE FINCH & LIZ SCHOTT, CTR. ON BUDGET & POLICY PRIORITIES, TANF BENEFITS FELL FURTHER IN 2011 AND ARE WORTH MUCH LESS THAN IN 1996 IN MOST STATES 10 (2011), available at http://www.cbpp.org/cms/?fa=view&id=3625.

29 Id.

30 21 U.S.C. § 862b (2012) (“Notwithstanding any other provision of law, States shall not be prohibited by the Federal Government from testing welfare recipients for use of controlled substances nor from sanctioning welfare recipients who test positive for use of controlled substances.”).

31 See, e.g., MO. ANN. STAT. § 208.027 (West Supp. 2013).

32 Sulzberger, supra note 1.

33 Id.

34 Id.

35 Id.

36 MO. ANN. STAT. § 208.027.

37 Id.

38 Id.

39 Id.

40 FLA. STAT. ANN. § 414.0652 (West 2013).

41 Id. § 414.0652(1)(b).

42 Id. § 414.0652(3)(a).

43 Plaintiff-Appellee Luis W. Lebron's Answer Brief at 11, Lebron v. Wilkins, 820 F. Supp. 2d 1273 (M.D. Fla. 2011) (No. 6:11–cv–01473–Orl–35DAB).

44 FLA. STAT. ANN. § 414.0652(2)(a) (West 2013).

45 Id. § 414.0652(2)(b).

46 Id. § 414.0652(2)(h).

47 Id. § 414.0652(3)(b).

48 GA. CODE ANN. § 49-4-193 (West 2012).

49 Id.

50 Id. § 49-4-3.1(b).

51 Id. § 49-4-3.1(f).

52 INST. OF MED., THE FUTURE OF PUBLIC HEALTH 1 (1988), available at http://www.nap.edu/openbook.php?record_id=1091.

53 PARMET, supra note 19, at 6.

54 Id. at 51-53.

55 Id. at 53.

56 Id. at 18.

57 Id. at 19.

58 Id. at 56.

59 Id. at 57.

60 Id.

61 Id.

62 Id. at 64.

63 Id. at 53.

64 Id. at 60-72 (discussing Supreme Beef Processors, Inc. v. U.S. Dep’t. of Agric., 275 F.3d 432 (5th Cir. 2001), aff’g Supreme Beef Processors, Inc. v. U.S. Dep’t. of Agric., 113 F. Supp. 2d 1048 (N.D. Tex. 2000)).

65 PARMET, supra note 19, at 60-61.

66 See id. at 60-62.

67 See id. at 71-72.

68 See id. at 63.

69 See id. at 63-65.

70 See Wendy E. Parmet, Beyond Privacy: A Population Approach to Reproductive Rights, in RECONSIDERING LAW AND POLICY DEBATES, supra note 21, at 34.

71 Skinner v. Ry. Labor Execs.’ Ass’n, 489 U.S. 602, 617 (1989).

72 U.S. CONST. amend. IV.

73 See Clancy, Thomas K., The Role of Individualized Suspicion in Assessing the Reasonableness of Searches and Seizures, 25 U. MEM. L. REV. 483, 523 (1995)Google Scholar.

74 See id. at 488.

75 See Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646, 653 (1995).

76 See, e.g., Vernonia, 515 U.S. at 652; N.J. v. T.L.O., 469 U.S. 325, 337 (1985).

77 THOMAS N. MCINNIS, THE EVOLUTION OF THE FOURTH AMENDMENT 124 (2009).

78 California v. Acevedo, 500 U.S. 565, 582 (1991).

79 See, e.g., Maclin, Tracey, The Central Meaning of the Fourth Amendment, 35 WM. & MARY L. REV. 197, 198-200 (1993)Google Scholar.

80 See Skinner v. Ry. Labor Execs.’ Ass’n, 489 U.S. 602, 619 (1989).

81 387 U.S. 523 (1967).

82 Id. at 527.

83 Id. at 534.

84 Id. at 535.

85 Id. at 537.

86 Id.

87 Id. (citing Frank v. Maryland, 359 U.S. 360, 372 (1959)).

88 Skinner, 489 U.S. at 536.

89 Id.

90 LAWRENCE GOSTIN, PUBLIC HEALTH LAW: POWER, DUTY, RESTRAINT 16 (2008).

91 N.J. v. T.L.O., 469 U.S. 325 (1985).

92 See id. at 328.

93 See id.

94 See id.

95 See id. at 328-29.

96 Id. at 329.

97 See id. at 337.

98 See id. at 340.

99 See id. at 339.

100 Id. at 345-47.

101 Id. at 346-47.

102 Terry v. Ohio, 392 U.S. 1, 21 (1985).

103 T.L.O., 469 U.S. at 351 (Blackmun, J., concurring).

104 See id.

105 See id.

106 Id. at 352-53.

107 O'Connor v. Ortega, 480 U.S. 709 (1987).

108 Griffin v. Wisconsin, 483 U.S. 866 (1987).

109 Ortega, 480 U.S. at 725.

110 Id. at 717.

111 Id. at 722.

112 Id. at 742.

113 Griffin, 483 U.S. 866.

114 Id. at 875.

115 Id. at 876.

116 Skinner v. Ry. Labor Execs.’ Ass’n, 489 U.S. 602 (1989).

117 Id. at 620.

118 Id. at 607.

119 Id. at 608.

120 Id. at 624.

121 Id. at 626; see also generally Control of Alcohol and Drug Use in Railroad Operations, 50 Fed. Reg. 31,508, 31,555 (Aug. 2, 1985) (codified as amended in scattered sections of 49 C.F.R.).

