A 2002 study of this program involving 142 participants found that compared with veterans who did not participate in compensated work therapy, “patients in the CWT program were more likely to (1) initiate outpatient addictions treatment, (2) experience fewer drug and alcohol problems, (3) report fewer physical symptoms related to substance use, (4) avoid further loss of physical functioning, and (5) have fewer episodes of homelessness and incarceration.”
A 2009 study, which focused on employment and recovery outcomes among 500 drug court clients – people participating in a specialized court docket program targeted toward individuals with substance use disorder — found that participants who were assigned to and remained active in an intervention that helped them find a job, keep it, and then find a better job, showed better outcomes in recovery — less substance use and less criminal activity — than those who received less or no career assistance.
However, the specifics of the relationship between work and recovery are difficult to disentangle. “Generally, when you look at people who are in regular community workplaces, there is a relationship between staying abstinent and staying employed,” Silverman said. “But it’s not clear whether employment causes abstinence, or people who are abstinent are also more likely to get employed.”
Nevertheless, some researchers are interested in the idea of employment as a benchmark — in other words, a measure of recovery.
Meaningful activity and abstinence
Robert E. Drake, a professor of community and family medicine at Dartmouth’s Geisel School of Medicine, explained in a phone call that a focus on short-term episodes of stabilization and abstinence as a measure of recovery is “short-sighted.”
“It doesn’t really address what we know and have known for more than half a century about recovery,” Drake said. “When people get abstinent, they have a high rate of relapsing.” To promote long-term recovery, Drake suggested that involvement in meaningful activities is essential.
Those meaningful activities include work, per findings from a survey of 356 individuals at various points in their recovery. In the 2010 study “What Are Your Priorities Right Now? Identifying Service Needs Across Recovery Stages to Inform Service Development,” researchers Alexandre Laudet and William White asked participants, “What are the priorities in your recovery and in your life right now?” About one-third of respondents in each stage of recovery cited employment as a priority. The only priority that was more popular than employment was recovery from substance use.
“‘Recovery,’ the ultimate goal of services, requires more than abstinence,” Laudet and White write. “Therefore substance use disorder services must give clients the tools to improve their life in all areas, not only to help them achieve abstinence.” But in another study conducted by Laudet in 2012 involving 311 people at various points in recovery, less than half were employed.
Impact of helping people in recovery find and keep jobs
Researchers suggest programs that help people find and keep jobs might help boost employment among people with substance use disorder.
One such model is Individual Placement and Support (IPS), which was designed for people with serious mental illnesses. IPS offers job training and counseling, among other services.
A 2017 pilot study of IPS among 45 people enrolled in an opioid treatment program found that 50 percent of those who were assisted in finding work through IPS attained competitive employment within six months, compared with 5 percent of the participants who were waitlisted for IPS. The study concludes that IPS “holds promise as an employment intervention for people with opioid use disorders.” (The study was not concerned with whether the program helped users quit.)
“Employment always has been intimately intertwined with psychological health,” Drake said. “We have to be helping people to stay abstinent and really rebuild their lives.”
In the interest of examining this important news topic through a research lens, Journalist’s Resource produced this research roundup in collaboration with The Burlington Free Press, where this piece first appeared. This piece is part of the newspaper’s series of stories about opioid recovery
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