Employment recovery capital in the treatment of substance use disorders: Six-month follow-up observations

Drug Alcohol Depend. 2019 Dec 1:205:107624. doi: 10.1016/j.drugalcdep.2019.107624. Epub 2019 Oct 16.

Abstract

Background: Recovery capital represents client strengths associated with substance use disorder (SUD) recovery. Employment is part of recovery capital supporting long-term recovery. However, specific employment recovery capital (ERC) factors associated with SUD recovery are not well understood.

Methods: The present study used retrospective logistic regression modeling to predict treatment completion at discharge and substance use at six-month follow-up from employment variables at intake and follow-up. An additional exploratory follow-up of ERC Change is further investigated. Existing clinical data from a random selection of all Iowa SUD treatment facilities receiving public funding from 1999-2016. Clients in the study (N = 8,925) were a mean age of 31.7 (SD = 11.8), mostly male (67.2%), and primarily White (86.6%). Measurements included substance use, treatment completion, ERC Change, demographic, and treatment statistical control variables.

Results: Results demonstrated that employment variables at intake predicted greater successful treatment completion, p < 0.0001. However, the same employment variables were predictive of maintained and increased use at six-month follow-up. Further investigation showed the best predictors of post-treatment recovery was a change in employment variables including months employed increase (AOR = 1.53, 95% CI = 1.34-1.75) and days missed from work due to substance use decrease (AOR = 2.43, 95% CI = 2.00-2.96).

Conclusions: Researchers and providers can help improve client recovery with intervention design, consultation, and policies focused on vocational growth in addition to employment benchmarks of gross income, full-time employment, occupation, primary support, months employed, and work missed. ERC is a promising route to improve the lives for those involved with substance use disorders.

Keywords: Abstinence; Intervention; Self-determination theory; Vocation; Work.

MeSH terms

  • Absenteeism
  • Adult
  • Databases, Factual / statistics & numerical data
  • Demography
  • Employment / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Income
  • Iowa / epidemiology
  • Logistic Models
  • Male
  • Occupations
  • Patient Compliance / statistics & numerical data
  • Retrospective Studies
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / therapy*
  • Treatment Outcome
  • Young Adult