122 See Nat’l Treasury Emps. Union v. Von Raab, 489 U.S. 656, 679 (1989).

123 Id. at 673-74.

124 Id. at 668.

125 Id. at 670.

126 Id. at 672.

127 See id. at 674.

128 Id. at 673.

129 See id. at 674.

130 See PARMET, supra note 19, at 130-31.

131 Id. at 52-53.

132 Parmet, supra note 70, at 15, 28.

133 Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646, 664-65 (1995).

134 Id. at 648-50.

135 Id. at 662-63 (quoting Acton v. Vernonia Sch. Dist. 47J, 796 F. Supp. 1354, 1357 (D. Or. 1992) (internal quotation marks omitted) (citation omitted)).

136 Id. at 663.

137 Id. at 653.

138 Id. at 652.

139 Id. at 656-57.

140 Id. at 657.

141 Chandler v. Miller, 520 U.S. 305 (1997).

142 Id. at 312.

143 Id. at 318.

144 Id. at 309.

145 Id. at 318-19.

146 Id. at 306.

147 Id. at 321.

148 Id. at 322.

149 Id. at 318.

150 Id. at 323 (emphasis added).

151 Ferguson v. City of Charleston, 532 U.S. 67 (2001).

152 Id. at 70.

153 Id.

154 Id. at 72.

155 Id. at 73-74.

156 Id. at 81.

157 Id. (quoting Indianapolis v. Edmond, 531 U.S. 32, 44 (2000)).

158 Ferguson, at 82-83.

159 Bd. of Educ. v. Earls, 536 U.S. 822, 836 (2002).

160 Id. at 838.

161 Id. at 826.

162 Id. at 835.

163 Id. at 835.

164 See Wyman v. James, 400 U.S. 309, 326 (1971).

165 Id. at 317-18.

166 Id. at 318-19.

167 Id. at 324.

168 Marchwinski v. Howard (Marchwinski I), 113 F. Supp. 2d 1134, 1136 (E.D. Mich. 2000), rev’d, 309 F.3d 330 (6th Cir. 2002), judgment of district court aff'd by an equally divided court on reh’g en banc, 60 F. App'x 601 (6th Cir. 2003).

169 Marchwinski I, 113 F. Supp. at 1136.

170 Id. at 1140-41.

171 Id. at 1140.

172 Id.

173 Id.

174 Marchwinski II, 309 F.3d 330 (6th Cir. 2002).

175 Id. at 335.

176 Id. at 336.

177 Id.

178 Marchwinski v. Howard (Marchwinski III), 60 F. App’x 601, 601 (6th Cir. 2003).

179 Id.

180 Id.

181 Lebron v. Wilkins, 820 F. Supp. 2d 1273 (M.D. Fla. 2011), aff’d 710 F.3d 1202 (11th Cir. 2013).

182 Defendant's Response to Plaintiff's Motion for Preliminary Injunction at 18, Lebron, 820 F. Supp. 2d 1273 (No. 6:11–CV–01473–ORL–35DAB).

183 Id. at 19.

184 Id. at 21.

185 Id.

186 Lebron, 820 F. Supp. 2d at 1286.

187 Id. at 1276.

188 Id. at 1277; Robert E. Crew, Jr. & Belinda Creel Davis, Assessing the Effects of Substance Abuse Among Applicants for TANF Benefits, 17 J. HEALTH & SOC. POL’Y 39, 41-42, 44 (2003) [hereinafter Crew & Davis, Assessing the Effects].

189 Lebron, 820 F. Supp. 2d at 1277.

190 Id. at 1280.

191 Id. at 1281.

192 Id. at 1286-87.

193 Id. at 1287.

194 Lebron v. Sec’y, Fla. Dep't of Children & Families, 710 F.3d 1202, 1211 (11th Cir. 2013).

195 Lebron v. Wilkins, No. 6:11–cv–01473–MSS–DAB, 2013 WL 6875563, at *17 (M.D. Fla. Dec. 31, 2013).

196 Press Release, Gov. Rick Scott, Governor Scott: We Will Appeal Welfare Drug Testing to Supreme Court (Feb. 26, 2013), available at http://www.flgov.com/governor-scott-we-will-appeal-welfare-drug-testing-to-supreme-court/.

197 Lebron, 820 F. Supp. 2d at 1278.

198 See GOSTIN, supra note 90, at 63.

199 See, e.g., id. In upholding the constitutionality of FRA regulations requiring drug and alcohol testing of railway employees, the Supreme Court in Skinner noted that the regulations furthered a significant government interest in ensuring railway safety by providing an “effective means of deterring employees engaged in safety-sensitive tasks from using controlled substances or alcohol in the first place.” Skinner v. Ry. Labor Execs.’ Ass’n, 489 U.S. 602, 629 (1989).

200 Chandler v. Miller, 520 U.S. 305, 323 (1997)

201 Metsch, Lisa A. & Pollack, Harold A., Welfare Reform and Substance Abuse, 83 MILBANK Q. 65, 68 (2005)CrossRefGoogle ScholarPubMed.

