Employment

Initiatives
Autumn Davis
 Introduction
People in treatment and recovery for substance use disorders (SUD) differ widely
in their mental health conditions, co-occurring disorders, geographic locations,
and socio-economic factors. These differences can make it challenging to assess
the effectiveness of SUD services and treatments. However, evidence shows that
well-designed programs can reduce substance use, alleviate mental health
symptoms, and enhance overall quality of life (Substance Abuse and Mental
Health Administration, 2010).
 Harm Reduction +
Employment Initiatives
There are several practical reasons for employers to hire and mobilize people who use substances (Balian & White, 2010):

1. Commitment to Health and Human Rights: Hiring substance users shows an organization's dedication to improving the health and rights of this
community, respecting their values and the importance of their skills and knowledge.

2. Role Models: Employed substance users can serve as role models, demonstrating that others can also find work and achieve stability in various
life aspects, including finances, housing, health, and relationships.

3. Public Health Advocacy: Often, substance users are more effective at communicating public health announcements to their peers as they are
trusted more than traditional healthcare professionals.

4. Valuable Knowledge: Substance users bring pertinent insights about substance use trends, practices, and strategies that can significantly benefit
service projects.

5. Self-Esteem and Empowerment: Employment in meaningful roles can boost self-esteem and empower users to make safer health choices.

6. Skill Development: Working in harm reduction programs helps drug users develop professional skills that can facilitate future job opportunities.

7. Community Integration: Employment in community projects fosters a sense of belonging and responsibility, reducing antisocial behaviors and
improving community perceptions.

8. Civic Engagement: Hiring substance users promotes their involvement in the political process which helps them understand and influence policies
that affect their lives and linking them with broader social justice movements.
Current Information +
Research
Studies indicate that clients who are employed during treatment are more likely to complete treatment programs
successfully (Substance Abuse and Mental Health Administration, 2010). Regardless of pay or volunteer, work helps
reduce substance use and maintain sobriety. Policy considerations on recovery-friendly employment practices
include hiring peer support specialists and peer recovery navigators. The U.S. Department of Labor has initiatives to
address the workforce impacts of the opioid crisis by training individuals in recovery for healthcare professions that
are related to SUD treatment and mental health.

Employers are encouraged to review and adopt recovery-friendly policies that create a supportive workplace culture,
provide prevention resources, offer intervention policies like leave for treatment, and maintain a strong Employee
Assistance Program (EAP).

While drug-free workplace policies are not legally required for most employers, some companies incorporate them to
prevent substance misuse and offer treatment programs that help potential employees who failed drug tests maintain
a substance-free lifestyle and secure employment.

States like New Hampshire have initiatives to encourage recovery-friendly workplaces, providing technical assistance
and resources to support recovery environments (Substance Abuse and Mental Health Administration, 2010). Private
and non-profit organizations also connect recovery-friendly workplaces with potential employees, and numerous
client-operated businesses serve as second-chance workplaces for individuals in recovery.
Current Information +
Research
Ways to help integrate an individual in recovery from substance use into
employment (Substance Abuse and Mental Health Administration, 2010):

1. Completing Education and Training

- High School Diploma or GED
- Entry-Level Credentials
2. Finding and Applying for Jobs
3.Creating a Resume
4. Using Mobile Technology + Online Media
5. Practicing Interview Skills
EVIDENCE-BASED PROGRAMS
Individual Placement and Support (IPS) is a model of supported employment
based on eight principles that helps individuals work in competitive jobs of
their choosing (Substance Abuse and Mental Health Administration, 2010).
Therapeutic Workplace (TW) is a motivational intervention that uses access to
employment and wages to promote therapeutic behavioral changes.
Participants learn basic academic and data entry operating skills and then are
employed in Therapeutic Workplace settings as data entry operators. Opiate-
and cocaine-negative urine samples are required for daily participation. Pay
rates are based on varying schedules of sustained abstinence, workplace
attendance, hours worked, and productivity.
 Challenges, Barriers, + Biases
The most commonly reported challenges to
employment for substance users included (Sherba et. The need for increased funding and resources to implement supportive
al, 2018):
1. Criminal History
2. Lack of Reliable Transportation
3. Probation/Treatment Program Requirements
4. Continued Substance Use/Relapse
5. Poor Work History
6. Lack of Education/Skills
7. Low Job Availability
8. Stigma/Employer Lack of Understanding
Additional Challenges on a Societal-Governmental
Level:
- Lack of Childcare
- Loss of Government Assistance
- Lack of Secure Housing/Homelessness
- Mental/Physical Health Issues
Need for Policy and Funding
employment programs is highly important for individuals with substance use
disorders (Sherba et. al, 2018). SAMHSA's grants for supported employment
programs, primarily for individuals with SMI (Severe Mental Illness), could be
expanded to include those with SUD. Enhanced funding could help develop the
necessary infrastructure to integrate employment services into substance abuse
treatment settings, potentially improving outcomes for individuals with SUD.
Limitations in Evidence-Based Research on SUD Recovery
1. Short Follow-up Periods
2. Lack of Long-term Data
3. Predictors of Long-term Recovery
4. Diversity Issues + Program Variations
5. Role of Peers
6. Future Research Directions
 Challenges, Barriers, + Biases
Organizational Policies and Procedures
To ensure program acceptance and success, it is important to outline core components of employment support and
assess if current policies and procedures facilitate their implementation. Common policies that may hinder access to
employment support include:
1. Abstinence Policies
2. Treatment During Work Hours
3. Court-ordered drug testing
4. Residential Program Requirements

Determining Organizational Readiness Training (Substance Abuse and Mental Health Administration, 2010):
• Staff Attitudes in the Workplace: Towards employment for individuals at different recovery stages.
• Leadership Engagement: Support for employment and education initiatives.
• Policies and Procedures: Assess if they hinder or support employment and education goals + Develop new
policies to ease implementation, such as eligibility requirements, recruitment mechanisms, intake forms, job
descriptions, and tracking procedures.
• Awareness: Evaluate staff awareness of the employment model and inform training needs.
• Staff Training: Train staff based on readiness assessments to ensure successful implementation.
• Allocate Funding for Community Resource Partnerships and Staff Training
 REFERENCES
Balian, R., & White, C. (2010). Harm reduction at work.
https://www.opensocietyfoundations.org/uploads/170e646d-bcc0-4370-96d7-
7cf2822a1869/work-harmreduction-20110314.pdf

Sherba, R. T., Coxe, K. A., Gersper, B. E., & Linley, J. V. (2018). Employment
services and substance abuse treatment. Journal of Substance Abuse
Treatment, 87, 70–78. https://doi.org/10.1016/j.jsat.2018.01.015

Substance Use Disorders Recovery with a Focus on Employment and

Education. Substance Abuse and Mental Health Administration. (2021).
https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/
pep21-pl-guide-6.pdf