Holtyn August F, Toegel Forrest, Arellano Meghan, Subramaniam Shrinidhi, Silverman Kenneth
Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Center for Learning and Health, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21224, USA.
Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Center for Learning and Health, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21224, USA.
J Subst Abuse Treat. 2021 Jan;120:108160. doi: 10.1016/j.jsat.2020.108160. Epub 2020 Oct 6.
Poverty is common among people who have substance use disorder. The therapeutic workplace addresses some of the interrelated and chronic problems of poverty, such as unemployment, lack of education and job skills, and drug use. A prior controlled trial showed that the therapeutic workplace was effective in promoting drug abstinence and self-reported community employment in unemployed adults in medication-assisted treatment for opioid use disorder. The current study extends this research by providing a detailed and objective analysis of employment outcomes using objective data abstracted from participants' pay stubs. Secondary analyses examined the types and patterns of employment that participants (N = 44) obtained during the trial, and the extent to which participants gained and maintained financially sufficient employment. Although most participants had relatively long histories of unemployment and underemployment, many participants (n = 26; 59%) obtained employment at some point during the intervention. Most participants worked part time and were employed in low-wage jobs, however. The mean number of hours worked per week was 20.6 h (range 5.5 to 41.3 h per week) and the mean hourly pay was $11.00 per hour (range $9.00 to $15.50 per hour). The most common type of employment was in food preparation and serving-related occupations (e.g., waiters and waitresses, restaurant cooks, and fast food counter workers). Many participants (n = 17; 65%) maintained employment in these jobs over several weeks, while others (n = 9; 35%) were employed sporadically for short durations. Additional supports may be needed for some chronically unemployed adults with substance use disorder to promote consistent employment in well-paying jobs.
物质使用障碍患者中贫困现象很常见。治疗性工作场所解决了一些与贫困相关的相互关联的长期问题,如失业、缺乏教育和工作技能以及药物使用问题。之前的一项对照试验表明,治疗性工作场所在促进接受阿片类药物使用障碍药物辅助治疗的失业成年人戒毒和自我报告的社区就业方面是有效的。本研究通过使用从参与者工资单中提取的客观数据对就业结果进行详细客观的分析,扩展了这项研究。二次分析考察了参与者(N = 44)在试验期间获得的就业类型和模式,以及参与者获得并维持经济上足够的就业的程度。尽管大多数参与者有相对较长的失业和就业不足历史,但许多参与者(n = 26;59%)在干预期间的某个时间点获得了就业。然而,大多数参与者从事兼职工作,且受雇于低薪工作。每周平均工作小时数为20.6小时(每周范围为5.5至41.3小时),平均时薪为每小时11.00美元(每小时范围为9.00至15.50美元)。最常见的就业类型是食品制备和服务相关职业(如服务员、餐厅厨师和快餐柜台工作人员)。许多参与者(n = 17;65%)在这些工作中持续工作了几周,而其他参与者(n = 9;35%)则是短期偶尔受雇。对于一些患有物质使用障碍的长期失业成年人,可能需要额外的支持来促进他们稳定地从事高薪工作。