202 Jayakody, Rukmalie et al., Welfare Reform, Substance Use, and Mental Health, 25 J. HEALTH POL. POL’Y & L. 623, 636-38 (2000)Google ScholarPubMed.

203 Id. at 637-38.

204 Pollack, Harold A. et al., Drug Testing Welfare Recipients—False Positives, False Negatives, Unanticipated Opportunities, 12 WOMEN's HEALTH ISSUES 23 (2002)Google ScholarPubMed.

205 OFFICE OF APPLIED STUDIES, SUBSTANCE ABUSE & MENTAL HEALTH SERVS. ADMIN., SUBSTANCE USE AMONG PERSONS IN FAMILIES RECEIVING GOVERNMENT ASSISTANCE 2 tbl.1 (2002), http://www.samhsa.gov/data/2k2/GovAid/GovAid.htm.

206 Id.

207 Metsch & Pollack, supra note 201, at 76.

208 Id.

209 Id.

210 Id.

211 Id.

212 See, e.g., CTR. FOR LAW & SOC. POLICY, RANDOM DRUG TESTING OF TANF RECIPIENTS IS COSTLY, INEFFECTIVE AND HURTS FAMILIES 7 (2013), available at http://www.clasp.org/admin/site/publications/files/520.pdf (arguing that mandatory drug testing of TANF applicants or recipients is a poor use of resources); Percentages Reporting Past Month Use of Any Illicit Drug, by Age Group and State: 1999, SUBSTANCE ABUSE & MENTAL HEALTH SERVS. ADMIN. tbl.2B, available at http://www.samhsa.gov/data/nhsda/99statetabs/tables2.htm#link_group_1 (last visited Feb. 1, 2014) (table listing the percentage of TANF recipients who reported using an illicit drug in the past month in 1999).

213 Crew & Davis, Assessing the Effects, supra note 188, at 45-46.

214 Id. at 42.

215 Id. at 46.

216 Lebron v. Wilkins, 820 F. Supp. 2d 1273, 1287 (M.D. Fla. 2011), aff’d 710 F.3d 1202 (11th Cir. 2013).

217 See id. at 1277, 1281.

218 Id. at 1278.

219 Monahan, John & Walker, Laurens, Social Authority: Obtaining, Evaluating and Establishing Social Science in Law, 134 U. PA. L. REV. 477, 506 (1986)CrossRefGoogle Scholar.

220 Id. at 505-06.

221 Id. at 499.

222 DOUGLAS WRIGHT, SUBSTANCE ABUSE & MENTAL HEALTH SERVS. ADMIN, STATE ESTIMATES OF SUBSTANCE USE FROM THE 2002 NATIONAL SURVEY ON DRUG USE AND HEALTH 81 app. tbl.A.1 (2004), available at http://www.samhsa.gov/data/2k2State/PDFW/2k2SAEW.pdf.

223 Metsch & Pollack, supra note 201, at 68-70.

224 Lebron v. Wilkins, 820 F. Supp. 2d 1273, 1281 (M.D. Fla. 2011), aff’d 710 F.3d 1202 (11th Cir. 2013).

225 Id. at 1287.

226 Id. at 1287-88.

227 Bd. of Educ. v. Earls, 536 U.S. 822, 836 (2002).

228 Id.

229 GOSTIN, supra note 90, at 57, 73.

230 See id.

231 Id.

232 The precautionary principle has its origins in environmental health. A widely cited formulation of the precautionary principle can be found in the 1992 United Nations Rio Declaration on Environment and Development. Id. at 72. As formulated in the Declaration and adopted by member states, including the United States, the precautionary principle provides, “[w]here there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation.” United Nations Conference on Environment and Development, June 3-14, 1992, Rio de Janiero, Braz., Rio Declaration on Environment and Development, U.N. Doc. A/CONF.151/26 (Vol. 1), Annex I (Aug. 12, 1992).

233 Tickner, Joel A. et al., A Compass for Health: Rethinking Precaution and Its Role in Science and Public Health, 32 INT’L J. EPIDEMIOLOGY 489, 489 (2003)CrossRefGoogle ScholarPubMed.

234 Sachs, Noah M., Rescuing the Strong Precautionary Principle From Its Critics, 2011 U. ILL. L. REV. 1285, 1288 (2011)Google Scholar.

235 Marchant, Gary E., From General Policy to Legal Rule: Aspirations and Limitations of the Precautionary Principle, 111 ENVTL. HEALTH PERSPS. 1799, 1799 (2003)Google ScholarPubMed.

236 Nat’l Treasury Emps. Union v. Von Raab, 489 U.S. 656, 668 (1989) (emphasis in original).

237 Id.

238 Id. at 674.

239 See supra Part V.A.

240 Von Raab, 489 U.S. at 673.

241 Id. at 675 n.3.

242 Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646, 648-49 (1995).

243 Id. at 649.

244 Id. at 663.

245 Id. at 662.

246 Bd. of Educ. v. Earls, 536 U.S. 822, 834-36 (2002).

247 Id. at 851-52.

248 Id. at 841, 847.

249 Lizette Alvarez, No Savings Are Found from Welfare Drug Tests, N.Y. TIMES (Apr. 17, 2012), http://www.nytimes.com/2012/04/18/us/no-savings-found-in-florida-welfare-drug-tests.html?_r=0.

250 Id.

251 Id.

252 Jennifer Cope, Proposed House Bill Would Drug Test Recipients of Government Assistance, KTUL (Mar. 12, 2012), http://www.ktul.com/story/17139440/proposed-house-bill-would-drug-test-recipients-of-government-assistance.

253 Alvarez, supra note 249.

254 The latter being a government interest endorsed by the Court in Wyman. See Wyman v. James, 400 U.S. 309, 318-19 (1971).

255 Chandler v. Miller, 520 U.S. 305, 318 (1997).

256 Id.

257 Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646, 667 (1995) (O'Connor, J., dissenting).

258 Id. at 669.

259 Defendant's Response, supra note 182, at 20.

260 OFFICE OF THE ASSISTANT SEC’Y FOR PLANNING & EVAL., U.S. DEP't OF HEALTH & HUMAN SERVS., BLENDING PERSPECTIVES AND BUILDING COMMON GROUND: A REPORT TO CONGRESS ON SUBSTANCE ABUSE AND CHILD PROTECTION 40 (1999), available at http://www.ncsacw.samhsa.gov/files/BlendingPerspectives.pdf.

261 ICF INT’L, ADMIN. FOR CHILDREN & FAMILIES, PROTECTING CHILDREN IN FAMILIES AFFECTED BY SUBSTANCE USE DISORDERS 21 (2009), available at https://www.childwelfare.gov/pubs/usermanuals/substanceuse/substanceuse.pdf.

262 See id. at 7.

263 Chandler v. Miller, 520 U.S. 305, 311 (1997).

264 Defendant's Response, supra note 182, at 20-21.

265 Id.

266 See Bd. of Educ. v. Earls, 536 U.S. 822, 840 (2002) (citing Vernonia v. Acton, 515 U.S. 646, 654-55 (1995)).

267 Brief of the States, supra note 11, at 4.

268 Id. at 10.

269 See CTR. FOR BEHAVIOR HEALTH STATISTICS & QUALITY, SUBSTANCE ABUSE & MENTAL HEALTH SERVS. ADMIN., RESULTS FROM THE 2011 NATIONAL SURVEY ON DRUG USE AND HEALTH 25 (2012), http://www.samhsa.gov/data/nsduh/2k11results/nsduhresults2011.pdf.

270 See Crew & Davis, Assessing the Effects, supra note 188, at 51-52; Crew, Robert E. & Davis, Belinda Creel, Substance Abuse as a Barrier to the Employment of Welfare Recipients, 5 J. POL’Y PRAC. 69, 79–80 (2006)Google Scholar [hereinafter Crew & Davis, Substance Abuse as a Barrier].

271 Crew & Davis, Assessing the Effects, supra note 188, at 51-52.

272 Marchwinski II, 309 F.3d 330, 336 (6th Cir. 2002).

273 Defendant's Response, supra note 182, at 21.

274 Id.

275 Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646, 650 (1995).

276 FLA. STAT. § 414.0652 (2)(f) (2012).

277 Lebron v. Wilkins, 820 F. Supp. 2d 1273, 1283 (M.D. Fla. 2011).

278 Id.

279 FLA. ADMIN. CODE ANN. r. 65A-4.221 (2012).

280 See supra Part IV.A.

281 Maclin, Tracey, Is Obtaining an Arrestee's DNA a Valid Special Needs Search Under the Fourth Amendment? What Should (and Will) the Supreme Court Do?, 33 J.L. MED. & ETHICS 102, 109 (2006)CrossRefGoogle Scholar; see also New Jersey v. T.L.O., 469 U.S. 325, 351-53 (1985).

282 Griffin v. Wisconsin, 483 U.S. 868, 880 (1987).

283 Ferguson v. City of Charleston, 532 U.S. 67, 82-86 (2001).

284 Id. at 68.

285 Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646, 658 n.2 (1995) (emphasis in original).

286 Skinner v. Ry. Labor Execs.’ Ass’n, 489 U.S. 602, 620 (1989).

287 See Sanchez v. Cnty. of San Diego, 464 F.3d 916, 923 (2006) (citing Wyman v. James, 400 U.S. 309, 318 (1971) (“[T]he public has a strong interest in ensuring that aid provided from tax dollars reaches its proper and intended recipients.”)); Defendant's Response, supra note 182, at 21.

288 Defendant's Response, supra note 182, at 20-21 (emphasis in original).

289 See New York v. Burger, 482 U.S. 691, 693-96 (1987).

290 Id. at 716-18.

291 Id. at 712 (both emphases in original).

292 Id. at 713.

293 Id. at 708.

294 Id. at 716.

295 Ferguson v. City of Charleston, 532 U.S. 67, 83 n.21 (2001).

296 Burger, 482 U.S. at 713.

297 N.J. v. T.L.O., 469 U.S. 325, 351 (1985) (Blackmun, J., concurring).

298 Ferguson, 532 U.S. at 83-86. Justice Stevens noted:

While state hospital employees, like other citizens, may have a duty to provide the police with evidence of criminal conduct that they inadvertently acquire in the course of routine treatment, when they undertake to obtain such evidence from their patients for the specific purpose of incriminating those patients, they have a special obligation to make sure that the patients are fully informed about their constitutional rights … . Id. at 84-85 (emphasis added).

299 See id. at 84.

300 GOSTIN, supra note 90, at 62.

301 See Roberts, Sarah C. M. & Pies, Cheri, Complex Calculations: How Drug Use During Pregnancy Becomes a Barrier to Prenatal Care, 15 MATERNAL & CHILD HEALTH J. 333, 338 (2011)Google ScholarPubMed; see generally Jessup, Martha A. et al., Extrinsic Barriers to Substance Abuse Treatment Among Pregnant Drug Dependent Women, 33 J. DRUG ISSUES 285 (2003)CrossRefGoogle Scholar; Poland, Marilyn, Punishing Pregnant Drug Users: Enhancing the Flight from Care, 31 DRUG & ALCOHOL DEPENDENCE 199 (1993)CrossRefGoogle ScholarPubMed.

302 See U.S. GEN. ACCOUNTING OFFICE, GAO/HRD-90-138, DRUG EXPOSED INFANTS: A GENERATION AT RISK 9 (1990), available at http://archive.gao.gov/d24t8/141697.pdf.

303 See, e.g., OFFICE OF THE ASSISTANT SEC’Y FOR PLANNING & EVALUATION, U.S. DEP't OF HEALTH & HUMAN SERVS., DRUG TESTING WELFARE RECIPIENTS: RECENT PROPOSALS AND CONTINUING CONTROVERSIES 3-4 (2011) [hereinafter OAS, DRUG TESTING WELFARE RECIPIENTS], available at http://aspe.hhs.gov/hsp/11/DrugTesting/ib.pdf (noting that Maryland, South Carolina, and Rhode Island require that a third-party beneficiary be appointed to ensure that benefits are used to meet the needs of minor children).

304 Since information sharing may be associated with public health gains, states should consider a middle ground that would allow TANF programs to share test results with child welfare agencies, but prohibit those agencies from using test results in a custody hearing or a criminal prosecution. For more on the benefits of interagency collaboration, see CYNTHIA ANDREWS ET AL., URBAN INST., COLLABORATION BETWEEN STATE WELFARE AND CHILD WELFARE AGENCIES (2002), available at http://www.urban.org/publications/310563.html.

305 See PARMET, supra note 19, at 6.

306 See id. at 56.

307 See OAS, DRUG TESTING WELFARE RECIPIENTS, supra note 303, at 10, App. A at 11-12.

308 See id.

309 See id.

310 See id.

311 See Gostin, supra note 90, at 63.

312 Nat’l Treasury Emps. Union v. Von Raab, 489 U.S. 656, 676 (1989).

313 Id. (holding that “the program bears a close and substantial relation to the Service's goal of deterring drug users from seeking promotion to sensitive positions”).

314 Chandler v. Miller, 520 U.S. 305, 319 (1997).

315 Id. at 320.

316 See id.

317 See Jayakody et al., supra note 202, at 637.

318 See Cary, Paul L., Marijuana Detection Window: Determining the Length of Time Cannabinoids Will Remain Detectable in Urine Following Smoking: A Critical Review of Relevant Research and Cannabinoid Detection Guidance for Drug Courts, 5 DRUG CT. REV. 23, 37 (2005)Google Scholar.

319 See Metsch & Pollack, supra note 201, at 76 (reporting that, of the 258 TANF recipients who tested positive for drugs in Michigan in October 1999, only 3 (1.2%) tested positive for “hard drugs,” including cocaine and amphetamine); see also Jayakody et al., supra note 202, at 638 (finding that only 6% of welfare recipients reported use of crack or cocaine during the past year, using data from 1995 data from the National Household Survey of Drug Abuse).

320 See ENNO FREY & JOSEPH V. LEVY, PHARMACOLOGY AND ABUSE OF COCAINE, AMPHETAMINES, ECSTASY, AND RELATED DESIGNER DRUGS: A COMPREHENSIVE REVIEW OF THEIR MODE OF ACTION, TREATMENT OF ABUSE, AND INTOXICATION 255 tbl.2 (2009).

321 Marchwinski I, 113 F. Supp. 2d 1134, 1136 (E.D. Mich. 2000), rev'd, 309 F.3d 330 (6th Cir. 2002), judgment of district court aff'd by an equally divided court on reh'g en banc, 60 F. App'x 601 (6th Cir. 2003) (noting that under Michigan's program, new applicants must be tested before their case opens, and twenty percent of adults and minor parent grantees will be randomly selected to be tested after they have been in the program for six months).

322 See supra Part IV.A.1.

323 See 42 U.S.C. § 601(a)(2) (2006).

324 See Gresenz, Carole Roan et al., Supplemental Security Income (SSI), Disability Insurance (DI), and Substance Abusers, 34 CMTY. MENTAL HEALTH J. 337, 337-38 (1998)Google Scholar.

325 See id. at 341-42.

326 See id. at 339-42.

327 See Swartz, James A. et al., Termination of Supplemental Security Income Benefits for Drug Addiction and Alcoholism: Results of a Longitudinal Study of the Effects on Former Beneficiaries, 78 SOC. SERV. REV. 96, 110 (2004)Google Scholar.

328 Hogan, Sean R. et al., The Effects of Eliminating Supplemental Security Income Drug Addiction and Alcoholism Eligibility on the Mental Health of Low-Income Substance Abusers, 25 SOC. WORK PUB. HEALTH 438, 448 (2010).Google ScholarPubMed

329 See id. at 446.

330 Swartz, James A. et al., Severe Mental Illness and Substance Use Disorders Among Former Supplemental Security Income Beneficiaries for Drug Addiction and Alcoholism, 57 ARCHIVES GEN. PSYCHIATRY 701, 704 (2000)CrossRefGoogle ScholarPubMed.

331 Id. at 706.

332 See Florida Bill Requires Drug Testing of TANF Applicants: Bill Summary, NAT’L CONF. ST. LEGISLATURES, http://www.ncsl.org/research/human-services/florida-legislation-requires-drug-testing-of-tanf.aspx (last visited Jan. 11, 2014).

333 MO. REV. STAT. § 208.027 (West 2012 & Supp. 2013).

334 See id.

335 Id.

336 Id.

337 McLellan, A. Thomas et al., Drug Dependence, A Chronic Medical Illness, 284 JAMA 1689, 1689 (2000)CrossRefGoogle ScholarPubMed.

338 See NAT’L INST. ON DRUG ABUSE, U.S. DEP't OF HEALTH & HUMAN SERVS., DRUGS, BRAINS, AND BEHAVIOR: THE SCIENCE OF ADDICTION 19 (2010).

339 See id. at 20.

340 See supra Part V.B.2.

341 See Shook, Kristen, Does the Loss of Welfare Income Increase the Risk of Involvement with the Child Welfare System?, 24 CHILD & YOUTH SERVS. REV. 781, 809-10 (1999)CrossRefGoogle Scholar.

342 Id. at 803-04.

343 Cook, John T. et al., Welfare Reform and the Health of Young Children: A Sentinel Survey in 6 U.S. Cities, 156 ARCHIVES GEN. PSYCHIATRY 678, 682 (2002)Google Scholar; see also Willis, Earnestine et al., Welfare Reform and Food Insecurity, 151 ARCHIVES PEDIATRIC & ADOLESCENT MED. 871, 873-74 (1997)CrossRefGoogle ScholarPubMed.

344 See Mario Batali Food Stamp Challenge: Chef Spending $31 on Food for One Week, HUFFINGTON POST (May 14, 2012), http://www.huffingtonpost.com/2012/05/15/mario-batali-food-stamp-challenge_n_1517572.html; see also BARBARA LEE ET AL., HATCHER GROUP, TAKE THE CHALLENGE: LIVING ON A FOOD STAMP BUDGET (2007).

345 Alaimo, Katherine et al., Food Insufficiency, Family Income, and Health in U.S. Preschool and School-Aged Children, 91 AM. J. PUB. HEALTH 781, 784-85 (2001)Google ScholarPubMed.

346 Defendant's Response, supra note 182, at 21.

347 PARMET, supra note 19, at 53.

348 PARMET, supra note 19, at 1.

349 GOSTIN, supra note 90, at 68.

350 Id. at 142.

351 Bd. of Educ. v. Earls, 536 U.S. 822, 837 (2002).

352 Id. at 835.

353 See Jacobson v. Massachusetts, 197 U.S. 11, 28 (1905) (holding that while governments may impose restraints on individual liberty for the common good, the exercise of police powers must be based on the “necessity of the case,” and may not go “beyond what was reasonably required for the safety of the public”); Childress, James F. et al., Public Health Ethics: Mapping the Terrain, 30 J.L. MED. & ETHICS 169, 172 (2002)Google ScholarPubMed (arguing that public health officials should interpret the least intrusive alternative requirement as a corollary of the requirement that governments exercise coercive public health powers in response to a genuine public health necessity).

354 Earls, 536 U.S. at 837.

355 Id. at 835.

356 Chandler v. Miller, 520 U.S. 305, 320 (1997).

357 Id. at 321.

358 Id. at 320.

359 PAMELA HOLCOMB, U.S. DEP't OF HEALTH & HUMAN SERVS., THE APPLICATION PROCESS FOR FOOD STAMPS, TANF, MEDICAID, AND SCHIP 9 (2003), available at http://www.acf.hhs.gov/sites/default/files/opre/urban_report.pdf.

360 Sulzberger, supra note 1.

361 Belsky, Martin H., Random vs. Suspicion-Based Drug Testing in the Public Schools—A Surprising Civil Liberties Dilemma, 27 OKLA. CITY U. L. REV. 1, 19 (2002)Google Scholar.

362 Griffin v. Wisconsin, 483 U.S. 868, 875 (1987).

363 New York v. Burger, 482 U.S. 691, 700 (1987).

364 Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646, 657 (1995) (internal quotation marks omitted); see also Bd. of Educ. v. Earls, 536 U.S. 822, 831 (2002).

365 Vernonia, 515 U.S. at 656.

366 Earls, 536 U.S. at 838; Vernonia, 515 U.S. at 655-56.

367 Vernonia, 515 U.S. at 665.

368 Chandler v. Miller, 520 U.S. 305, 305 (1997).

369 Skinner v. Ry. Labor Execs.’ Ass’n, 489 U.S. 602, 627 (1989).

370 Nat’l Treasury Emps. Union v. Von Raab, 489 U.S. 656, 672 (1989).

371 Katz v. United States, 389 U.S. 347, 347 (1967).

372 Id. at 350.

373 Carroll v. United States, 267 U.S. 132, 153-53 (1925).

374 Burris, Scott et al., Integrating Law and Social Epidemiology, 30 J.L. MED. & ETHICS 510, 510 (2002)Google ScholarPubMed.

375 Id. at 511.

376 Id. at 512.

377 Id. at 513.

378 JOHN GILLIOM, OVERSEERS OF THE POOR: SURVEILLANCE, RESISTANCE, AND THE LIMITS OF PRIVACY 78 (2001).

379 Id. at 77.

380 Marmot, Michael G., Status Syndrome: A Challenge to Medicine, 295 JAMA 1304, 1304 (2006)Google ScholarPubMed; see also Hemingway, Harry et al., Does Autonomic Function Link Social Position to Coronary Risk? The Whitehall II Study, 111 CIRCULATION 3071, 3071 (2005)Google ScholarPubMed.

381 Hemingway et al., supra note 381, at 3074.

382 Id. at 3074.

383 McEwen, Bruce S. & Seeman, Teresa, Protective and Damaging Effects of Mediators of Stress: Elaborating and Testing the Concepts of Allostasis and Allostatic Load, 896 ANNALS N.Y. ACAD. ARTS & SCI. 30, 30 (1999)CrossRefGoogle ScholarPubMed.

384 Burris et al., supra note 374, at 513.

385 See Daniels, Norman et al., Why Justice Is Good for Our Health: The Social Determinants of Health Inequalities, 128 DAEDALUS 215 passim (1999)Google ScholarPubMed (advancing a parallel argument in the literature on public health and ethics).

386 STUDENTS FOR SENSIBLE DRUG POL’Y, ELIMINATE THE HARMFUL AND COSTLY STUDENT DRUG TESTING GRANTS 2 (2013), available at http://ssdp.org/assets/files/campaigns/sdt/drug-testing-backgrounder.pdf.

387 Burris et al., supra note 374, at 513.

388 Speiser v. Randall, 357 U.S. 513 (1958).

389 Id. at 518.

390 Id. at 518-19.

391 Id. at 518.

392 Sherbert v. Verner, 374 U.S. 398, 409-10 (1963).

393 Id. at 413.

394 Id. at 404.

395 Id.

396 Id.

397 Id. at 405.

398 Id. at 404.

399 Id. at 407.

400 Id.

401 Shapiro v. Thompson, 394 U.S. 618 (1969).

402 Id. at 621-22.

403 Id. at 627.

404 Id. at 627.

405 Id. at 633-36.

406 Id. at 637.

407 Mem’l Hosp. v. Maricopa Cnty., 415 U.S. 250, 250 (1974).

408 Id. at 257-59.

409 Id. at 258 (quoting Shapiro v. Thompson, 394 U.S. 618, 634 (1969)).

410 Mem’l Hosp., 415 U.S. at 259.

411 Id. at 260.

412 Id. at 285.

413 See id. at 250; Shapiro, 394 U.S. at 622; Sherbert v. Verner, 374 U.S. 398, 402 (1963).

414 Maher v. Roe, 432 U.S. 464 (1977).

415 Harris v. McRae, 448 U.S. 297 (1980).

416 Maher, 432 U.S. at 464.

417 Harris, 448 U.S. at 298.

418 Id. at 317 n.19; see also Maher, 432 U.S. at 476 n.8 (rejecting the argument that “[Connecticut] ‘penalizes’ the woman's decision to have an abortion by refusing to pay for it”).

419 Lying v. Int’l Union, 485 U.S. 360, 360-61 (1988).

420 Id. at 365.

421 Id. at 369.

422 Dandridge v. Williams, 397 U.S. 471, 477-78 (1970).

423 Id. at 483-84.

424 Id. at 485. Nor did the Dandridge majority pause to consider Memorial Hospital, where the Court indicated that conditions resulting in a denial of the basic necessities of life require strict scrutiny under the Equal Protection Clause. Id.

425 Wyman v. James, 400 U.S. 309, 309-10 (1971).

426 Id. at 324.

427 Id. at 321.

428 Id. at 324.

429 Sanchez v. San Diego Cnty., 464 F.3d 916, 918 (9th Cir. 2007).

430 Id. at 930-31.

431 Speiser v. Randall, 357 U.S. 513, 529 (1958).

432 U.S. CONST. amend. I.

433 Speiser, 357 U.S. at 516.

434 Sherbert v. Verner, 374 U.S. 398, 409-10 (1963).

435 Speiser, 357 U.S. at 403.

436 Id. at 403-04.

437 Id. at 406-07.

438 Sullivan, Kathleen M., Unconstitutional Conditions, 102 HARV. L. REV. 1413, 1428 (1989)CrossRefGoogle Scholar.

439 Speiser, 357 U.S. at 519.

440 Sherbet v. Verner, 374 U.S. 398, 404 (1963).

441 South Dakota v. Dole, 483 U.S. 203, 204 (1987).

442 For an argument along these lines, see ALAN WERTHEIMER, EXPLOITATION 123-57 (1999).

443 Kreimer, Seth F., Allocational Sanctions: The Problem of Negative Rights in a Positive State, 132 U. PA. L. REV. 1293, 1351-52 (1984)Google Scholar.

444 Id. at 1359.

445 Id.

446 Id. at 1359-63.

447 Id. at 1363.

448 Id.

449 Id. at 1368.

450 Id. at 1356. Kreimer concedes that this may be a problem but proceeds without an adequate response.

451 See Kreimer, supra note 443, at 1371; Simons, Kenneth, Offers, Threats, and Unconstitutional Conditions, 26 SAN DIEGO L. REV. 289, 299 (1989)Google Scholar.

452 See, e.g., Palmer v. Thompson, 403 U.S. 217, 219 (1971) (closing public swimming pools rather than operating them on a desegregated basis did not violate Equal Protection); see also Green, Robert L. & Hofmann, Louis J., A Case Study of the Effects of Educational Deprivation on Southern Rural Negro Children, 34 J. NEGRO EDUC. 327 passim (1965)Google Scholar (discussing the decision by Prince Edwards County to close all public schools rather than comply with court ordered desegregation).

453 Sullivan, supra note 438, at 1420.

454 Id. at 1490.

455 Id.

456 Id. at 1499-1500.

457 Id. at 1501.

458 Id. at 1498.

459 Compare Dandridge v. Williams, 397 U.S. 471, 486-87 (1970) (holding that a state regulation placing an absolute limit of $250 per month on AFDC grants regardless of family size did not violate the Equal Protection Clause), with Jimenez v. Weinberger, 417 U.S. 628, 637 (1974) (determining the equal protection clause is violated by discriminatory laws concerning the status of birth when the classification is not justified by a state interest) and Graham v. Richardson, 403 U.S. 365, 376 (1971) (finding provisions of state welfare laws conditioning benefits on citizenship and requiring durational residency for aliens violated the Equal Protection Clause).

460 Lynch, John W. et al., Income Inequality and Mortality in Metropolitan Areas of the United States, 88 AM. J. PUB. HEALTH 1074, 1074 (1998)Google ScholarPubMed.

461 Id.

462 Id. at 1079.

463 Kennedy, Bruce P. et al., Income Distribution and Mortality: Cross Sectional Ecological Study of the Robin Hood Index in the United States, 312 BRIT. MED. J. 1004, 1004 (1996)Google Scholar.

464 Kawachi, Ichiro, Income Inequality and Health, in SOCIAL EPIDEMIOLOGY 76, 86 (Berkman, Lisa & Kawachi, Ichiro eds., 2000)Google Scholar; see also Kennedy et al., supra note 463, at 1006 (finding that states with high levels of income inequality spent a smaller proportion of their budgets on education and had poorer educational outcomes, which ranged from poorer scores in reading and math to lower rates of high school graduation).

465 Kawachi, supra note 464, at 86; see also Kennedy et al., supra note 463, at 1006.

466 Kawachi, Ichiro & Kennedy, Bruce, Health and Social Cohesion: Why Care About Income Inequality?, 314 BRIT. MED. J. 1037, 1037 (1997)CrossRefGoogle ScholarPubMed.

467 Id. at 1038.

468 MICHAEL MARMOT, STATUS SYNDROME: HOW SOCIAL STANDING AFFECTS OUR HEALTH AND LONGEVITY 61-81 (2004).

469 Id.

470 See generally Lynch, John et al., Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review, 82 MILBANK Q. 5 (2004)CrossRefGoogle ScholarPubMed.

471 Income Inequality and Health: What's the Relationship?, ROBERT WOOD JOHNSON FOUND., http://www.rwjf.org/pr/product.jsp?id=20839 (last visited Dec. 1, 2013).

472 JOHN HART ELY, DEMOCRACY AND DISTRUST 7-8 (1980).

473 Id. at 73-104.

474 Id. at 103.

475 Id. at 78.

476 States Consider Drug Test Requirement for Benefits, NAT’L PUB. RADIO (Oct. 11, 2011), http://www.npr.org/2011/10/11/141240653/states-consider-drug-test-requirement-for-benefits.

477 Dandridge v. Williams, 397 U.S. 471, 485 (1970).

478 Id. at 487.

479 ELY, supra note 472, at 103.

480 San Antonio Indep. Sch. Dist. v. Rodriguez, 411 U.S. 1, 29 (1973); see also Dandridge, 397 U.S. at 485.

481 PARMET, supra note 19, at 56.

482 See discussion supra Part V.B.2.

483 Pollack, Harold A. & Reuter, Peter, Welfare Receipt and Substance Abuse Treatment Among Low-Income Mothers: The Impact of Welfare Reform, 96 AM. J. PUB. HEALTH 2024, 2025 (2006)Google ScholarPubMed. It may be that programs like TANF provide an important source of funding for treatment. See, e.g., CTR. FOR BEHAVIORAL STATS. & QUALITY, U.S. DEP't OF HUMAN & HEALTH SERVS., RESULTS FROM THE 2010 NAT’L SURVEY ON DRUG USE & HEALTH 80 (2011) (finding that among those who reported substance abuse treatment at a specialized facility during the past year, 29.2% reported using their Medicaid benefits, but 35.6% reported using public assistance other than Medicaid).

484 Jason Kilmer et al., Reducing Harm Associated with Illicit Drug Use: Opiates, Amphetamines, Cocaine, Steroids and Other Substances, in HARM REDUCTION PRAGMATIC STRATEGIES FOR MANAGING HIGH RISK BEHAVIORS 212, 212 (G. Alan Marlatt et al. eds., 2d ed. 2012).

485 Metsch & Pollack, supra note 201, at 71.